Alzheimer's Disease - Symptoms, Stages, Treatment

It’s important to understand what is Alzheimer's disease and how it progresses before discussing the available treatment options. This irreversible neurological disorder gradually damages memory and affects the normal thought process and behaviour of the affected individual, making it increasingly difficult for them to carry out everyday tasks. Dementia is mostly caused by Alzheimer’s disease, accounting for 60% to 80% of these cases worldwide.

In 1906, Dr. Alois Alzheimer first identified this neurological disorder. Scientists explain that Alzheimer's disease is believed to result from a complex interaction of genetic, biological, environmental, and lifestyle factors. Abnormal accumulation of amyloid-beta plaques and tau tangles are hallmark pathological features that contribute to disease progression. These protein deposits, known as amyloid plaques and tau tangles, hinder the communication between brain cells. They damage the areas responsible for memory, learning, and cognitive function, eventually leading to cell death in the brain.

The number of cases of Alzheimer's disease is growing in India. The Indian Council of Medical Research (ICMR) reports that over 8.8 million Indians aged above 60 experience dementia. In the coming decades, the number of patients with Alzheimer’s disease is expected to grow with the rise in the elderly population. Early diagnosis and awareness, along with long-term care planning, are becoming increasingly important for families.

Alzheimer's disease is different from many acute illnesses, as it develops gradually. The symptoms build up gradually over the years, and they can be mistaken for normal age-related changes. After diagnosis, life expectancy varies from person to person, depending on factors like age, health, stage of diagnosis, and response to care. Median survival after diagnosis is often around 4–8 years, although survival can range from 3 to over 20 years, depending on age, overall health, and stage at diagnosis.

As the disease spreads gradually, early diagnosis and long-term care planning are critical. Financially prepared families are better poised to provide adequate medical support to the patients.

As Alzheimer's disease is common in the ageing Indian population, families should be aware of the risk factors associated with the disease. Research exploring the causes of Alzheimer's disease suggests that the disorder occurs due to a combination of several factors. These include:

• Changes related to age
• Genetics
• Lifestyle factors
• Environmental influences

Age is the most significant risk factor, as the risk of Alzheimer's increases substantially after the age of 65. The following table gives an overview of the major risk factors along with ageing.

Families who are able to recognise the Alzheimer's disease symptoms early can seek timely medical attention before the patient undergoes a significant cognitive decline. They can plan long-term care and arrange the finances as the disease progresses.

In the early stages, symptoms of Alzheimer’s disease are often mistaken for normal age-related memory changes. However, patients with Alzheimer’s disease show a progressive decline that interferes with daily functioning that goes beyond typical forgetfulness. Gradually, the disease affects their decision-making and routine activities.

Some of the early warning signs of Alzheimer's disease include:

• Loss of memory disrupting daily life
• Asking the same questions repeatedly
• Difficulty in planning and resolving problems
• Inability to follow familiar instructions
• Getting confused about dates, seasons, or locations
• Visual information becomes difficult to understand
• Challenges to find words while speaking
• Misplacing belongings frequently
• Unusual financial decisions and poor judgement
• Withdrawal from social activities
• Changes in personality and mood swings
• Difficulty in completing routine tasks

At times, patients with Alzheimer's disease may miss out on important appointments due to their forgetfulness. They may even feel confused in familiar surroundings. Some individuals may find routine tasks increasingly difficult, even the ones they could previously perform with ease.

Subtle changes in behaviour are often noticed by the families first, even before the patient recognises the issue. Some of these symptoms can overlap with other neurological or psychiatric conditions. In these situations, it’s essential to consult a neurologist or geriatric specialist.

Alzheimer's disease develops gradually, but some symptoms still need immediate medical attention. If families notice any of these symptoms, they should seek medical evaluation at the earliest to ensure timely diagnosis.

• Severe confusion arising suddenly
• Rapid changes in behaviour
• Violence or aggression
• Inability to recognise close relatives completely
• Repeated falls
• Significant loss of coordination
• Unwillingness to take meals
• Tendencies of neglect or self-harm
• Suspected financial exploitation

These are some signs that indicate that the disease might have progressed to advanced stages. The patient may also experience underlying medical conditions like infection, dehydration, stroke, or medication-related complications. Prompt intervention can reduce the chances of serious complications.

