The Tribune

By DR KENNETH D KEMP

I’M OFTEN asked by friends, patients and family members alike what I consider the most frightening, the most difficult or the most agonizing of all medical conditions that I’ve seen throughout my career. In every case they were, as I assume you will be, surprised to hear my response.

Alzheimer’s disease, one of the most devastating and crippling forms of dementia, is consistently my pick for this disreputable designation. This progressively degenerative brain disease outstrips the very essence of one’s identity and robs you callously of every memory, every desire, every love and leaves you crippled, frightened and alone.

Imagine a lifetime’s worth of memories slowly and haphazardly slipping away and then descending into the abyss where you cannot remember anyone or anything. You are completely alone. Everything you have ever learned and everyone you have ever met is now gone and you are surrounded by total strangers.

In its most advanced stage, Alzheimer’s patients can even lose the ability to communicate, swallow and control their movements. In almost every other disease known to man, you are at least able to comprehend what is happening to you and find comfort in your situation from loved ones near and far. This should never be taken for granted particularly since Alzheimer’s patients are typically and universally viewed as being “dopey”, “befuddled” and a “burden” rather than given the profundity of sympathy they so desperately require. That pervasive general perception, left unchallenged, gives tacit consent for many to continue.

One of my patients began displaying symptoms, like her mother, at age 68 but wasn’t diagnosed with Alzheimer’s until two years later. Her family doctor prescribed various medications but she routinely swapped the morning for the evening dosages and lashed out at her caregivers whenever they corrected her. She got lost very easily. Eventually her keys had to be taken away; an act she saw as robbing her of her independence. As the disease progressed, she displayed very aggressive outbursts, had to be tied with soft straps and was confined to a wheelchair. She couldn’t talk, cried constantly and barely slept for nights on end.

Behavioural neurologists and geriatric psychiatrists, like those at Sandilands Rehabilitation Centre, are best equipped at treating these patients. The Bahamas Alzheimer’s Association is another great resource for individuals looking for information and support.

The Mayo Clinic describes Alzheimer’s as a progressive neurological disorder that causes the brain to shrink and brain cells to die. What causes it is not yet known to a certainty primarily because it cannot be attributed to one single cause. Some researchers suggest the same risk factors as heart disease (like smoking, high blood pressure, obesity, high cholesterol, lack of exercise and poorly controlled Diabetes) also increases the likelihood of developing Alzheimer’s.

Future research incentives hinge on the fact there remains little known as to what makes one individual more susceptible than another. The most significant factor appears to be increasing age wherein occurrence of the disease doubles every five years after the age of 65. In fact, between 2000 and 2019, global deaths from heart disease have decreased by 7.3 percent but deaths from Alzheimer’s have conversely increased by 145 percent.

To date there remains no cure available and treatments are admittedly limited in their scope of effectiveness. Calls for increased attention on treating this disease are becoming more and more prevalent as the geriatric population worldwide continues to grow.

We are all a sum of our life experiences so what remains of us if those experiences are suddenly taken away? The answer to that has been debated often in the upper echelons of academia for years but one needs not to overthink it. Just look into the eyes of one of the 35 million people worldwide who suffer from this condition and the answer is abundantly clear. What remains is a crippling sense of loss; the perception of nothingness and what replaces it is a justifiable fear.

Alzheimer’s disease has been described as death before death and going forward, may we each help to ease the anxiety of those affected by showing compassion, not just to them but also to their caregivers.

This is the KDK report.

Nick-named ‘The Prince of Podiatry’, Dr. Kenneth D. Kemp is the founder and medical director of Bahamas Foot and Ankle located in Caves Village, Western New Providence. He served as the Deputy chairman for the Health Council for 5 years and he currently sits on the board of directors for the Princess Margaret Hospital Foundation in his role as co-Vice-chairman.