Spain’s ageing population and the accompanying rise in neurodegenerative diseases such as Alzheimer’s is clearly reflected in statistics about causes of death.
According to the National Statistics Institute (INE), in 2000, a total of 5,382 people died of the same illness that afflicted the recently deceased Adolfo Suárez, Spain’s first democratically elected prime minister.
By 2012, the last year for which figures are available, that number had risen to 13,015, representing a 141.8-percent increase. This is an enormous rise considering that overall deaths in Spain only grew 11.8 percent over the same period.
The Spanish Neurology Society (SEN) estimates that around 600,000 individuals suffer from Alzheimer’s, although other researchers place the figure at closer to 800,000. The problem is that between 30 and 40 percent of sufferers are unaware of their condition, since symptoms in the initial stages of the disease are nearly imperceptible.
Between 30 and 40 percent of
Alzheimer’s does not kill directly. Instead, it irreversibly deteriorates cognitive functions as a result of a failure in the brain’s cleaning system that causes an accumulation of two types of protein: amyloid beta proteins outside the neurons and tau proteins within them. This deterioration “does not affect the autonomous nervous system, which keeps the heart beating and the lungs working” explains Alberto Lleó, head of the Memory Unit at the neurology department of Sant Pau Hospital in Barcelona. “What happens is that Alzheimer’s produces a general weakening of the patient.”
That is why around 75 percent of patients actually die from infections, notes Pedro Gil Gregorio, head of the geriatrics department at Madrid’s Hospital Clínico and chief of its Memory Unit.“We need to distinguish between the immediate cause, pneumonia, and the underlying cause, which is the Alzheimer’s that shows up in the statistics” he says.
Another key element affecting Alzheimer’s patients is malnutrition. And then there are all the other conditions that come with old age.“Having Alzheimer’s does not preclude also having cancer or a heart attack,” notes Gil Gregorio.
Even in advanced cases patients’ eyes light up when a loved one is near
But infections remain the number one concern.“If elderly people in general have weaker immune systems, this seems to be even more so with Alzheimer’s patients, although we do not have an explanation for it,” adds Gil Gregorio.
Yet despite all the deterioration, “the limbic system, which deals with emotions, is highly resistant. That is why even in very advanced states [of Alzheimer’s] there is still a reaction to emotion and warmth,” says Lleó, who is also a principal researcher at Ciberned (Center for Networked Biomedical Research on Neurodegenerative Diseases).“This is very important for their families. Even in very advanced cases we can see how their eyes light up when a person they love comes near. They do not recognize this person or know who it is, but they feel that it is someone important. That is why it is so important for them to feel this warmth until the very end. In this sense, families play a very useful role.”