Common myths about Alzheimer’s disease that still mislead millions of people: From ‘it’s just normal ageing’ to ‘only older people get it,’ here’s what experts want everyone to stop believing

Alzheimer's disease is the most common cause of dementia, accounting for roughly 60 to 70 percent of all cases worldwide. It's a progressive brain condition that gradually destroys memory, thinking ability, and eventually the capacity to carry out even the simplest daily tasks.It typically starts with small things. Forgetting recent conversations, misplacing objects, struggling to find the right word. Easy to dismiss as normal ageing. But Alzheimer's is something different. In the brain, abnormal protein deposits or clumps of amyloid beta and tangled threads of tau build up and interfere with how nerve cells communicate. Over time, those cells die. The more we understand about how it starts, the better the chances of one day stopping it.Dr. Joy Desai, Director Neurology, Jaslok Hospital and Research Centre has debunked certain myths related to the disease.Dementia is a term implying progressive loss of acquired brain related skill sets that result in loss of functional efficiency. Neurologists divide these skill sets into domains: personality and behavior, memory, language, praxis (the ability to perform a complex sequential task without having to focus on its individual steps), visuo-spatial skills ( the ability to navigate geographic spaces), and executive functions (goal directed behavior, motivation, social harmony, recognition of cause and effect, etc.) Impairment in three or more of these domains is implied in using the term dementia. Alzheimer is one type of degenerative dementia and there are many other causes. Alzheimer’s disease can occur in the young, especially familial ones cause by specific mutations in genes like Presinilin1, Presenilin 2 and APP. These genes play an important role in maintaining biological integrity of the brain’s neural networks. Such families as for example some well studies ones in Colombia (the town of Yarumal in Antioquia) have contributed to the understanding of susceptibility and resilience to the precipitation of Alzheimer changes in human brains. While the risk of developing Alzheimer’s disease increases with aging, biological investment in dietary discretion ( a diet rich in green, legumes, proteins, and bereft of processed foods), regular cardiovascular and resistance exercises ( many exerkines like irisin, and meteorin like protein protect against Alzheimer’s disease), a rich social network and fulfilling purposeful activity, a lifetime pursuit of awe and learning, sleep hygiene, managing pollution and hearing impairment can all protect against the risk of developing Alzheimer’s disease. There are other genetic protective factors like klotho variants, aquaporin 4 genes, the Christchurch mutation, etc that impart resilience to the risks of aging, resulting in “super-agers” whose cognitive abilities in the eight decade remain unsullied. Alzheimer’s disease is a tragic consequence of injured brain networks resulting from abnormal protein deposition both within and outside of neurons resulting in inflammation in the brain and loss of function. While in some patients the initial symptoms are behavioral change and change in personality the underlying disorder is not psychiatric. Alzheimer’s disease is best evaluated by trained neurologists experienced in the assessment and management of cognitive disorders. While it is true that Alzheimer’s disease is relentlessly progressive and no therapy has resulted in reversal, symptomatic medications can improve the burden of symptoms, especially the neuropsychiatric manifestations. This can relieve caregiver burden and improve patient quality of life. In the very early stage of the disease known as minimal cognitive impairment, there may be a role for emerging immunotherapies in the research pipeline. Diligent and judicious evaluation of patients may result in successful treatment of Alzheimer mimics like auto-immune encephalitis and reversible symptomatic dementias. Recent trials have raised hopes for meaningful therapies emerging soon.