September has been designated World Alzheimer's Month to raise awareness and challenge the stigma surrounding dementia. Today, Sept. 21, is celebrated as Alzheimer's Disease Day and marks the pinnacle of this month's observance.

In 1901, Dr. Alois Alzheimer, a German neurologist, described the first case of a patient affected with the disease, which later came to bear his name. Over a century has passed, but we still have no cure for this enigmatic and progressive neurological disease.

Alzheimer's disease is the most common form of dementia. This accounts for 65% to 70% of all dementia. It is a progressive brain disease that results in a progressive loss of memory function, impairment of thinking and changes in behavior and emotion.

About 6 million Americans live with dementia, and it remains the sixth leading cause of death in the U.S. The physical, psychological, social and economic impact of Alzheimer's disease on patients, families and caregivers is enormous.

Increasing the public's awareness by education and disseminating correct information is the main objective of this monthlong observance. The early symptoms of Alzheimer's disease can include memory loss, difficultly performing familiar tasks, problems with language, disorientation to time and place, poor or decreased judgment, problems with keeping track of things, changes in personality, misplacing things, changes in mood and behavior and trouble with images and spatial relationships, as well as withdrawal from work and social activities.

There are risk factors that affect the likelihood of developing dementia. Some of these are modifiable, while others are not. The most critical risk factor is age. Alzheimer's disease affects 6 out of 100 people less than 65 years old and another 10% from 66 to 79 years old. About 35% of people between 85 and 90 years old will have dementia, and half of those 90 years old and over. Another risk factor is family history, since abnormal genes are implicated and heighten the risk of developing dementia. However, the majority of people who develop dementia have no known family history.

The other risk factors include smoking and alcohol consumption. Research has shown that smoking significantly increases the risk of mental decline and dementia. A large amount of alcohol appears to increase the risk of dementia. People with untreated or poorly controlled vascular diseases such as high blood pressure, diabetes mellitus and high cholesterol are at an increased risk of developing dementia. Untreated obstructive sleep apnea can also contribute to dementia by starving the brain of oxygen at night.

Research has shown that staying physically and mentally active, along with maintaining a well-balanced diet, being socially connected, and optimally managing existing vascular diseases such high blood pressure, diabetes and high cholesterol can curve or delay the onset of cognitive decline as we get older.

If you or your loved ones have any concerns about developing dementia or any significant cognitive decline, please consult your primary physician for evaluation and appropriate testing and referral for treatment.

Caring for someone with dementia can be highly taxing and stressful but can also be rewarding and honorable. Particularly in our culture where taking care of our elders has been considered not to be an obligation but an honored responsibility to people who once raised us and helped us shape who we are today.

I will leave you with this bible verse: "Honor your father and mother, which is the first commandment with a promise, so that it may go well with you and that you may enjoy a long life on earth." Ephesians 6:2.

Dr. Ramel Carlos is a board-certified neurologist practicing in Guam for 18 years and a specialist in epilepsy and clinical neurophysiology. He is also a pediatrician, a diplomate of the American Board of Disability Analysts and the editor-in-chief of The Guam Medical Association Journal.


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