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Dementia patients confined at the intersection of routine therapeutic activities and violation of Covid-19 containment measures

Dementia & Covid 19

Dementia & Covid 19

By Stephen Macharia

Today, Azibeta Likhaya, 81, does not understand why she cannot embrace, shake hands or get physically close to family members at her home in Roasterman Village, Kakamega County even as Covid-19 infections upsurge in Kenya.

She lives with comorbidities; Dementia a syndrome characterized by a decline in memory, language and ability to perform daily activities; Arthritis which is a chronic disabling condition affecting body joints, muscles plus connective tissues; and Hypertension, an illness that subjects blood vessels to persistently raised pressure.

However, Azibeta’s dementia syndrome is what worries the family as cases of Covid-19 spread across the country.

Oblivious of her susceptibility to contracting Covid-19, Azibeta, now living under stricter confinement measures her family imposed since Kenya recorded the first Covid-19 case in mid-March, currently manifests forms of aggression towards regaining lost reassuring habits: visiting neighbours; greeting people; and freedom from family surveillance.

The family is now in a rattrap when it comes to handling her situation amid rising Covid-19 infections, her son and caregiver Mr. Wyclif Likhaya, admits. “Granting her freedom to move around increases her exposure to Covid-19 but we understand excessive restrictions may end up upsetting her mental well-being.”

Worse still, she cannot wear a facemask for long before throwing it away for making her “feel uncomfortable”.

In Roasterman Village, located four kilometers from Kakamega town, residents live in palpable fear of Covid-19 infections. A section of the village serves as the town dump site where all forms of waste, including used facemasks and medical waste, litter the surface. The dumpsite is less than two kilometers from Azibeta’s home.

Mr. Likhaya, a graduate in Social Work who also serves as a volunteer caregiver for two other neighbours living with chronic illnesses, knows her mum’s condition requires “careful handling”.

Outside the home compound, the family discerns, Azibeta cannot consistently observe Covid-19 preventive measures enforced by the government, setting her up for arrest by authorities.

“Mum keeps asking why people do not show her appreciation by …..

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Alzheimer’s Disease and Diabetes: What’s the connection?

ALZHEIMER’S DISEASE AND DIABETES

ALZHEIMER’S DISEASE AND DIABETES

Research has shown that the pathophysiology of Alzheimer’s disease (AD) is related to various processes in diabetes. This article summarizes what is currently known about the diabetes-Alzheimer’s connection and how this may pave the way for new treatments for the disease.

What is Alzheimer’s Disease?

Alzheimer’s disease (AD), sometimes also called “late-onset dementia,” is a neurological disorder that accounts for more than half of all diagnosed cases of dementia. Its incidence is increasing, and it is estimated that by 2025, over 7 million Americans will be affected.

The main symptoms of AD are short-term memory loss and cognitive impairment, which can affect many vital functions, including:

  • Communication
  • Decision making
  • Motor control
  • Numerous behavioral aspects

Typically, the disease is progressive, with escalating symptoms that eventually interfere significantly with typical daily life tasks.

On the molecular level, AD is primarily caused by the accumulation of abnormally processed proteins (in particular, amyloid beta) in the brain. The abnormal proteins form aggregates, referred to as plaques, which can be visualized with various brain imagining techniques. These abnormalities can “trigger oxidative stress, microvascular dysfunction, and blood–brain barrier (BBB) disruption, and can induce the activation of an inflammatory response within the brain, ultimately resulting in neuronal damage and consequent neurodegeneration.”

Connections to Diabetes

The pathophysiology of Alzheimer’s appears to be related to certain processes that occur in diabetes. In fact, the….

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Raising Awareness of Dementia in Kenya

Raising Awareness of Dementia in Kenya

Raising Awareness of Dementia in Kenya

Raising Awareness of Dementia in Kenya

Most health care plans in Kenya have excluded older persons, especially those living with dementia, which makes it more difficult to advocate for their health since it has not been made a priority compared to other diseases that the government supports. Dementia is usually not viewed as a disease but more as a normal part of ageing.

Wambui Karanja, WYLD lead for the African Region, shares some of the key activations during World Alzheimer’s Month 2018, and efforts in raising awareness of dementia in Kenya

Alzheimer’s and Dementia Organization Kenya (ADOK1) is a non-governmental organization which was recently founded to support people with dementia and their caregivers and to create awareness on dementia in Kenya. The work of ADOK is crucial as we see a rise of neurodegenerative disorders here in Kenya.

While speaking on World Alzheimer’s day in Nairobi, Dr Juzar Hooker, a consultant neurologist at the Agha Khan University Hospital, noted that he has seen the number of cases of dementia increase over the past 15 years. As the number of older people grows due to an increased life expectancy in Africa, more cases of dementia are estimated to arise.

ADOK’s first priority is creating awareness on dementia in the country. According to the Alzheimer’s Disease International report on Dementia in sub-Saharan Africa2, there is often no equivalent term for dementia in local languages and a general lack of awareness in local communities. When we held awareness campaigns on dementia, we found that people lacked the term to describe dementia. However, they could understand what we were describing and knew someone living with dementia-like symptoms in the community.

For the first time, ADOK marked World Alzheimer’s month last September and took various steps to create awareness despite shortage of resources. Members and volunteers of the organization came together to engage in various initiatives. The events included visits to different churches to create awareness on Alzheimer’s Disease and other types of dementia. In addition to the five churches we visited, we went to an old people’s home where we donated food items and toiletries and had a fun day with them. We found it more cost-effective to engage already organized groups and institutions on awareness creation compared to organizing independent events.

ADOK appeared on five local national television stations – four of which are English broadcasting stations and one broadcasting in Kikuyu, a local language widely spoken in Kenya. It was the very first time a feature on dementia was done in a local language. The feature in Kikuyu was a huge success as compared to those in English. It gained over 17,000 views on YouTube, while the others received less than 1000 views each. We also realized that we had more feedback on awareness created in local languages than during sessions we conducted in English. This shows the great need for health education in local languages which we tended to ignore before, and with which we need to engage more with.

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