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Sunday, July 31, 2011

Alzheimer's disease in India : Scientific Papers, Bibliography. (2)

1: Bharath S, Purushottam M, Mukherjee O, Bagepally BS, Prakash O, Kota L, Krishnappa SB, Sivakumar PT, Jain S, Varghese M. Apolipoprotein E polymorphism and dementia: a hospital-based study from southern India. Dement Geriatr Cogn Disord. 2010;30(6):455-60. Epub 2011 Jan 20. PubMed PMID: 21252538.

2: Narayanaswamy JC, Varghese M, Jain S, Sivakumar PT, Prakash O, Bharath S, Kandavel T. Is there a familial overlap between dementia and other psychiatric disorders? Int Psychogeriatr. 2010 Dec 16:1-7. [Epub ahead of print] PubMed PMID: 21205363.

3: Loganathan S, Phutane VH, Prakash O, Varghese M. Progression of vascular depression to possible vascular dementia. J Neuropsychiatry Clin Neurosci. 2010 Fall;22(4):451-t.e34-451.e35. PubMed PMID: 21037152; PubMed Central PMCID:PMC3059119.

4: Prasad K, Gupta H, Bharath S, Prakash O, Sivakumar PT, Kumar CN, Varghese M. Clinical practice with antidementia and antipsychotic drugs: Audit from a geriatric clinic in India. Indian J Psychiatry. 2009 Oct-Dec;51(4):272-5. PubMed PMID: 20048452; PubMed Central PMCID: PMC2802374.

5: Bagepally BS, Prakash O. Nonsignificant weight gain with atypical
antipsychotics in men with Alzheimer's Disease: an important result of the CATIE-Alzheimer's disease study
. Am J Psychiatry. 2009 Sep;166(9):1063-4; author reply 1064-5. PubMed PMID: 19723796.

6: Prakash O. Role of community health workers to diagnose dementia. Acta Psychiatr Scand. 2007 Aug;116(2):155; author reply 155-6. PubMed PMID: 17650281.

7: Prakash O, Gupta LN, Singh VB, Singhal AK, Verma KK. Profile of psychiatric disorders and life events in medically ill elderly: experiences from geriatric clinic in Northern India. Int J Geriatr Psychiatry. 2007 Nov;22(11):1101-5. PubMed PMID: 17357180.

8: Group intervention for carers of geriatric patients: experiences from a clinic in India. J. Henry, A. Jagannathan, K. Bhavana, B. Thomas, S. Bharath, M. Varghese, O. P. Jhirwal and P. T. Sivakumar. International Psychiatry. Vol. 7, Number 2, April 2010. 

Read about the author at :

9: Brodaty H et Arasaratnam C. Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia. Am J Psychiatry 2012; 169(9): 946-953. 1er Septembre Gitlin LN. Good News for Dementia Care: Caregiver Interventions Reduce Behavioral Symptoms in People With Dementia and Family Distress. Am J Psychiatry 2012; 169(9): 894-897. 1er Septembre 2012. 

MYTHS on Alzheimer's Disease in India.

AD is a neurodegenerative disease, means it is a BRAIN DISEASE "auto-deteriorating itself" and then affecting the person's abilities in daily life. The auto-deterioration of the neuronal process starts many decades ago with small symptoms we don't pay attention to, sometimes with depression episodes too. Symptoms and deterioration get worse without following a psycho-social programme avoiding stress and combined with a behavioral and psychological disorders treatment.

There is NO DEFINITIVE CURE found yet. It is not coming from western countries only the syndrome has been identified around a century ago by a western doctor. There is NO CONTAMINATION PROCESS neither from western countries or within people in India.

There is no way, after coming from a trip in the USA or Europe, that you or your siblings come back with the disease ; it starts a long time ago and sometimes Non-Residents Indians come back in their old age to take rest and benefit from the local community living and low caregiving cost in India. Then some families notice the changes.

So EVERYBODY IN THE WORLD HAS A BRAIN so everybody could be potentialy affected by this disease, disregarding origins/nationality/culture/country/religions.


