Every year on September 21, World Alzheimer's Day is observed. It is a global effort to raise awareness and challenge the stigma around Alzheimer's disease and other dementia.

Alzheimer's is a severe brain disorder of memory loss and confusion. If it is not diagnosed and managed on time, it can also adversely impact one's mental abilities of learning, thinking, reasoning, remembering, problem-solving, decision-making, and attention.

Every year, a particular theme is followed, this year, the theme is "Time to act on dementia, Time to act on Alzheimer's".

The theme focuses on attitudes towards dementia and addresses the stigma and discrimination that still exists. Some of the common attitudes towards dementia are the common belief that dementia is a normal part of ageing, with 62% of healthcare practitioners actually believing it to be true. 35% of carers had hidden a diagnosis of dementia and 1 out of 4 thought that nothing could be done about it.

History

The first time this day was introduced was in 1994 in Edinburgh, on the occasion of the 10th anniversary of Alzheimer's Disease International (ADI). This organisation was founded in 1984 to support and guide Alzheimer's disease patients and their families.

The organisation also runs Alzheimer's University and aims to connect people around the world to promote Alzheimer's Month, which is also celebrated in September.

What Is Dementia, What Is Alzheimer's?

As per Neha Sinha, Dementia Specialist, CEO and Co-founder of Epoch Elder Care, it is a progressive decline in cognitive abilities, including memory, language, problem-solving and other thinking skills. It is severe enough to interfere with daily life. "It primarily affects older adults, with Alzheimer's being the most common," she says.

Alzheimer's accounts for 60 to 80% of all dementia cases around the world. It is estimated that the prevalence of Alzheimer's worldwide is around 2.4 crores.

While Dementia is the general term for a range of symptoms that affect cognitive abilities, while Alzheimer's is the most common form of dementia.

Shilpi Saraswat, Clinical Psychologist at Sakra World Hospital, Bengaluru points out that the main risk factors of dementia are age, genetics, long-term health conditions, lifestyle choices such as smoking or excessive alcohol use, one's gender and cognitive reserve.

Dementia In Indian Household

Sinha points out that in India, the subtle onset of dementia is quietly emerging as a silent epidemic, affecting millions of households across the country. As per the Neurological Health Atlas of India, 8.8 million elderly are currently living with dementia. "A number that can be doubled by 2036," says Sinha.

Sinha also points out that since its earliest symptoms are often ignored as signs of early ageing, Dementia stays ignored and creeps into the household unnoticed.

"Discovering Alzheimer’s early can be a pivotal moment, offering a window of opportunity that changes the course of the disease. With an early diagnosis, we can initiate medical treatments and a management plan, that may slow down the progression, giving patients and their loved ones more quality time together," says Sinha.

When care is tailored to the person, not just the disease, it profoundly enhances their quality of life. It’s about more than just managing symptoms—it’s about nurturing emotional well-being, maintaining dignity, and providing the support that adapts as the disease evolves.

Can Hearing Loss Lead To Dementia?

While age is one of the risk factors in dementia, Dr Sanjay Sachdeva, a senior ENT at HearClear India suggests a link between hearing loss and dementia.

As per a study by the Lancet Commission on Dementia, untreated hearing loss can give rise to greater cognitive decline and even account for approximately 8% of dementia cases worldwide. This means, 8 lakh of the nearly 1 crore new cases of dementia are diagnosed every year.

"Considering that auditory information plays a pivotal role in forming memories and associations, hearing impairment interferes with the brain’s ability to process auditory information, which consequently deteriorates memory and learning abilities," says Dr Sachdeva. Additionally, hearing loss in ageing people can go beyond the inability to hear things and can contribute to social isolation in them.

What Can Help Reduce It?

Saraswat point out that by modifying 12 risk factors through lifestyle changes, 40% of the dementia cases can be delayed.

Some of the specific actions include maintaining systolic BP of 130 mm Hg or less in midlife from around age 40 years (antihypertensive treatment for hypertension is the only known effective preventive medication for dementia).

Encouraging the use of hearing aids for hearing loss and reduce hearing loss by protecting of ears from excessive noise exposure.

Other such prevention methods include:

• Reduce exposure to air pollution and second-hand tobacco smoke.
• Prevent head injury.
• Limit alcohol use, as alcohol misuse and drinking more than 21 units weekly increase the risk of dementia.
• Avoid smoking uptake and support smoking cessation to stop smoking, as this reduces the risk of dementia even in later life.
• Provide all children with primary and secondary education about brain health.
• Reduce obesity and the linked condition of diabetes. Sustain midlife, and possibly later life physical activity.
• Addressing other putative risk factors for dementia, like sleep, through lifestyle interventions, will improve general health.

