One evening, I was editing videos for my YouTube channel, Nirogi Lanka. I had been working on a new series about common health issues in Sri Lanka, aiming to simplify medical concepts for the public. The video I was tweaking was about diabetes management, and I was adding voiceovers to make the information more engaging. My goal was clear: to provide easy-to-understand and relatable health education.

Just as I was about to finish, Indika, my brother’s friend, stopped by unexpectedly. I could see from his face that something was weighing heavily on him. After a few moments of small talk, he finally shared what was troubling him.

“Doctor, I’m really worried about my mum,” he said, his voice tinged with concern. “Lately, she’s been acting very differently. She forgets where she is sometimes, and even what day it is. Her judgment is slipping too—she hides money in random spots around the house and forgets where she put it. It’s creating a lot of tension at home. My wife is uncomfortable living there, especially with our son, because my mum’s hygiene has gotten worse. She spits saliva everywhere and doesn’t care for herself. She used to run the family business, but now, everything has changed.”

Indika’s description was familiar to me. It sounded like Alzheimer’s disease, a condition where memory, thinking, and behavior decline progressively. His mother’s behavior wasn’t just normal aging; it pointed to something more serious.

What Is Alzheimer’s Disease?

I explained to Indika that Alzheimer’s is the most common form of dementia, making up 60-80% of dementia cases. It’s a long-term, progressive disease that worsens over time. People over 65 are at a higher risk, but it can also occur earlier, known as early-onset Alzheimer’s.

Alzheimer’s damages brain cells, causing memory loss, disorientation, and significant changes in behavior. The symptoms develop gradually, making it difficult for families to notice early on. However, what Indika was describing—his mother’s forgetfulness and poor judgment—were classic early signs of the disease.

Symptoms of Alzheimer’s

I went over some of the symptoms Indika might continue to notice in his mother. Alzheimer’s doesn’t just cause occasional forgetfulness. It leads to ongoing memory issues that interfere with daily life. His mother’s habit of hiding money in odd places, her confusion about time and place, and her slipping hygiene were all part of the disease’s progression.

Other common symptoms include:

• Difficulty completing familiar tasks, such as managing finances or making tea.
• Trouble with problem-solving, like forgetting how to follow a recipe.
• Language problems, struggling to find the right words in conversations.
• Mood and personality changes, including irritability and withdrawal from family or social activities.

Alzheimer’s also leads to decreased judgment and increased disorientation. Over time, these symptoms intensify, and people begin to lose their independence.

How Alzheimer’s Is Diagnosed

Indika asked about the next steps. I explained that doctors can diagnose Alzheimer’s through a combination of medical history and cognitive tests. They will review her symptoms, assess her memory and problem-solving skills, and may even order brain scans, like MRIs, to rule out other possible conditions, such as strokes or brain tumors.

While it’s difficult to diagnose definitively before death, doctors can still make a reliable diagnosis using a series of tests and observations.

Causes and Risk Factors

Indika then asked what could have caused his mother to develop Alzheimer’s. I explained that the exact cause is not fully understood, but age is the biggest risk factor. People over 65 are much more likely to develop the disease. However, family history and genetics also play significant roles. Certain genes, like APOE, increase the risk of Alzheimer’s, though they don’t guarantee it.

Lifestyle factors, like cardiovascular disease, smoking, or depression, can also contribute. Indika’s mother’s past health and lifestyle might have played a part. For more detailed information, I recommended reading about the Alzheimer’s Disease Genetics Fact Sheet provided by the National Institute on Aging.

Treatment Options for Alzheimer’s

Indika was worried there was nothing he could do to help his mother. I reassured him that while there’s no cure for Alzheimer’s yet, treatments can help slow the disease’s progression. Some medications are designed to improve cognitive function, such as donepezil and rivastigmine, which are commonly prescribed to manage symptoms in the early and middle stages of the disease.

For moderate to severe cases, memantine can help regulate chemicals in the brain linked to memory and learning. There are also newer drugs, like aducanumab, that target amyloid plaques, the proteins that build up in the brains of people with Alzheimer’s. These treatments can slow the progression but not cure the disease. More information on Alzheimer’s treatments is available from the National Center for Biotechnology Information.

Supportive care is just as important. Indika’s mother could benefit from a speech therapist to maintain communication skills, or a physical therapist to stay active. Emotional well-being matters too—cognitive-behavioral therapy can help with the anxiety or depression that often accompany Alzheimer’s.

Stages of Alzheimer’s

Alzheimer’s progresses in stages. Indika’s mother was likely in the early stages, where confusion, poor judgment, and memory lapses are noticeable but not overwhelming. As the disease advances, she might need help with more basic tasks like eating and dressing.

In the later stages, people with Alzheimer’s often lose their ability to recognize loved ones or even communicate. They may require full-time care.

Managing Alzheimer’s Care

Caring for someone with Alzheimer’s is emotionally and physically challenging, and I could see that Indika was already feeling the weight of it. His wife’s concerns about their child living in the same house were valid, given his mother’s deteriorating hygiene and behavior. I suggested considering respite care—temporary care that allows caregivers to take a break. In the long run, they might also need to think about long-term care facilities.

Planning ahead is key. Alzheimer’s care requires a strong support system, and Indika didn’t have to do it all on his own. There are support groups and resources that can help families manage the disease’s challenges.

The Takeaway

As Indika was about to leave, I reminded him that Alzheimer’s is a complex and progressive disease. It’s hard for families to accept, but understanding the condition is the first step. Although there’s no cure, treatments and support can make a huge difference in slowing the progression and maintaining the quality of life.

Alzheimer’s will change many things, but with the right care and support, families can navigate this difficult journey with compassion and dignity.