Hendi Lingiah.
Clinical Psychologist in Gerontology.

Senior Citizens National Solidarity Day 16th August 2011, common Charter of Demands across all States.

Senior Citizens National Solidarity Day 16th August 2011, common Charter of Demands across all States :

- Adoption & Implementation NPOP 1999 / National Policy on Senior Citizens (NPOS) 2011;

- Immediate implementation of The Maintenance and Welfare of Parents and Senior Citizens Act, 2007 by adoption, framing rules , forming tribunals, Appellate Tribunals and case registration & redressal ;

- Health Insurance cover for all Senior Citizens ;

- National Commission of Senior Citizens ;

- Setting up State Senior Citizens Council and Commissionerates ;

- Comprehensive national policy for Dementia and Alzheimer’s ;

- Inclusion of Ageing in Corporate Social Responsibilities (CSR) from Company Law Angle ;

- Specialized Courses in Social Science & Medical Colleges in Gerontology and Geriatrics respectively ;

- Fast track Courts for speedy, time-bound disposal of pending cases of Senior Citizens in all Courts ;

- Uniform Old Age Pension Scheme for all Senior Citizens in BPL in all states ;

- Fast Implementation of National Programme for the Healthcare of the Elderly (NPHCE) started in February 2011 ;

- Charter of Rights and Responsibilities for Senior Citizens ;

- Providing concessional Bus fares for senior citizens.

Saturday, July 30, 2011

DNA Pune article on Alzheimer's Disease awareness in India today. (link)

On DNA PUNE, full page on Alzheimer's Disease in indian context today !!!
Article entitled : "Awareness on Alzheimer's, Crying Need of the Hour", released on Friday, July 29, 2011.

Available on request on Pdf version if the below link doesn't open, also on the right side bar of this Blog under section "Alzheimer's basic websites".

Saturday, July 23, 2011

6 month course of geriatric care at the Geriatric India Center in Kochi, state of Kerala.



KMM Academy of Health Sciences is sponsored by KMM Educational & Charitable Trust. The KMM Trust is a non-profit making non sectarian charitable institution and is headed by Prof. V.J. Pappoo, formerly Pro-Vice-Chancellor of Cochin and Calicut Universities, as the Chief Executive Trustee. The institution is on its way to implement many innovative and futuristic projects.


This is a unique course, the first of its kind in India. It is designed to meet the requirements of the personnel engaged in health care services and the needs of the increasing number of senior citizens all over the Globe. The course is carefully structured as a multidisciplinary program to suit the requirements of medical practitioners in Modern medicine, Homeopathy, Ayurveda,Dentistry, Physiotherapy, Alternate medicine, Nursing and other paramedical sciences who are interested to pursue a career in Geriatrics, Geriatric Care and related areas. Professional social workers are also eligible to undergo the course.


Geriatrics is that branch of medicine dealing with the diagnosis and treatment of illnesses due to ageing. Geriatrics being an emerging field and Geriatric services and specialized services to senior citizens in a scientific way being relatively new, there is dearth of qualified personnel in the field.

A number of new institutions for the care and protection of the elderly are likely to be established in the years to come. Therefore, Doctors, nursing staff, medical support staff and social work personnel acquiring additional qualifications in the area of Geriatric services and Gerontechnology may have better employment /self employment opportunities in India and abroad.

The medical speciality of Geriatrics began in Western countries for the medical and psychological support of the senior citizens. This specialization has been a necessity in those countries due to the social and family environment prevailing there. The modern family set up in India too warrants the increased Gerontology need of Geriatric Care as one of the most important fields of Medicine, Nursing, Physiotherapy and social work professions. The 6 months PG Diploma Programme is treated as "ADAPTATION PROGRAMME" in many foreign countries. 240 hrs credit is given those who have taken a Diploma in Geriatric Care.


