Patients with Alzheimer's disease are just like sand sculptures standing in the desert, after a gust of wind, some sand will fall off. As time goes by, the sculpture will gradually lose its original form. Professor Yu Xin from Peking University's Institute of Psychology Sanitation made these remarks at a seminar to mark World Alzheimer's Day, which falls on September 21.

The proportion of senior citizens in China has grown rapidly as a result of both greatly improved living standards and medical conditions, as well as the adoption of the family planning policy.

The incidence of Alzheimer's disease increases with age. "One third of those aged 85 are believed to suffer from some degree of Alzheimer's disease," said Doctor Zhang Zhenxin from the neurology department of the Peking Union Medical College Hospital.

Together with about 100 other doctors, Doctor Zhang has just completed a wide epidemiologic survey, visiting about 42,000 people aged over 55 in Beijing, Shanghai, Xi'an, Chengdu, Guangzhou and Shenyang.

The survey suggested for the first time that China is no longer a region with a low incidence of dementia, with 6.9 per cent of people aged over 65 in the north and 3.9 per cent of people aged over 65 in the south afflicted with the disease.

Researchers found that Alzheimer's disease contributes to about 62.7 per cent of all cases of senile dementia.

In another survey of 405 elderly people diagnosed as dementia cases by the group, the researchers identified the following common signs of the disease, memory loss, difficulty in performing familiar tasks, decreased judgment, problems with numbers and disorientation with time and place.

However, as many as 60 per cent of the patients' families believed that those symptoms were only natural age-related decline and did not take them as signs of the disease.

The families mainly provide the most basic care for the patients, such as ensuring that they are fed and helping to protect them from everyday dangers around the home.

"Locking up the patients at home would be of no good to either them or their families, and they should consult the doctors," said Doctor Zhang.

"Individuals with mid-stage Alzheimer's disease increasingly need help with their customary daily activities, and it has inflicted a great economic and emotional burden on their family members, whose normal arrangement of work and study will also be heavily affected," said Professor Xu Xianhao, director of the neurology department of the Beijing Hospital as well as the director of Alzheimer's Disease China (ADC).

"It is hard for people to accept that their fathers or mothers living together with them for decades suddenly step into another world and become complete strangers," he added.

Early diagnosis of Alzheimer's disease is an important step, because there are several drug treatments that may improve or stabilize symptoms and several care strategies and activities that may minimize or prevent behavioural problems. However in China, its unique family structure and the social prejudice against dementia patients bring great obstacles for early diagnosis.

Though the number of families with three generations living under the same roof is decreasing, old people seldom live alone and are mostly taken care of by their family, so it is not easy to find when they have developed signs of impaired memory, such as forgetting to pay their water, electricity and gas bills, Xu noted.

Also, the Chinese name for Alzheimer's disease contains a tone of insult, and for a patient in the early stage, admitting that they have the disease is harmful for their sense of self-respect. "They feel too uncomfortable to go to the hospital to receive a diagnosis. Similarly for their families, accepting the disease's name will be as difficult as accepting the patients being turned into strangers by Alzheimer's," said Doctor Yu. He argued the necessity of finding another Chinese term for Alzheimer's disease.

Doctors at the seminar all appealed to those aged over 50, especially those with a family history of Alzheimer's disease, to care more about their mental health, and suggest them to have at least one annual check-up.

Doctor Xu said that Alzheimer's Disease China had opened a free national hotline - Senile Memory Disorder and Dementia (800-820-8220), the first of its kind in the nation. The hotline will not only spread knowledge about Alzheimer's disease, but also provide a room of privacy for patients and their families who are reluctant to go to hospital.

"The hotline will be helpful in the early diagnosis of the disease and avoid any unnecessary delay of treatment," said Doctor Xu.

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