The United States Food and Drug Administration has recently approved cabozantinib (Cabometyx) for patients with previously treated advanced neuroendocrine tumors. This is an oral tyrosine kinase inhibitor, which is offering a new standard for care of this patient group. This has been announced by the Dana-Farber Cancer Institute.

How Was The Drug Approved?

The approval came on the bases of the results from the phase 3 CABINET study. The study compared cabozantinib to a placebo in patients with advanced pancreatic neuroendocrine tumors.

As per the National Cancer Institute, neuroendocrine tumor grows from neuroendocrine cells. These cells receive and send messages through hormones to help the body function. These cells are found in organs throughout the body. The neuroendocrine tumor was called carcinoid tumor

These tumors grow very slowly and are mostly found in appendix, also known as appendiceal neuroendocrine tumors. When found in lungs, they are also called bronchial tumors. These areas are more common in children and young adults. Whereas for adults, it is mostly found in the digestive tract, called the GI neuroendocrine tumor. What makes it concerning is that it can also spread to other parts of the body but does so more in adults than in children.

They are rare in children and more common in adults, affecting up to 4 in 100,000 adults.

The drug which FDA has approved based on the phase 3 CABINER study's results have been published last September in the New England Journal of Medicine. Patients who were treated with cabozantinib survived significantly longer with no worsening of their disease compared with patients who received placebo. This also improved the efficacy as was observed in the interim analysis. The trial was in fact terminated early and unblinded in August 2023.

Are There Any Side Effects From The FDA Approved Drugs?

The reported side effects of cabozantinib were similar to those found in other studies of the drug. They include:

• Hypertension
• Fatigue
• Diarrhea

"Patients with neuroendocrine tumors often face a difficult journey," lead author of the CABINET study, Jennifer Chan, M.D., M.P.H., of the Dana-Farber Cancer Institute, said in a statement. "Despite advances in recent years, there has remained a critical need for new and effective therapies for patients whose cancer has grown or spread. Cabozantinib significantly improved outcomes in this patient population and this FDA approval provides new hope."

How Is Neuroendocrine tumor diagnosed?

While some people have symptoms, others may do not have any symptoms. These symptoms depends on where in your body the tumor has grown.

Patients who have appendiceal neuroendocrine tumors may have symptoms of appendicitis, such as pain in abdomen. They could also be later diagnosed with carcinoid tumor in case the doctor removes the appendix and finds a tumor. Patients with carcinoid tumor in other parts of the digestive tract may have symptoms such as:

• Pain in the abdomen
• Nausea or vomiting
• Diarrhea

Other ways to detect is by lab tests, imaging, and biopsy.

For most women, this reality is what menopause feels like, a time when hormonal changes impact everything from sleep routines to mood stability. Oprah Winfrey recently shared her own personal battle with menopause, exposing how it left her unable to read her favorite books or even host her famous book club. In a candid conversation, Winfrey explained how the overwhelming symptoms—especially heart palpitations and an inability to concentrate—left her feeling like she was “literally going to die every single night.”

It’s a topic that’s often kept behind closed doors, but menopause affects millions of women globally. According to the National Institute on Aging, menopause is reached when a woman has had no period for 12 months in a row, normally between the ages of 45-55, and may create a variety of symptoms ranging from hot flashes to emotional upset. Oprah's announcement of her own menopause experience highlights the not-so-well-known symptoms and raises awareness of the need for greater information and support. Let's take Oprah's journey and see how we can learn more about and cope with this natural but too-often-misunderstood phase of life.

But media mogul Oprah Winfrey is breaking that. In a recent interview, Winfrey, 71, spoke candidly about her own menopause experience, describing an ordeal so overwhelming that she thought she was "going to die every single night."

Winfrey's confession is not simply another celebrity revelation—it's a wake-up call for millions of women across the globe who suffer from menopausal symptoms in ignorance, without proper medical attention, or public support.

Menopause, that phase of life when a woman's menstrual cycle permanently ceases because of the decrease in estrogen and progesterone levels, is usually coupled with symptoms of hot flashes and night sweats. But in Winfrey's case, it was different—though no less unsettling.

One of the most surprising and disturbing symptoms that she experienced was one of inattention. An avid reader since childhood and the face of Oprah's Book Club, she discovered that she couldn't read.

The worst for me, this is when I realized I really was in trouble, is when I couldn't focus reading," Winfrey explained to ABC News' Kayna Whitworth. "I adore reading so much, but I abandoned the book club because I could not focus when I was reading. I could no longer complete a book.

It wasn't until she began hormone therapy with estrogen that she regained her concentration. "I brought back [the book club] when I began taking estrogen because I could concentrate again, but I actually never mentioned that before," she confessed. "It makes me want to cry."

Lesser-Known Symptoms of Menopause

Although night sweats and hot flashes are universally acknowledged as symptoms of menopause, other physical and psychological consequences tend to go unmentioned. Winfrey felt palpitations of the heart—a symptom she never correlated with menopause.

