[Common Diseases] Alzheimer's Disease (AD)

🧩Alzheimer's Disease Guide (Hong Kong Edition)

Alzheimer's disease is the most common type of dementia , accounting for over 60% of dementia cases in Hong Kong. According to data from the Hong Kong Hospital Authority and the World Health Organization (WHO), with the aging population, approximately one in 10 people aged 65 and over in Hong Kong suffer from some degree of dementia, with Alzheimer's disease being the leading cause.

I've visited elderly day centers and witnessed Alzheimer's patients go from forgetting to buy groceries to later failing to recognize their own family members. This presents a significant challenge for both patients and their families. Therefore, early identification, proactive treatment, and support are crucial.

1️⃣ Causes and pathological mechanisms

Alzheimer's disease is a chronic, progressive neurodegenerative disease with the following main pathological features:

  • Beta-amyloid deposits : These build up into plaques between brain cells
  • Tau protein hyperphosphorylation : tangles form in nerve cells
  • Gradual death of nerve cells → brain atrophy → cognitive decline

The cause is not fully understood, but known risk factors include:

  • Advanced age (the most important factor)
  • Familial inheritance (APOE ε4 gene)
  • High blood pressure, high cholesterol, diabetes
  • Lack of exercise and long-term social isolation
  • History of head trauma

2️⃣ Main symptoms (according to the course of disease)

Early

  • Memory loss (especially short-term memory)
  • Asking the same question repeatedly
  • Difficulty finding words and decline in language expression
  • Easy to get lost and forget familiar routes

mid-term

  • Decreased comprehension and judgment
  • Personal hygiene and housework skills have declined significantly
  • Mood swings, anxiety, irritability
  • Sleep disorders

Late stage

  • Loss of language ability
  • Requires comprehensive care (dressing, feeding, toileting)
  • Difficulty moving, muscle stiffness
  • Difficulty swallowing and susceptibility to pneumonia

3️⃣ Common treatment methods in Hong Kong

There is currently no cure for Alzheimer's disease, but through medication, non-drug treatment and care, degeneration can be slowed and quality of life can be improved.

💊 Medication

  • Cholinesterase inhibitors
    • Donepezil, Rivastigmine, Galantamine
    • Suitable for mild to moderate AD, improving memory and concentration
  • NMDA receptor antagonists
    • Memantine
    • Suitable for moderate to severe AD, reducing excitotoxicity
  • Combination therapy
    • Mild to moderate: Cholinesterase inhibitors
    • Moderate to severe cases: Memantine can be added

🔬 Emerging Therapies (International)

  • Anti-β-amyloid monoclonal antibodies (eg, Lecanemab)
    • The US FDA has approved it, but it is not yet widely available in Hong Kong due to its high cost and the need to evaluate side effects.

4️⃣ Non-drug treatment and rehabilitation intervention

  • Cognitive training : memory games, puzzles, reading, music therapy
  • Physical therapy : maintaining mobility and preventing falls
  • Occupational therapy : maintaining independence and adapting to home environment
  • Psychological support : reduce depression and anxiety
  • Social activities : delaying cognitive decline

5️⃣ Hong Kong support and resources

  • Hospital Authority Geriatric Psychiatry/Memory Clinic (doctor's referral required)
  • Elderly Day Centre (providing cognitive training and social activities)
  • Social Welfare Department Elderly Community Care Service Voucher Scheme
  • Hong Kong Alzheimer's Disease Association (support group, caregiver training)
  • Private medical and rehabilitation centres (higher flexibility but higher costs)

6️⃣ Daily care and editor’s tips

  • Establish a regular routine : set wake-up, meal, and sleep times
  • Simplify the environment : reduce clutter and mark the location of important items
  • Safety protection : anti-slip floor, removal of dangerous objects
  • Stay social : Encourage participation in community activities
  • A balanced diet : Mediterranean diet boosts brain health
  • Caregiver self-care : taking breaks, seeking support, and avoiding caregiver burnout

7️⃣ Common myths among Hong Kong citizens

  • "Having a poor memory in old age is due to Alzheimer's disease" ❌
    Normal aging is different from Alzheimer's disease, in which memory loss affects daily life.
  • "Dietary health supplements can cure AD" ❌
    There is currently no health product with definitive clinical evidence that can cure AD.
  • "The patient will not be treated without treatment" ❌
    Early intervention can delay degeneration, improve quality of life and reduce the stress of care.

8️⃣ Editor’s Summary

Alzheimer's disease is more than just a simple memory loss; it's a long-term, multifaceted illness that affects patients and their families. While there's currently no cure in Hong Kong, a combination of medication, cognitive training, and community support can effectively slow the progression of the disease. We recommend that if you notice a significant decline in an elderly person's memory or ability to function, you should seek specialist evaluation as soon as possible. Early intervention can help patients and their families spend more quality time together.

Disclaimer : This article is for reference only and does not constitute any medical advice. The source is referenced from major medical articles.

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