a) Distance education program so that candidates from anywhere may be able to register for the course

b) On-line Examination in order to enable candidates residing in different places to appear for the examination with out coming to the office of the Academy at Kochi

c) Examinations are arranged every month at the Kochi centre of the academy for the benefit of those who do not prefer On Line Examination system

d) Contact classes conducted by experts at periodical intervals

Governing Body

Prof. V.J Pappoo Managing Director

Dr.Joshi Joseph Director

Mr Jojo Joseph Director

(Member of American Geriatrics Society and Geriatrics Society of India, Authorized Agency for Certification under GSCC, United Kingdom.


i Three months theoretical orientation with the help of the course materials made available by the Academy

ii Three months field work for the preparation of a project report as part fulfillment of the course.


a) MBBS or any other degree in any branch of medicine including Dentistry Ayurveda or Alternate medicine

b) A Degree in Physiotherapy

c) A Degree/ Diploma in Nursing or any other paramedical subjects

d) BSW, MSW or equivalent qualifications

e) Motivation for taking up self employment/ employment in the area of Geriatrics, geriatric Care and related areas.


Candidates having the prescribed qualifications can register for the course on any date in a year, being a distance education program offered through correspondence. The period of 6 months duration of the course will be reckoned only from the date of registration on payment of the first installment of the course fees.

Course curriculam

Theory Papers
  • Introduction to Geriatrics Care
  • Biology of Ageing
  • Geriatrics Care and Modern Medicine
  • Geriatrics Care and other branches of Medicine
  • Environment and housing for the Elderly
  • Geriatric Counseling and Guidance
  • Dietetics for Geriatrics Care
  • Rehabilitation of the Elderly
  • Agencies for the welfare of the Elderly
  • Project work

Alzheimer's Disease in India : misconceptions, symptoms, needs of the caregivers... by Nitin J. Bahuguna, 2002.

"Alzheimer's - Grey Menace"

by Nitin Jugran Bahuguna

"In the absence of any known cure, Alzheimer's disease, a debilitating malaise that afflicts the elderly, continues to be regarded as the most dreaded manifestation of ageing.

Alzheimer's inspires many fears and misconceptions. Anxious queries about the disease range from the normal "Is it a mental disease, is it hereditary or is it the result of normal ageing", to the more ludicrous "Are past life events responsible for the onset of Alzheimer's disease".

Relatively little is known about Alzheimer's in India; and doctors here caution that people must now sit up and take notice of a disease which, according to one estimate, kills one out of four Indians over the age of 80. Without getting into the numbers game, Dr Kalyan Bagchi, President of the Society for Gerontological Research, a Delhi-based NGO, says, "It is quite possible that today, there may be thousands of patients totally undetected and undiagnosed."

Seema Puri, senior lecturer (her PhD work is related to gerontology) at the Institute of Home Economics, Delhi University, describes Alzheimer's as a condition of unknown origin that causes a gradual loss of abilities in memory, thinking, reasoning, orientation and concentration. It is not the
result of ageing but it does occur more frequently in persons 65 years of age or older, she explains.

The early stage of Alzheimer's is often overlooked and incorrectly labeled both by professionals as well as by family and friends as "old age" or a normal part of the ageing process. In an illustrative case, a 69-year-old retired Colonel in south Delhi started exhibiting moody behavior, alternating between bouts of animation and depression. His family however, attributed what they felt were temper tantrums to the onset of advancing years. They realized something was wrong only when he began to show signs of disorientation and uncharacteristic behavior which included cracking inappropriate jokes before guests.

Dr Bagchi explains that Alzheimer's affects each patient in a different way. The symptoms can broadly include difficulties with language, significant short-term memory loss, time disorientation, difficulty in making decisions, showing signs of depression and aggression and lack of initiative and motivation.

In the case of the retired Colonel, he started referring to the calendar to remember dates and had major gaps in memory. Most of his behavioral problems began in the evenings when he fell into a state of cognitive decline or dementia.

Dementia is defined as the loss of intellectual functions severe enough to interfere with an individual's daily function. Dementia is not a disease in itself but a group of symptoms that may appear in certain diseases or conditions; Alzheimer's is the most common among such conditions.

