Perspective

I’m an Englishman in New York

Gordon Matthew Thomas Sumner aka Sting is an English singer, songwriter, and actor. He was the principal songwriter, lead singer, and bassist for the new wave rock band ‘’the Police’’ from 1977 to 1986, and launched a solo career in 1985.

The chorus of his 1987 single headlined captures it all; ‘’Oh, I’m an alien, I’m a legal alien I’m an Englishman in New York Oh, I’m an alien, I’m a legal alien I’m an Englishman in New York’’ A critical analysis of the dramatis personae portrayed by Sting revealed the following;

  1. The subject is well oriented

  2. He has awareness of who he is and his legal status

  3. He has awareness of where he came from and his present location

  4. He has a sound memory recall Imagine the reverse of these; the subject is not aware of who he is, unaware of his legal status and doesn’t know where he came from and the present location and worst of all has an impaired memory. He is surely as bad as being lost!

The scene

Mama AJK lives with her daughter and son-in-law in the satellite town area of Lagos. She has had having recurrent bouts of memory loss over the years for which various orthodox and unorthodox medications have been used. She is also a known diabetic. On a fateful morning, she was home with the maid who had to dash out to buy some items in the neighbourhood market. She returned later and assumed Mama was in bed as is customary. About 3 hours later she went to her room to get her for lunch only to discover she was absent, searched and searched the whole house, compound, adjoining houses and neighbourhood but Mama was nowhere in sight. The search continued over the next 2 weeks but graciously enough a neighbor called their attention to a ‘’special announcement’’ on television which indicated Mama had been found in Badagry! The old woman looked unkempt, could not recall how she got there or what actually happened and was unable to recognize any member of the household including her daughter!!

What could have gone amiss, could she be suffering from a memory impairing disease? In the past week another senior citizen went missing in Lagos (graciously, was also found), presumably because he was said to have ‘’…….memory issues and can’t find his way home……….’’

What is Alzheimer’s disease?

Alzheimer’s disease is an irreversible, progressive brain disorder that leads to slow destruction of brain cells which in turn leads to impairment of memory and thinking skills, and eventually the ability to carry out the simplest tasks. Alzheimer’s is the most common cause of dementia among older adults. Dementia is the loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities to such an extent that it interferes with a person’s daily life and activities.

The process

In Alzheimer’s disease, when brain cells start to deteriorate, the body attempts to stop this process by producing a protein called amyloid. However, amyloid deposits build up in the brain, leading to further deterioration. These deposits of amyloid are referred to as “plaques” and cause the brain cells to shrivel up and form “tangles”, which in turn lead to changes in the brain structure and cause the brain cells to die. The formation of plaques and tangles also prevents the production of some important brain chemicals, called neurotransmitters (eg: acetylcholine, which is important in memory function). Over time the loss of brain cells causes the brain to shrink.

Causes

While there is no known cause for Alzheimer’s disease, it has been indicated that the following factors may play an important role in the development of the condition: • Genetic factors, such as the presence of, or changes to, certain genes • Environmental factors, such as long-term exposure to some environmental solvents (eg: pesticides, glues and paints) or infection with certain viruses or bacteria • Lifestyle factors, such as a lack of exercise, poor-quality sleep and a diet lacking fruit and vegetables. However, it is now believed that a combination of these lifestyle, environmental and genetic risk factors trigger an abnormal biological process in the brain that, over time, results in Alzheimer-type dementia. Identified risk factors for developing the condition include: Old age, Down syndrome, History of a head injury, Smoking, Alcohol intake, Family history of Alzheimer’s disease, Obesity, High blood pressure, High cholesterol and Diabetes.

The catch

Symptoms commonly experienced during the early stages of Alzheimer’s disease include: • Mild forgetfulness – especially short-term memory loss • Mood changes, including irritability and anxiety

• Difficulty processing new information and learning new things

• Loss of spontaneity and initiative

• Confusion about time and place

• Communication difficulties

• Decline in ability to perform routine tasks. As Alzheimer’s disease progresses the following symptoms may develop:

• Increasing short-term memory loss and confusion
• Difficulty recognising family and friends

• Shorter attention span and feelings of restlessness

• Difficulty with reading, writing and numbers

• Possibly neglectful of hygiene

• Loss of appetite

• Personality changes (eg: aggression, significant mood swings)

• Requires increasing assistance with daily tasks. Towards the later stages of the disease the following symptoms may be experienced:

• Inability to understand or use speech

• Inability to hold urine / faeces

• Inability to recognise self or family

• Severe disorientation

• Increasing immobility and sleep time. Diagnosis of the condition is via history taking, examination and request for some tests.

Treatment

There is no known cure for Alzheimer’s disease, treatment focuses on managing symptoms, associated chronic conditions and supporting the person and their family.

Preventive measures

• Stop smoking and cut down on alcohol

• eating a healthy, balanced diet and maintaining a healthy weight

• staying physically fit and mentally active

• Avoid exposure to pesticides, glues and paints These measures have other health benefits, such as lowering the risk of cardiovascular disease and improving overall health.

Please note!

The picture painted above was replicated in the past week when a septuagenarian was declared missing after haven visited a hospital unaccompanied. It is therefore expedient that someone should always be in the company of the elderly if they must venture out of the safety of the home environment.

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