Demography: Interview

World Alzheimer's Day: When memories slowly start to fade

Two Allianz experts answer questions about the insidious disease that afflicts more than 36 million people worldwide.
An elderly man moves on his wheel chair to the yard of the Canevaro old people\'s home in Lima. .../ Credits: Reuters
Anyone can be diagnosed with Alzheimer's disease. More than 36 million people worldwide are already suffering from this form of dementia, for which there is still no cure. As the number of older people in our society increases, the number of people affected by the disease will also rise over the next few years: if the condition remains incurable, an estimated 115 million people will have been diagnosed by 2050.

Alzheimer's disease usually manifests in old age and its onset is insidious - but its impact on the individuals affected and their environment is considerable. The two Allianz experts Michela Grimm, senior economist at Allianz Group Economic Research and Corporate Development and Dr. Max Link, head of Medical Consultants, answer the main questions about the condition.

Why is World Alzheimer's Day so important?
Link:
Alzheimer's is the most significant form of dementia and is, without a doubt, one of the greatest medical, but also socioeconomic challenges facing our society today. Considerable human suffering hides behind the figures. Our society has to rise to this challenge.
The motto of this year's World Alzheimer's Day is "Dementia: Living together". The day is designed to raise people's awareness of the plight of people suffering from dementia and their relatives.

How can society adapt to take account of the condition?
Grimm: Due to demographic developments, it is important to create a broad understanding of the disease and also how to deal with the individuals affected among members of society at large. After all, one of the effects of the disease is, for example, a gradual loss of spatial and temporal orientation. It is also about finding solutions to allow the individuals affected to lead independent lives for as long as possible. This also means providing support to relatives and helpers who are responsible for providing care. One possible option in this respect is, for example, the expansion of day-care institutions.

Is there any hope that Alzheimer's will be curable one day? Is research on the condition currently making progress?
Link: Unfortunately, we have not yet achieved a breakthrough as far as the causal treatment of the disease is concerned. But there is certainly hope that we will make significant progress over the next few years. The research conducted over the past few years has allowed us to arrive at a much better understanding of the fundamental characteristics of the disease. We now know that Alzheimer's is connected with deposits of abnormal protein fragments. These protein fragments arise when larger protein complexes that transfer nerve impulses in the brain cells disintegrate. Even the most minor deviations can result in protein fragments being produced that are deposited in the nerve cells, hardly disintegrate at all, clump together more and more and then ultimately result in the nerve cells dying off. The causal treatment approach that is being looked at in a research environment is therefore aimed at either preventing the formation of these protein fragments exhibiting abnormal changes, or aiding their disintegration. Success has already been achieved in animal experiments performed on transgenic mice. Over the next few years, we will be able to tell whether these success stories can also be achieved in humans.

Can the development of the disease be slowed down following diagnosis?
Link: Definitely, yes. Nowadays, there are good medication-based and non medication-based treatment methods. It is important to start with this treatment as early on as possible when the condition is still in the very early stages. The medication administered is aimed at compensating for the lack of neurotransmitters in the brain caused by neuronal cell death. This works fairly well in many cases in the early stages of the condition, but tends to become less effective as the disease progresses. But non medication-based forms of treatment are also extremely important to ensure that the individuals diagnosed can remain independent for as long as possible. Cognitive training, reality orientation, behavioral and memory treatment can have a positive impact.

Why would it appear that we have only really become aware of the disease in recent years?
Grimm: In some cultures, changes in the behavior of older people were previously, and sometimes still are, not associated with illness. Rather, it was considered normal for old people to become a bit eccentric and forgetful. What is more, there is also often a lack of opportunities for diagnosis. But we have to be honest and admit that, even in the industrialized nations, many cases of dementia are not diagnosed until very late on. In the US, it is estimated that 50% of all cases remain completely undiagnosed. This is why research is also focusing on developing new diagnostic procedures. Dementia is a disease that comes with old age. The higher the life expectancy and, as a result, the number of older people in an economy, the more people there will be suffering from dementia.

What should people do as soon as they have been given this serious diagnosis?
Dr. Max Link:
• When a patient or his/her relatives are confronted with the diagnosis of Alzheimer's disease, it always comes as a shock. This shock and the associated fear are understandable. People have to be offered help and support.

• Your GP can certainly be one of your first ports of call. GPs tend to have known the individual affected and his/her family for many years. GPs can help to alleviate any initial fears, can explain the disease and refer the individual to the right specialists.

• These specialists tend to be psychiatrists, neurologists and nerve specialists. These doctors will then not only start a course of drug treatment, but will also arrange non medication-based treatment.

• I would recommend anyone suffering from the disease and his/her relatives to contact the German Alzheimer's Society (Deutsche Alzheimergesellschaft). This is a self-help institution for individuals suffering from dementia and has a lot of experience in this field. Patients and their relatives receive a great deal of support from the society, e.g. contact details for regional treatment centers, but also information on possible social support, e.g. benefits provided under the long-term care insurance scheme.

• In addition to the medical treatment services on offer, this sort of financial support is also particularly important for individuals suffering from dementia and their families, as it helps to ensure that patients can remain in their familiar home environment for as long as possible. Private long-term care insurance policies can also provide additional valuable help in this respect.
 
 

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