With the rapid increase of the grey population in India, Alzheimer's and other forms of dementia are becoming more prevalent among the elderly. Life expectancy has gone up from 20 years at the beginning of the 20th century to 62 years today, says Ms Nidhi Raj Kapoor of the Delhi-based NGO, HelpAge India. At present, India has an ageing population of 77 million; by 2025, the country will have 177 million elderly people.

Creating mass awareness about this tragic condition can help detect Alzheimer's at an early stage and create avenues for appropriate support and care to patients, says Dr Bagchi. The Society for Gerontological Research (SGR) has taken a concrete step in this direction with the recent launch of a publication titled 'Alzheimer's Disease in India".


Many thanks to of 23 July, 2011.

Research on Curcumin impact on Alzheimer's Disease in mice model (2004). Extract.

UCLA-VA study names India dietary staple as potential Alzheimer's weapon

Yellow pigment in curry spice blocks, breaks up brain plaques in mice.

"A dietary staple of India, where Alzheimer's disease rates are reportedly among the world's lowest, holds potential as a weapon in the fight against the disease.

The new UCLA-Veterans Affairs study involving genetically altered mice suggests that curcumin, the yellow pigment in curry spice, inhibits the accumulation of destructive beta amyloids in the brains of Alzheimer's patients and also breaks up existing plaques.

Reporting in the Dec. 7, 2004, online edition of the Journal of Biological Chemistry, the research team also determined curcumin is more effective in inhibiting formation of the protein fragments than many other drugs being tested as Alzheimer's treatments. The researchers found the low molecular weight and polar structure of curcumin allow it to penetrate the blood-brain barrier effectively and bind to beta amyloid.

In earlier studies (Journal of Neuroscience, 2001; 21:8370-8377; Neurobiology of Aging, 2001; 22:993-1005), the same research team found curcumin has powerful antioxidant and anti-inflammatory properties, which scientists believe help ease Alzheimer's symptoms caused by oxidation and inflammation.

The research team's body of research into curcumin has prompted the UCLA Alzheimer's Disease Research Center (ADRC) to begin human clinical trials to further evaluate its protective and therapeutic effects. More information about enrolling in this and other clinical trials at the Center is available by calling (310) 206-3779 or online at

"The prospect of finding a safe and effective new approach to both prevention and treatment of Alzheimer's disease is tremendously exciting," said principal investigator Gregory Cole. He is professor of medicine and neurology at the David Geffen School of Medicine at UCLA, associate director of the UCLA Alzheimer's Disease Research Center, and associate director of the Geriatric Research, Education and Clinical Center at the VA Greater Los Angeles Healthcare System at Sepulveda, Calif.

"Curcumin has been used for thousands of years as a safe anti-inflammatory in a variety of ailments as part of Indian traditional medicine," Cole said. "Recent successful studies in animal models support a growing interest in its possible use for diseases of aging involving oxidative damage and inflammation like Alzheimer's, cancer and heart disease. What we really need, however, are clinical trials to establish safe and effective doses in aging patients."

The research was funded by the Siegel Life Foundation, Veterans Affairs, Alzheimer's Association, UCLA Alzheimer's Disease Research Center and private donors".


Public release date: 28-Dec-2004
Contact: Dan Page

read more at :

5 Ayurvedic plants studied for their possible action on Alzheimer's Disease. BBC News 2006.

"India drug gives Alzheimer's hope",

Tuesday, 5 September 2006, BBC News.

"Scientists in the UK and India are examining the ancient Indian ayurvedic medicine for possible use in drugs to treat Alzheimer's disease.

Researchers say ayurveda works in the same way as conventional drugs for boosting mental agility in the disease.

They found that the plants used in ayurveda acted to improve memory and concentration in Alzheimer's sufferers.

Alzheimer's disease is a progressive, degenerative and irreversible brain disorder. There is no known cure.

The disease causes intellectual impairment, disorientation and eventually death.

Researchers from King's College, London and Jadavpur University in the eastern Indian city of Calcutta, studied five plants commonly used in ayurvedic medicine.

