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“The little deaths all along the way”

Alzheimer’s, A neurodegenerative disease also known as AD, the commonest form of dementia among the elderly. This is not just an old man disease. In India, more than 4 million people are estimated to be suffering from Alzheimer’s and other forms of dementia , giving our country the third highest caseload in the world , it has been predicted that by the year 2030 the number of cases will be increased upto 7.5 million. In this disease not only the patients suffers, but their families as well. Families lose a little more of their loved ones every day. But still this disease in India is a hidden problem. Only a fragment of patients are treated or even diagnosed properly. Most citizens of our country still remain in thought that memory loss is an inevitable part of ageing. Little do they consider that it could be sign of degenerative disease.

AD begins slowly, firstly involves the parts of the brain that control thought, memory and language.  AD patients have trouble remembering things that may have happened recently or names of the people they know. In AD with time the symptoms get worsen. Some of the symptoms not being able to  recognize the family members, speak, read or write. Their behavior becomes anxious and aggressive. They might even start recalling incidences from their past. They start reliving in those situations which don’t exist.

A better insight to this disease may be given when, when we try to understand story of a patient who has been suffering from this disease. A disease that steals a person from itself and its family. A 82 year old woman now, started experiencing symptoms of this disease in January 2018 after the death of her husband. She started forgetting things like switching off the gas stove , where her room is and the names of people , with time her conditions onlybecame worse. As of march 2020 she was in a condition in which her family never wanted to imagine her. She forgot her husband has died, constanly keeps asking her grandchildren “ babaji ko bula lo , babaji school gaye hai kya ? “. Even after constantly reminding her that her husband has been dead for more than two years, only a minute later she starts asking the same questions again and again and never accepts the truth. She has started living in the existence of the non- existent. Now, she has started forgetting where she is. She stopped recognizing her own home. She didn’t knew whether it was day or night. She has started living two days in one. But somewhere or other she knows that some pieces of the puzzle are missing, she tries to recollect those pieces but can’t. She and her family are constantly lives in pain and terror.

Quoting few lines from a patient to his loved one,

Don’t ask me to remember,

Don’t try to make me understand,

Let me rest and know you’re with me,

Kiss my cheek and hold my hand,

I am confused beyond your concept,

I am sad and sick and lost,

All I know is that I need you to be with me at all cost,

Don’t lose your patience with me,

Don’t scold or curse my cry,

I can’t help the way I am acting,

Just remember that I need you,

That the best of me is gone,

Please don’t fail to stand beside me,

Love me till my life is done,

Oh, love me till my life is done.

There is no one stronger than a caregiver of a patient suffering from such a disease. There are many testing’s for this cruel disease like lab tests , mental status and neuropsychological testing , brain imaging and so on. But not a permanent cure or treatment. Only few drugs help in worsening the symptoms donepzil, galantamine (cholinesterase inhibitors) and memantine. Various clinical trials are being undertaken in some of the best medicinal institutions like the mayo clinical. Till the time a clinical trial becomes successful. We need to battle this disease on our own. Lets create awareness. Let us not ignore the symptoms , lets not think of them just as mere a process of ageing.


Pawani Goel  , Mayo Institute Of Medical Sciences
Radhika Awasthi , Rama medical college, Kanpur



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