The Alzheimer's vs dementia difference is something families must understand clearly. These two terms are often used interchangeably, but they carry different meanings. Dementia is not a specific disease, but an umbrella term describing a group of conditions that affect memory, thinking, and reasoning abilities.

This is a broad term that describes a group of symptoms affecting memory, reasoning, language, judgement, and daily functioning. Alzheimer's disease is a specific neurological disorder where the brain cells undergo progressive damage that gradually impairs cognitive functions. It is the most common cause of dementia. The following table explains the difference between the two terms.

Other forms of dementia include vascular dementia, Lewy body dementia, and frontotemporal dementia. All patients with Alzheimer's disease have dementia, but not all dementia patients have Alzheimer's disease.

At present, there is no definitive cure for Alzheimer's disease. The currently available Alzheimer's disease treatments help patients manage symptoms and slow down the progression to improve the quality of their lives. In India, common treatment plans include a combination of medication, therapy, lifestyle adjustments, and caregiver support. Some of the common treatments include the following:

No. Alzheimer's disease cannot be cured or reversed as per current treatment options that are available. However, timely medical intervention remains critical, as it helps to slow the progression of symptoms. Medical support helps patients to maintain independence for longer and improve the overall quality of life.

Do you know?

Donanemab is one of the modern therapies used to treat Alzheimer’s patients. It targets amyloid plaques early in Alzheimer’s, and in one major study, it slowed cognitive decline by 35.1% over 76 weeks.

The Alzheimer's treatment cost in India varies significantly depending on the stage of the disease. The level of care required and the duration of treatment also influence the cost. Considering the long-term care needed and the increasing need for medical services, having adequate health insurance coverage is essential to manage the financial burden.

The table below gives an overview of the recurring expenses for the families of Alzheimer’s patients.

Disclaimer: The costs associated with treating Alzheimer’s disease can vary significantly across hospitals. The specific condition of the patient, care level required, and response to medication also determine the overall costs.

Families may consider suitable and closely associated health insurance for Alzheimer's disease to help manage eligible medical expenses associated with treatment. The coverage for Alzheimer's depends largely on whether the patient was diagnosed with the disease before or after purchasing the policy. In general, here are some key considerations in most policies.

• The waiting periods for pre-existing diseases generally range from 2 to 4 years.
• If a patient is diagnosed with Alzheimer’s before the policy is purchased, the insurer will treat the disease as a pre-existing medical condition.
• A standard health insurance policy primarily covers expenses related to hospitalisation.
• Traditional plans usually do not cover long-term caregiving expenses.
• If Alzheimer's or dementia is included as a covered condition in critical illness plans, patients may receive lump-sum benefits.

For families exploring critical illness insurance for Alzheimer's in India, it’s advisable to purchase coverage before symptoms appear. This is a part of financial planning to manage ongoing expenses once the patient is diagnosed.

The government-sponsored Ayushman Bharat Alzheimer's coverage in India may cover certain expenses related to hospitalisation for eligible beneficiaries. Eligible beneficiaries may receive coverage for hospitalisation related to approved conditions and procedures. Coverage for Alzheimer's disease specifically depends on applicable package guidelines and eligibility.

Patients can get coverage for admissions linked to complications that arise from chronic conditions related to Alzheimer’s disease.

The goal of the scheme is to support secondary and tertiary care, but coverage is limited to specific treatments and approved hospital procedures. Long-term outpatient care, custodial support, and non-hospitalisation expenses are excluded from the coverage.

However, long-term care required for dementia often lies beyond the scope of hospitalisation benefits funded by the government.

Standard health insurance plans generally do not include the full range of expenses associated with treating Alzheimer’s disease. The coverage usually includes the cost of hospitalisation, which covers inpatient admission, investigations, and prescribed treatments during the stay at the hospital. However, any service required outside a hospital setting, like supervision or long-term caregiving, is excluded from the policy.