They found that the plants acted to prevent the breakdown of neurotransmitters, improving memory and concentration in people with Alzheimer's disease - the most common form of dementia.

The scientists are now trying to identify the chemical compounds responsible so they can be used to develop more effective drugs.

Alternative medication

Ayurveda is a 5,000-year-old Indian tradition of herbal and "alternative" medication.

Ayurvedic medicine uses herbs and spices like basil, turmeric, garlic, ginger and aloe vera, as well as yoga exercises, to treat physical and psychological problems.

The causes of Alzheimer's disease are not yet fully understood.

There are some very rare inherited cases caused by genetic mutations, but these account for around 1% of people with Alzheimer's.

Various types of therapy are used to try to stimulate Alzheimer's patients.

These include: psychological methods, art therapy, music therapy, playing with toys.

Some health professionals try to encourage patients to reminisce about past memories as a way to reduce depression without the use of drugs.

A variety of drug treatments have been shown to benefit patients. None are a cure, but they can temporarily relieve some of the symptoms in some patients".

Source : BBC News South Asia

Alzheimer's Disease in India Facebook Page.

Dear members, Alzheimer’s Disease in India is a discussion group connected with ARDSI, HelpAge India, Dementia Care Notes from Bangalore, Silver Innings in Mumbai... with the aim of raising awareness on AD and Dementia Syndromes care in India. We are on the Net to build a strong care professionals and family caregivers network for/ in India. 

At our Facebook page, you may get inputs from other care professionals and family members involved in dementia syndromes care in India but also from various places in the world. Here, you can get informations on AD, on the available support groups in India and get to know more on the ressource places wherever you are located in India. Of course, the value of this group will depend on the informations you’ll feed us with.

For private counseling, requesting the disclosure of your situation you may (if you feel more comfortable with that) email me or “leave a note” at the Dementia Care Notes facebook page. To get the AD brochures provided by our members in your langage, you may send your address through their inbox and not on the facebook page. 

You may also take a look at our LinkedIn Group for care professionals. These groups are open to inputs from various places and practices as Ageing and AD are global issues. They are patients centered and family centered of course, but also, deals with the serious issue of the Public Health Care System in India, to better cope with the needs of the raising elderly population there. 

They are made to share our views, our practices, our strategies, to provide support and ideas to be discussed for possible implementations in the indian setting.

Thanks for your contributions,

Ms Hendi Lingiah.

Clinical Psychologist in gerontology.

Friday, July 22, 2011

"Twelve steps for care-givers" : advices toward caregivers in South East Asian context.

Friday, July 22, 2011

"Care-givers and caring

The immediate family members of patients are often elderly themselves and have their own medical problems. The care-givers should never neglect their own health as their well-being is vital for appropriate care of the patient.

It has been said about Alzheimer’s disease that although the patient has the disease, the family members suffer the most.

In the cultural context of the Member Countries of South-East Asia, care of Alzheimer’s disease patients is best provided by lay care-givers. These lay care-givers should be specifically trained in patient care. They must understand what Alzheimer’s disease is, and what the patient is capable or incapable of doing. Ideally, continuity of care by the same care-giver is desirable, but this may not be practical. The "fatigue factor" of care-givers also needs to be taken into consideration. Immediate family members should be available to extend psychological support and supervision of lay care-givers. It is not necessary for them to do the physical work themselves.

It has been reported that almost half the patients in a study undertaken in Mumbai, India, were either single or widowed. This finding is significant as research workers came across patients who, having nobody to take care of them, were being looked after by neighbours. Clearly, there is a pressing need for state and community organizations to create the infrastructure necessary for the care of such persons. Ironically, none of the residential institutions for the elderly were willing to take in persons diagnosed with Alzheimer’s disease. Since the patients are looked after by their families until the time of death, there is a tremendous need for the education of care-givers and other forms of support. Without this, there is a high risk of patient neglect.

Management of patients of Alzheimer’s disease

While there is no specific cure for Alzheimer’s disease, there is a need to look after the patients as well as their care-givers. Non-pharmacological interventions and the use of residential and domestic resources, such as day care, respite care and nursing home care, may reduce symptoms and suffering. Another important factor is financial and legal counselling essentially needed to preserve income and take decisions affecting the whole family.

