FEBRUARY 2019 ISSUE - Digital Edition

Study to Prevent Cognitive Impairment
and Disability (FINGER) showed heart
health management, a healthy diet and
increased exercise, plus intellectual and
social stimulation can slow cognitive decline
in at-risk older adults. FINGER studies are
being carried out in China, in Singapore and
in Australia.
Tackling stigma
The costs of long-term care for individuals
with Alzheimer’s are substantial, as
dementia is one of the costliest conditions
to society. The total per-person health
care and long-term care payments from
all sources for Medicare beneficiaries with
Alzheimer’s or other dementias were
over three times as great as payments for
other Medicare beneficiaries in the same
age group in the US, according to 2018
Alzheimer’s Disease Facts and Figures by
Alzheimer’s Association, Chicago.
Such cost estimations are yet to be
carried out through studies in India, where
AD has not become a public health concern
yet like in many other parts of the world.
Stigma is yet another issue. A substantial
amount of stigma is still attached to
dementia in India. “Not only dementia,
almost every disease affecting the brain is
considered ‘paagal’ (lunacy) in many parts
of India. Woh toh paagal hai (the person
is mad) … this is the way people describe
individuals with neurological disorders,”
comments Dr Chauhan.
Chauhan and others in CBR are part
of a soon-to-be-launched large-scale
genome-wide study on Alzheimer’s and
other dementias in the country. Currently,
whatever data on Alzheimer’s is available
is limited to certain pockets, or based on
the information provided by hospitals.
Initial results of the study could be out
within the next couple of years. The data
will put things in perspective. Hopefully, a
clear understanding about the prevalence
and other aspects of the disease could
not only help create appropriate policies,
but also bring down the stigma. As World
Alzheimer’s Report 2018 by Alzheimer’s
Disease International, UK points out: “More
diagnosis means more awareness. More
awareness means less stigma. Less stigma
means more hope.”
Not only dementia,
almost every
disease affecting
the brain is
considered ‘paagal’
(lunacy) in many
parts of India.
Dr Ganesh Chauhan
Assistant Professor
Centre for Brain
Research
Bengaluru
TAU TANGLES AND AMYLOID
Two proteins in the brain are heavily
involved in the development of Alzheimer’s,
agree most scientists. Beta-amyloid (Aβ)
reaches abnormal levels in the brain of
people with Alzheimer’s and forms plaques
that collect between neurons and disrupt cell
function. The amyloid cascade hypothesis
considers that the deposition of the amyloid-β
peptide in the brain parenchyma is a central
event in Alzheimer’s disease pathology.
Tau proteins forms neurofibrillary tangles
inside neurons which block the neuron’s
transport system.
However, it is not clearly known exactly
26 / FUTURE MEDICINE / FEBRUARY 2019