Panaji: It has been nothing short of a roller coaster ride for Donna Noronha who has been caring for her mother, a fiercely independent woman who was diagnosed with Alzheimer’s in 2017. Early signs of the disease were not easy to identify, she said, as her mother had always been strong-willed by nature.“She was irritable, constantly losing things and blaming people around her, but we never thought much of it until things got out of hand,” Noronha said.Her mother would head to the market every day to buy groceries under the impression that there was no food in the house. “I couldn’t stop her from leading an independent life but at the same time, I had to silently enter her space to manage affairs, which was challenging,” Noronha told TOI. She went around explaining her mother’s condition to shopkeepers and vendors, and requested them to contact her in case there was a difficult situation.Noronha says she takes it one day at a time as her mother, who is not ready to give in to anything without a fight, can get abusive too. “The abuse can get terrible, but I remind myself that this is the disease taking over my mother and that I must disassociate myself from the feelings of hurt she throws towards me. It’s like having to navigate a storm,” she said.Noronha drew strength from interacting with others who are also caring for family members with the same disease, and said she felt relieved to exchange notes and find that she was not alone in her struggles.“The idea is not to do everything for the person with Alzheimer’s out of goodness. This only adds to their decline. One needs to give them the right support and at the same time, keep them physically and functionally independent,” said head of the GMC’s neurology department, Dr Teresa Ferreira.The GMC sees an average of five new dementia patients each week, of which four have Alzheimer’s, she said. Sixty per cent of them come in with moderate to severe Alzheimer’s. “Most get diagnosed when the disease has already significantly advanced because the signs of dementia are often dismissed by family members as being a natural process of ageing and because they feel nothing can be done about it,” she said.“When Alzheimer’s is diagnosed early, patients can be helped to function independently for a few more years. It is also important for them to keep blood pressure, diabetes and lipid profile under control,” Ferreira said. “Uncontrolled sugars and blood pressure along with Alzheimer’s puts the patient at higher risk of small strokes which tends to accelerate the progression of the disease.”Director of COOJ Mental Health Foundation, Dr Peter Castelino, told TOI that although dementia is a disease of the elderly, he has seen people in their early 40 and 50s diagnosed with it. They are people who may have chronic alcoholism, HIV/AIDS or brain injuries.“Diet, exercise, social interaction and challenging the brain are very important to keep the elderly stimulated. Learning something new at any age is excellent for the brain,” Castelino said. “Many elderly come in with sleep disturbance problems, but when we probe further, we find there’s a larger issue. They say they’re sad, losing interest in daily activities, can’t get rid of ruminating, and are worried a lot of the time. People need to be aware that these are not normal signs of ageing but signs of mental health issues which can be addressed.”Another problem that needs to be addressed is the social isolation of the elderly. “Although we don’t have studies done, social isolation is a factor contributing to cognitive decline. People today don’t mingle as much as they used to and without social stimulation, the elderly tend to decline faster,” Ferreira said, suggesting the need for area-wise day care centres where senior citizens can meet. One must maintain some level of physical activity too to prevent onset of diseases, she said.Castelino said forgetfulness associated with other cognitive issues must be assessed by a psychiatrist or neurologist. “Ultimately, Alzheimer’s is a neurodegenerative disease which worsens over time, but early treatment can delay the progression and severity of the disease,” he said.