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Monday, March 26, 2007

Alzheimer's Disease, Indian cultural traditions and languages - by Dr M.S. Thirumalai


Old age creeps in slowly for the young adult. Sudden changes may take place for the old, however. The old person becomes forgetful. At first it becomes a matter for laughter and joke in the family. Soon one notices that the old person is more confused than ever. He has more frequent mood changes, and begins to act in strange ways. He forgets the names of people around him, names of his own children and grandchildren whom he loved deeply. He begins to suspect your motives and wants to avoid you. Soon the old person becomes a different person altogether. He does not know his name, does not recognize his environment, and does not recognize his family. He is a stranger in his own family. He leaves home at his will and does not know where he goes or how he could return home. Family members are greatly worried and do not know what to do. The disease progresses rather slowly.

Only when the disease shows some severity, the family members often begin to seek medical consultation and attention for the patient.

The Alzheimer's disease was not recognized as a devastating one until the 1980s. But, since then, we read about it almost daily, and come across people and families that have been affected by it. The German doctor Alois Alzheimer described the disease somewhat definitively in 1912, I think. The disease is named after him.

In India and South Asian nations, cultural traditions took the onset of senility as a natural process of aging. Since life expectancy was rather short in these nations until a few decades ago, the Alzheimer's disease was assumed to be an occurrence or the phenomenon of the Western materialistic nations. There is a greater recurrence of this disease now noticed in India, especially among the people of middle classes.

Sadly, the belief that the Alzheimer's disease is a Western phenomenon is not really true. Indian family traditions make us suffer from within, mourn our fate, and feel sorry for our dear old person who is now a stranger in his own family. We do not publicize our "fate," and we are trained to put up with what we are faced with. Our public caregiving or medical systems are not prepared to handle such cases. I know of several cases of suspected Alzheimer's disease in India and my heart breaks when I think of such cases.

In the country where I am now settled, I have come across several Alzheimer's patients. These men and women were good friends of mine a few years ago, but with the onset of the disease I became a stranger to them. I could watch these developments and recognized certain linguistic characteristics of these persons. With a heavy heart I present here some of my observations on language use in Alzheimer's patients.

In terms of Indian languages, the pronominal usage is much affected, at variance with what the person would have done if he were not an Alzheimer's patient. The verb inflection with appropriate pronoun endings is also affected. He has problems with number and person attached to the main verb, but his problem with the gender is not as intense as his problem with the number and person of his addressee.

The most significant early process (and this continues to deteriorate further) is the patient's frequent substitution of one word for another. This begins with the confusion between related items such as ripe fruit and unripe fruit in Indian languages. The substitution process takes place between the similar items in some sense. Similarity is usually related to the similarity in meaning and appearance of the object or quality or action referred to.

However, as the disease progresses, the patient may not restrict himself to the substitution of one word by another from a related field only. Some of his substituted words may come from the related fields and some others from totally unrelated fields. Perhaps the intensity and frequency of failure relating to the transfer of words from the unrelated fields may be used as a diagnostic tool to assess the deterioration of the condition".

M. S. Thirumalai, Ph.D.
Bethany College of Missions
6820 Auto Club Road #320
Bloomington, MN


Anonymous said...

Has anyone done any significant investigation into the relationship between indian curries and alzheimers

Subodh said...

Joint family system that ensured constant company of growing children in the family that ensured reasonable social communication with post 60 elderly and delayed on set of AD.
Lack of social interactions, less usage of vocal verbal facility, less usage of language writing and reading also bring on set of AD in modern life style family set up.

Subodh said...

Some researchers say that about 4 tea spoons of raw coconut oil is found use full in AD treatment. What are the expert comments on this?
In Kerala where maximum coconut oil is consumed in diets, is there lesser incidence of AD?

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Subodh said...

Experts should confirm that AD is related more to little physical and mental activity in daily life and a feeling lack of responsibilities in post retirement life style rather than just a result of age. Perhaps the pollution in environments and newer modern daily food also have a role to play in AD.

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