Published by the government of Zimbabwe
Sifelani Tsiko
2 November 2005
Harare — AFRICA lacks reliable information to understand and manage Alzheimer's disease, a brain disorder that gradually destroys a person's memory and the ability to learn, reason and make judgments.
The condition affects mainly people of caucasian extraction.
Visiting South African specialist physician and geriatrician, Dr Stanley Lipschitz told a public lecture held in Harare recently that no epidemiological studies have been made around Alzheimer's disease making it impossible to draw useful and relevant data on the prevalence of the disease in Africa.
"There are no epidemiological studies that have been carried out," he told a gathering of mainly doctors and the public.
"No studies have been made too in South Africa. What we have are studies based on findings made in Europe and America, which we link up to the mainly white population."
"There are isolated cases in the black population and no studies have been made to ascertain the prevalence and incidence of the disease on this section of our society."
Dr Lipschitz says some medical analysts say the disease has not been evident in black people probably due to the benefits of the African extended family system or low life expectancy in black people.
"No conclusive studies have been made on whether it is because life expectancy is lower or it is because of the care of the elderly in the African extended family system. We don't have data on this."
The lecture was organised by the Zimbabwe Alzheimer's and Related Disorders Association (Zarda).
Alzheimer's disease often affects people in the late 40s and 50s and the first symptoms are impaired memory, followed by impaired thought and speech and finally complete helplessness.
Dr Lipschitz said there is no cure for the disease that he says is not static. A lot is still to be known about it.
"There is no such medicine available, there is no such medicine in the pipeline or drugs to reverse the disease," he said.
However, he said expensive drugs like Galantamine and Donepezil only delay cognitive disorders, postpone the emergence of behavioural problems and lessen the burden of caregivers.
"It will function for a year or so. The benefit is not that dramatic," he says. "No medicine is available to cure it. There is enormous amount of work going on in disease management and we hope with time there will be treatment," he added.
He gave an overview of the disease outlining its history, detecting the early signs, diagnosis, risk factors, management and ongoing research on this disease, which is complex and little known in the vast field of medicine.
Dr Lipschitz says some of the early signs of the disease include speech difficulties, difficulties in coping with familiar tasks, difficulties in recognising familiar people and objects, decline in the ability to manage finances and job and there is distinct change of personality and withdrawal from society.
"A husband may say to his wife who are you?" he said adding, "It is uncommon before the age 60 and when you hit 90s there is a 50 percent chance of the disease. By the time we administer therapies, vast parts of the brain would have been damaged. The disease changes over time it is not static," he said.
"It is difficult to notice the early signs. It is very important to make early diagnosis."
Some of the early warning signs include forgetting dates, seasons, recent conversations or events, repeating the same question, becoming more withdrawn and passive, becoming irritable, stubborn, paranoid and irrational or denying problems.
"All these symptoms including anxiety, hallucinations, screaming and restlessness are of major concern," he added.
"The Alzheimer brain is like a computer if you load it with a lot of things it will go slower and slower. It is important to manage the disease well by determining the causes, preventing the trigger, adjusting medication and avoiding over stimulating the patient."
Dr Lipschitz warned people against using herbal remedies that had no proven results.
"Heavy doses (herbal) may be harmful and there is no evidence that these work," he said. "Even the use of vitamin E has anti-oxidant effects and heavy doses may be harmful.
"People should be encouraged to save their money. Buying these herbs may leave them a lot poorer and (an) angry lot. There is no medicine to cure this disease."
Medical experts say Alzheimer's disease is now the fourth leading cause of death in adults afflicting about 4,3 million people in the US, 890 000 in Britain and eight million more worldwide.
Age is the biggest risk factor for the disease and the number of cases of Alzheimer's disease doubles every five years in people over 65 years and by 85 years, nearly half of the people are affected.
The exact cause of the disease is still unknown but medical experts say as the disease progresses, it destroys chemical messengers used by the cells of the brain to communicate with each other.
Dr Lipschitz has his own practice at the Memory Centre, Rosebank in Johannesburg and lectures to final year medical students in geriatric medicine.
In Africa, stigma and other societal beliefs can be a hindrance to understanding the disease.
Health experts in Africa say rapid growth in the disease has been worsened by the adoption of European diets instead of the traditional African diet, the same way indigenous American communities have been affected.
Though the condition is considered a 'white man's disease,' unless epidemiological studies are carried out and effective methods for prevention and treatment developed, Alzheimer's disease will reach epidemic proportions killing millions more in Africa in the coming years.
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