Alzheimer’s disease–why we need to know more about our ‘ulyanin’ old folk | Lifestyle.INQ

OCTOBER 27, 2022

It is a truism that older people are generally respected and taken care of by their families in the Philippines.

There are exceptions, as in the case I recently read in Facebook, in which a school principal had become a janitress in the same institution when she ran out of means to support herself.

She did not have family, friends or associates who could provide her with adequate care. Hence, the poor lady was left to fend for herself in the same place over which she had reigned in her salad days. It must have been awkward and embarrassing for some of her former pupils to run into her in such circumstances.

I have a growing number of friends now caring for parents who are in their 80s and 90s. Most, if not all, are only too glad to watch over their elders.

But, as in the case of the former school principal-turned janitress, roles have been reversed and children have to grapple with unfamiliar issues and unexpected challenges.

One of these is Alzheimer’s disease, or what used to be simply described as ulyanin, or the dementia that sometimes accompanies old age. Forgetfulness or absentmindedness was the hallmark of this condition, and family folklore was enriched by what lolo or lola forgot, or who he/she was unable to identify on a particular day or occasion.

Nobody worried much about their grandparents being ulyanin since that was perceived as only natural for aged people entering into a second childhood where they need guidance and supervision.

New specter

But the specter of Alzheimer’s disease as a syndrome arrived by way of America. It was described as a form of dementia, which, in its final stages, led to the breakdown of such automatic functions as breathing, swallowing or digestion. Scientifically, it was described as resulting from a process “when an abnormal buildup of protein in the brain forms neurofibrillary tangles and amyloid plaques, which appear like clumps in the brain.”

Interrupted synapses (or connections) between the neurons in the brain resulted in disruption in the person’s cognitive function, and the hippocampus was the first area to be impaired. In layman’s term, memory would begin to be affected, since the signals traveling across the brain could no longer proceed, with their pathways having ceased to exist.

Worldwide, there are at least 46.8 million cases of dementia. The World Health Organization has described Alzheimer’s as among the top seven ailments disabling the general population, and estimates that it will cost the world some $1 trillion in 2018.

Little awareness

Although the Philippines does not lack for specialists or
associations focused on Alzheimer’s disease, there is limited awareness among Filipinos about what could be a future major epidemic—though it’s reportedly already the sixth leading cause of death in the Philippines.

In 2003-2004, out of a population of 84 million, 2.9 percent were 65 years or older, and 11.9 percent or 289,884 reportedly had dementia.

In 2014-2015, the Population Commission reported that the elderly population had increased to 4.3 percent of the total population, and some 490,000 Filipinos were extrapolated to have “varying types of dementia.”

It would appear that in the Philippines, Alzheimer’s disease has not been clearly defined as a separate category within dementia. It is important that Filipinos know more about this malady so the afflicted can be treated accordingly. Perhaps, our more senior politicians could pick up the cause of their peers.

For example, Alzheimer’s is not necessarily an illness that affects only seniors. Among its relatively young victims was the actress Rita Hayworth when she was still in her 50s. On the other extreme were seniors like President Ronald Reagan and Prime Minister Margaret Thatcher in their twilight years.

Beautiful friend

My own encounter with a young Alzheimer’s patient was a bright and beautiful friend, Regina, who had been a glamorous professional involved in society and media events, One of her prized possessions at her trendy Malate home, shared with another off-shoulder beauty, was a picture with Audrey Hepburn.

Her mother, also a career woman, had likewise been struck down by Alzheimer’s before she had reached 60. One could always mistake the signs of Alzheimer’s for occasional fits of absentmindedness. However, Regina’s friends began to notice her nonappearance at events, along with repeated phone calls from her on the same topics within minutes or hours of each other. Her job performance also became erratic.

Shortly after I had retired, I announced the good news to Regina at her residence, which happened to be within spitting distance of mine. I said I was glad that we were now neighbors since I lived a few blocks down from her apartment and I was here to stay.

We went on to exchange news about the years that elapsed when I was abroad. Finally, after a pause, she said, “And so, where do you live now, and when will you leave again for your next assignment?”

I realized that her Alzheimer’s had advanced, and that concerned friends were right in their fear that she might leave the oven on, or let some stranger in without knowing their identity. There were days when she reportedly did not take any sustenance. I later learned that it had been a major struggle for her family to convince her to leave her solitary existence and move in with them, so that they could take better care of her. She is now safely in the bosom of her sisters’ home care.

Other causes

In Regina’s case, genetics and family history most probably played a large role in her Alzheimer’s. However, there are other causes, such as brain tumor, stroke, HIV infection, immune disorders (like the “mad cow disease” aka Creutzfeldt-Jakob Disease), diabetes, smoking, depression, sleep apnea, poisoning and nutritional deficiencies.

As in the latter six cited cases, some conditions could be reversible if the causes are halted—but not in the final, full-blown version of Alzheimer’s, where, unfortunately, the executive function of the brain is most affected, which includes attention, concentration, abstract thinking and judgment.

One of the most moving recent films on this topic was “Away From Her,” in which the magnificent Julie Christie masterfully portrayed the deterioration of an Alzheimer’s patient.

Specialists have recommended various measures to counteract the potential development of Alzheimer’s, including regular physical activity, avoidance of head injuries, brain-boosting hobbies (such as crossword puzzles, Scrabble, chess), social interaction, daily imbibing of alcohol such
as champagne, sound sleep, organic nutrition and quitting smoking.

Fortunately, there are signs of more awareness and action about this looming health issue. There is now a Philippine Alzheimer’s Support Group, as well as a website for Dementia Nursing Homes. A 2005 book on “Recommendations in the Diagnosis, Prevention and Treatment of AD” was updated in 2014 with a second edition.

On Sept. 22-23, a postgraduate course for doctors on “Dementia: Multifaceted Care Across Old Settings” will take place at the Crowne Plaza Hotel on Ortigas Avenue.

One last thing: I still think one of the best antidotes recommended against Alzheimer’s is champagne thrice daily.