"I did not have night sweats, and I did not have hot flashes, but I had never heard that palpitations [were] a symptom of menopause," she explained. "When I was going through it, there was nothing. There was nobody."

This absence of knowledge concerning the entire range of menopausal symptoms is a crucial concern. Menopause influences each woman uniquely, with some suffering from anxiety, depression, insomnia, mental fogginess, or even arthritis, says the National Institute of Health (NIH). And though it touches everyone equally, menopause has been among the least talked about and most under-studied topics in women's health.

Committed to making sure that other women do not have to endure in silence, Winfrey is leveraging her platform to ignite a long-overdue discussion. Her new Hulu special, An Oprah Winfrey Special: The Menopause Revolution, seeks to inform and empower women on menopause, offering expert advice and real-life stories to guide them through this stage of life with confidence.

She also tweeted to highlight how crucial it was to discuss menopause. "When I underwent menopause, I couldn't sleep for two years. I couldn't concentrate. I couldn't read my favorite books. I had heart palpitations. Nobody informed me about this. Now we're discussing it, so no woman suffers," she posted on Facebook.

Winfrey's advocacy is part of a larger effort to make menopause conversations mainstream and better healthcare responses. Women should have access to proper information and healthcare providers who seriously consider their symptoms.

What Women Need to Know About Seeking the Right Medical Support?

Winfrey's experience teaches an important lesson: women need not be afraid to get a medical consult when they are experiencing symptoms of menopause. "Because it hits every cell in your body, the first time you have any of the symptoms, that's when you need to go go find a doctor who will hear you, listen to you, and take action for you," she encouraged.

Far too frequently, women's menopausal symptoms are downplayed, and they must cope with the changes by themselves. Professionals advise going to see a gynecologist or a menopause specialist as early as perimenopause—the pre-menopause phase—so that possibilities such as hormone therapy, lifestyle modifications, and other forms of treatment can be discussed.

Oprah Winfrey's honest narrative about her battle with menopause is a call to change the way society understands and responds to this natural phenomenon. It's about tearing down the taboo and myth surrounding menopause so that future generations of women will be better equipped and empowered.

With powerful voices such as Winfrey at the forefront, menopause is no longer a silent battle—it's a dialogue that must be heard.

In an exclusive interview with Health and Me, Lt Gen Dr. Vimal Arora who is the Chief Clinical Officer (CCO) at Clove Dental talked about his experiences of treating the former Presidents of India and the time when he served as one of the doctors at the Air Force Institute of Dental Sciences in Bengaluru.

In 1982, Rakesh Sharma was selected as a cosmonaut for a joint Soviet-Indian spaceflight. With him, ex IAF Pilot Ravish Malhotra was also selected who was trained to fly on that mission as a backup for Rakesh Sharma. For this mission, Sharma was rigorously trained at Moscow's Yuri Gagarin Cosmonaut Training Center for two years. He also underwent a test for claustrophobia in Bengaluru's Indian Air Force facility with being locked in a room for 72 hours for the test.

It was there only when Dr Arora had come across the case. "I was young in Bengaluru, and we had these India astronauts who would go along with Russian astronauts and the medical were also going on. At that time, I distinctly remember Rakesh Sharma and Ravish Malhotra and only one of them were supposed to go," he shares.

It was there when Dr Arora got caught in a debate with regards to their medical checkup. It was on whether the astronauts should have their wisdom tooth removed.

"Their dental checkups were done and we were told that their wisdom teeth had to be taken out. We were fighting with them (Russian doctors)," Dr Arora shares.

"I said, 'they are perfectly fine, why is there a need to extract their tooth? It is not going to cause any trouble.' But it was made very clear from the Russians and their team of doctors and dentists that wisdom teeth must be removed."

The reason for this was, as Dr Arora explained, the astronauts, the mission and everyone else who have invested in the spaceflight could not let a wisdom tooth ache become a issue to cancel the trip. Even if there is a chance that this may cause tooth pain, the trip had to be called back and the team could not afford that.

"This is when I learned the wisdom tooth has to go away. It was a different lesson for me at that time," he shares.

After that, Dr Arora says that many more things had enlightened him, including the first intra oral full mouth x-ray machines which had also been imported there.

He says that dentistry has changed unimaginably. The amount of technology that dentists used is not used in any other health sector.

His experiences do not just end there. He has also treated the former Presidents of India including Dr APJ Abdul Kalam and Dr Pranab Mukherjee.

"What makes them stand apart was the simplicity with which they treated the doctor. I remember that I was more nervous when I had to talk to Dr Kalam. But he always had this child-like simplicity and child-like curiosity. He always left with some kind of messages and it gave me a different lesson in my life."