In the early stages of Alzheimer’s disease, when intellectual function is reasonably preserved, patients may be encouraged to attend to legal matters and give consent to the types of treatment that they desire. These would form the Advance Directives of the person. An Enduring or Durable Power of Attorney could be prepared in favour of a loved one in the family or some close friend if such procedures are established in the country’s legal system. A formal will could also be executed before it is too late as a result of the patient’s mental incompetence.

In the later stages of Alzheimer’s disease, the patient may not be aware of the consequences of the illness and it would then be a family decision to get him/her assessed and investigated.

Treatment would mostly be based on the symptoms observed and arrangements have to be made for the long-term care of the individual by way of providing for care-givers, especially if there are none in the family.

11.- Although I cannot control the disease process, I need to remember I can control many aspects of how it affects my relative.
2. - I need to take care of myself, so that I can continue doing the things that are most important.
3. - I need to simplify my lifestyle so that my time and energy are available for things that are really important at this time.
4. - I need to cultivate the gift of allowing others to help me because caring for my relative is too big a job to be done by one person.
5. - I need to take one day at a time rather than worry about what may or may not happen in the future.
6. - I need to structure my day because a consistent schedule makes life easier for me and my relative.
7. - I need to have a sense of humour because laughter helps to put things in a more positive perspective.
8. - I need to remember that my relative is not being difficult on purpose; rather that his behaviour and emotions are distorted by the illness.
9. - I need to focus on and enjoy what my relative can still do rather than constantly lament over what is gone.
10. - I need to increasingly depend upon other relationships for love and support.
11. - I need to frequently remind myself that I am doing the best that I can at this very moment.
12. - I need to draw upon the Higher Power, which I believe is available to me".

from theAlzheimer's Assoc :​pdfs/caregivers.pdf

Thursday, July 21, 2011

An indian movie on Alzheimer's Disease : "Maine Gandhi Ko Nahin Mara" (2005).

Maine Gandhi Ko Nahin Mara (translated as I Did Not Kill Gandhi) (2005), is an Indian film, directed byJahnu Barua and produced by Anupam Kher. The film stars Anupam Kher and Urmila Matondkar in lead roles.

In the film, a poem by noted Hindi poet, Nirala, Himmat Karne Walon Ki Har Nahi Hoti (Those who have courage never fail) was depicted as the favorite poem of the main character.

The film explores the downward spiral of a retired Hindi professor, Uttam Chaudhary, (portrayed by Anupam Kher), as he falls victim to dementia. After he sees someone carelessly place a cup on a newspaper photograph of Mahatma Gandhi, his senility increases. One night his daughter Trisha, played by Urmila Matondkar, and son Karan discover his room on fire. Trisha takes him to a doctor who says nothing can be done.

Then Uttam believes he killed Mahatma Gandhi by accidentally playing with a toy gun which had real bullets and shooting Gandhi during his walk in Birla House. So they go see Uttam's brother for details. Uttam's brother says that when they were young, they played darts by filling ballons with red dye and placing it on someone's picture.

One day someone found Gandhi's picture and Uttam popped a ballon while their father saw who believed he killed Gandhi, with Uttam replying "Maine Gandhi Ko Nahin Mara" while his father hit him. Later they go to another doctor named Siddharth Parvin Dabas who helps Uttam when he thinks that his house is jail and people poisoned his food because he killed Gandhi. Siddharth eats the food so Uttam knows the food is not poisoned. Later they are in court and a gun expert says that a toy gun (which Uttam believes he killed Gandhi with) can not kill anyone.

The movie did not do well at the box office. However, it was much appreciated by audiences and critics. Anupam Kher received critical acclaim for his performance and won a Special Jury Award at the National Film Awards. He also received awards at several international film festivals. Matondkar was also much appreciated for playing the caring daughter of Kher and won the Bollywood Movie Award - Best Actress for her performance.

source Wikipedia :