Alzheimer’s: Symptoms, Treatments, and Insurance in India

Alzheimer’s disease and related dementias (ADRD) are a progressive disorder that affects the brain and nervous system. They are currently non-reversible and the primary Alzheimer’s symptoms include disruptions to memory and thinking. New research states that 7.4% of seniors (above 60 years of age) have dementia. This amounts to about 8.8 million people. It is estimated that by 2050, 75% of ADRD cases will come from low and middle-income countries. Given that India’s population will have nearly 20% senior citizens (about 319 million individuals) by 2050, there could be an alarming rise in ADRD cases – given that age is the strongest risk factor for ADRD cases. Insurance for Alzheimer’s patients must be addressed in healthcare systems for adequate Alzheimer’s treatment and caregiving support. 

Understanding dementia

Dementia is a term used to describe a decline in mental ability severe enough to interfere with daily life. It’s not a specific disease but a general term for the impaired ability to remember, think, or make decisions that affect everyday activities. Here are some common types of dementia:

1. Alzheimer’s disease: The most common type, causing memory loss and confusion.
2. Vascular Dementia: Caused by reduced blood flow to the brain, often after a stroke.
3. Lewy Body Dementia: Involves protein deposits in the brain, leading to memory issues, hallucinations, and muscle stiffness.
4. Frontotemporal Dementia: Affects the brain’s frontal and temporal lobes, altering personality, behaviour, and language skills.

Alzheimer’s symptoms and other dementias

As these are progressive diseases, the symptoms tend to get worse over time. We can categorise them as follows:

Early Alzheimer’s symptoms:

• Forgetting recent events or information
• Trouble making plans or solving problems
• Difficulty doing familiar tasks

Progressive Alzheimer’s symptoms:

• Confusion about time or place
• Trouble understanding visual images and spaces
• Problems with speaking or writing

Advanced Alzheimer’s symptoms:

• Severe memory loss and confusion
• Changes in mood and behaviour
• Inability to perform everyday activities
• Unable to recognise family members

Causes and risk factors

The causes and risk factors for ADRD are not black and white. While carrying certain variants of specific genes significantly increases the likelihood of developing dementia, there are a host of other factors that we are still discovering. 

For Alzheimer’s disease:

• Genetic: The APOE variant 4 gene has shown a strong link to developing Alzheimer’s. 
• Age: The biggest risk factor that we know is age. Alzheimer’s primarily occurs in individuals above the age of 65.
• Lifestyle: Smoking, lack of exercise, excessive alcohol intake, obesity, hypertension, diabetes, and depression can all increase the likelihood of Alzheimer’s. 

For related dementias:

• Vascular dementia: Factors that affect cardiovascular health and can cause a stroke such as smoking, high cholesterol, and high blood pressure.
• Lewy body dementia: Age is the biggest factor, along with SNCA or SNCB gene mutations.
• Front-temporal dementia: A rare type of dementia that usually affects individuals in the 45-60 age group, researchers are still finding specific causes for FTD.

Alzheimer’s diagnosis and treatment

While there is no cure for ADRD, the adage ‘a stitch in time saves nine’ still holds true. Early diagnosis can help manage Alzheimer’s symptoms and may even slow the progression of the disease. Diagnosis involves cognitive and neuropsychological tests to assess thinking and memory. Brain imaging such as MRI or CT scans can reveal brain changes while blood tests may help rule out other conditions.

Treatment Options for Dementia

Medication: Cholinesterase inhibitors like Donepezil and Memantine help manage cognitive symptoms by supporting communication between nerve cells. Other drugs and therapies target other Alzheimer’s symptoms such as agitation, bipolar disorder, insomnia, and others to improve the quality of life. 

Non-drug therapies: Cognitive stimulation therapy, physical activity, and social engagement support cognitive function and overall well-being.

Insurance for Alzheimer’s patients

Inclusions: Most insurance policies cover Alzheimer’s treatment – some have it as part of their comprehensive health insurance plan, others have a dedicated plan, while some could include it in a critical illness cover. These plans typically cover diagnosis and testing, pre- and post-hospitalisation costs, medication, hospitalisation or domiciliary care, and ambulance fees.

Cost: Depending on the progression, severity, and lifestyle factors of the affected, perhaps the main cost would be that of the caregiver at home. Some estimates say it could cost about ₹40,000 a month. At-home care, including skilled nursing care and therapy, that some insurers provide can alleviate this burden to a significant extent.

Exclusions: However, the standard waiting period rules and exclusions apply. Most policies have a waiting period after which the coverage begins. If the illness is diagnosed within 30 days (waiting period) of having purchased the policy, it may not be covered. Furthermore, pre-existing illnesses are excluded. Brain damage caused due to intentional alcohol or drug abuse may not be covered. 

That is why it is recommended to purchase a comprehensive health insurance policy which covers Alzheimer’s treatment well in advance, especially if you have the mentioned risk factors. If someone in your family has had a form of dementia, or if you begin to experience some of the symptoms yourself, you can plan for your care with adequate coverage.

Key Takeaways

Firstly, individuals should prioritise regular health check-ups and screenings to monitor cognitive health. Financial planning is essential, including estimating potential care costs and exploring insurance for Alzheimer’s patients that could provide support. It’s crucial to establish legal frameworks such as power of attorney and living wills early on to ensure decisions are made with your personal preferences as your cognitive abilities change. Building a strong support network, including family members, and caregivers, can provide both practical assistance and emotional support. Staying mentally and physically active through activities like cognitive exercises and regular exercise can also help maintain brain health.

Additionally, you can consider platforms like PhonePe for a seamless and hassle-free insurance purchase experience.