Critical illness coverage may provide a lump-sum benefit if Alzheimer’s disease or related conditions are included among the covered conditions. Families can use this amount across different stages of the disease to manage the expenses associated with specialised care, caregiving support, medical expenses, or lost income. The cost overheads managed depend on how the patient's condition progresses over time.

Alzheimer's patients often undergo prolonged treatment over several years. While purchasing a health insurance policy is important, families must understand the scope of coverage they can receive. The following overview provides an outline of the expenses covered and excluded under most health insurance plans.

Covered

• In-patient hospitalisation
• Treatment for infections at the hospital
• Treatment needed after falls or injuries
• Diagnostic imaging during admission to the hospital
• Day-care procedures are covered under the terms of the policy
• Eligible claims related to acute medical complications

Not Covered

• Long-term residential care
• Accommodation in nursing homes
• Professional caregivers at home
• Routine outpatient consultations
• Memory care programmes
• Cognitive screening outside the period of hospitalisation
• Long-term expenses for medicines

Review the wording of the policy carefully to understand the coverage limits and exclusions. This helps families to plan ahead and remain financially prepared for the long-term expenses of the treatment.

The coverage of the policy largely determines the cost of treatment that can be managed without putting excessive strain on personal savings or household finances. Before selecting an insurance policy, families must consider the following factors.

• Purchase the health insurance policy before any diagnosis begins. If a patient is diagnosed with Alzheimer's, insurance companies would treat it as a pre-existing condition, which might affect the scope of coverage.
• Ensure that Alzheimer's disease or dementia is listed specifically within the list of conditions covered.
• Evaluate the requirements related to the survival period. Patients may have to wait for a survival period before the benefit becomes payable. In some rider documents, this period is 30 days from diagnosis, but patients should check the specific policy for clarity.
• Determine whether the coverage is adequate. Expenses for long-term care can amount to several lakhs over the course of treatment.
• Evaluate the tax benefits of the policy. Certain health insurance premiums may qualify for deductions under Section 80D of the Income Tax Act, 1961.

Disclaimer: Tax benefits are subject to prevailing tax laws. Deductions under Section 80D depend on the applicable tax regime and prevailing tax laws.

Families should also consider the financial risks related to the caregiver. One family member of the patient often needs to reduce their working hours to provide the necessary care.

An organised approach to documentation can significantly streamline the insurance claims process for Alzheimer’s patients. It can reduce delays and ensure smoother coordination with the insurer when the family is already going through challenges. The process involves several medical records, evaluations from specialists, and bills.

The verification process takes a shorter time when all the documents are in place. The following steps can help families of patients file the claim seamlessly:

• Step 1: First, secure a written diagnosis from a neurologist or geriatric specialist.
• Step 2: Notify the insurance company that the patient has been diagnosed with Alzheimer's disease.
• Step 3: Collect the necessary documents like reports, scans, policy documents, and KYC records.
• Step 4: Fill out the claim form accurately and submit it.
• Step 5: Coordinate with the insurance company as they evaluate the documents or ask for additional information.
• Step 6: When the claim is settled, the approved reimbursement or lump-sum benefit will be provided to the insured individual.

While filing for the claim, the following documents may be required:

• Diagnosis certificate from the neurologist
• MMSE or MoCA assessment reports
• Reports of MRI or PET scans
• Hospital records
• Policy documents
• Details of Aadhaar and PAN
• Claim forms

Families holding Axis Max Life Insurance policies must adhere to the claim procedures explained in the policy documents. The company records a claim settlement ratio of 99.80%^, which indicates that most of the claims are settled against the ones received.

Disclaimer: The information provided in this article is for general informational and educational purposes only and should not be construed as medical advice, diagnosis, treatment recommendation, or professional healthcare guidance. Treatment costs mentioned are indicative and may vary based on factors such as the patient's medical condition, hospital, city, surgeon's expertise, room category, and other treatment-related requirements.

Readers are advised to consult qualified healthcare professionals and obtain cost estimates directly from healthcare providers before making any medical or financial decisions. Axis Max Life Insurance does not provide medical services, endorse any specific healthcare provider.