Alzheimer’s disease emerging as a growing concern in ageing Goa: Dr Parul Dubey

PANAJI: As Goa’s population continues to age, neurologists are witnessing a steady rise in cases of memory loss, confusion and cognitive decline, prompting concerns that Alzheimer’s disease and other forms of dementia could emerge as a significant public health challenge in the State.

While occasional forgetfulness is often dismissed as a normal part of ageing, medical experts caution that dementia is a progressive neurological condition that requires greater awareness, timely diagnosis and long-term care.

June is observed globally as Alzheimer’s and Brain Awareness Month, providing an opportunity to highlight a condition that affects millions of families worldwide. According to global estimates, more than 55 million people are currently living with dementia, with a new case diagnosed every three seconds. In India, around 8.8 million people above the age of 60 are estimated to be living with dementia, accounting for nearly 7.4 per cent of the elderly population.

For Goa, the issue is particularly relevant. Census data shows that approximately 11.2 per cent of the State’s population comprises senior citizens, significantly higher than the national average of 8.6 per cent. As life expectancy rises, healthcare experts believe dementia-related illnesses are likely to place increasing demands on families, caregivers and healthcare systems.

According to Dr Parul Dubey, Lead Neurologist at Manipal Hospital, Dona Paula, dementia has become a regular diagnosis in neurological practice.

“Based on what we are seeing in practice, I would say dementia is definitely increasing,” she asserts.

Dr Dubey, who has been practising in Goa for the last 15 years, explains that Alzheimer’s disease is the most common form of dementia.

“Alzheimer’s disease is a type of dementia,” says Dr Dubey. “Dementia means a decline in thinking and memory that affects life and it gets worse with time.”

She stresses that Alzheimer’s disease should not be confused with the mild forgetfulness that may accompany ageing.

“After 85, some people may experience what is called senile forgetfulness. That is different from Alzheimer’s disease. In dementia, memory loss is much worse and affects a person’s life,” she explains.

Although Alzheimer’s is commonly associated with advanced age, symptoms can begin much earlier.

“Most patients we see are in their 60s and above. So, Alzheimer’s can happen before 80,” she notes.

One of the earliest warning signs is persistent difficulty in remembering recent events. Families often observe that an elderly relative repeatedly asks the same questions, forgets appointments, misplaces commonly used items or struggles to follow conversations.

“Recent memory is usually affected first. Someone may forget something they were told in the morning by afternoon. They may keep searching for their glasses or forget messages,” says Dr Dubey.

She believes that improved awareness and advances in diagnosis have contributed to the identification of more cases.

“Today, doctors have ways to diagnose dementia. We are recognising it more often than before,” she explains.

At the same time, demographic changes are also contributing to the growing burden.

“We have more elderly people now than ever before and dementia becomes more common with age,” she says.

Medical experts point out that many of the risk factors associated with Alzheimer’s disease mirror those linked to stroke and cardiovascular disease. Uncontrolled diabetes, hypertension, smoking, excessive alcohol consumption, obesity, sleep disorders and physical inactivity have all been linked to a higher risk of developing dementia.

“The same factors that increase the risk of stroke can also increase the risk of dementia. Managing blood pressure, controlling diabetes, exercising regularly and maintaining a healthy lifestyle are important,” she advises.

Experts stress that early detection can significantly improve the management of the disease. Although there is currently no cure for Alzheimer’s disease, an early diagnosis enables families to plan treatment, care and support more effectively.

“Whenever there is concern about memory loss, it is essential to consult a doctor or neurologist. Sometimes, forgetfulness may be due to causes such as vitamin deficiency, thyroid disorders or depression,” Dr Dubey explains.

Neurologists typically use clinical assessments, cognitive testing and brain imaging studies such as MRI scans to evaluate patients and rule out other underlying causes before confirming a diagnosis of dementia.

The emotional and physical burden of Alzheimer’s disease often falls heavily on caregivers.

“As dementia progresses, patients may become aggressive, suspicious or depressed. Many no longer realise they have a problem. The challenge is often much greater for family members who provide care,” says Dr Dubey.

Caregivers frequently face difficulties related to sleep disturbances, medication management and behavioural changes. Experts say maintaining familiar surroundings and encouraging mentally stimulating activities can help improve a patient’s quality of life.

While treatment options remain limited, recent developments in medical research have offered hope. New antibody-based therapies such as Donanemab and Lecanemab have been approved for use in the United States following clinical trials.

“The US has approved treatments that target amyloid protein deposits in the brain, one of the hallmarks of Alzheimer’s,” says Dr Dubey.

However, she cautions that these therapies are not cures.

“At present, this is the most promising and expensive treatment available globally for Alzheimer’s disease,” she mentions, adding that studies suggest the drugs may slow cognitive decline by approximately 20 to 30 per cent in patients with mild Alzheimer’s disease.

Although these treatments are not yet widely available in India, some patients with the financial means have imported the medication. Experts believe access to such therapies could improve in the coming years.

For Dr Dubey, however, the conversation around Alzheimer’s disease extends beyond medicine.

“Every individual has a right to dignity. People with dementia gradually lose abilities but they should never be allowed to lose their dignity. We must care for them in a way that allows them to live a dignified life,” she urges.

As Goa’s elderly population continues to grow, healthcare professionals believe greater awareness, early diagnosis and compassionate care will be essential in addressing the rising challenge of Alzheimer’s disease and dementia in the years ahead.