The Hindu : Tamil Nadu / Chennai News : “Evolve better treatment protocols for managing stroke, dementia”

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Monday, Nov 30, 2009
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“Evolve better treatment protocols for managing stroke, dementia”

Special Correspondent

Dementia, a major public issue, says Singapore-based neurologist

— Photo: K. V. Srinivasan

BRAINY SESSION: E. S. Krishnamoorthy, honorary secretary, VHS ( left), speaking at a forum in Chennai on Sunday. R Kalaria UK-based neurologist, C P Chen, Singapore-based neurologist and Krishnamoorthy Srinivas, chairman emeritus, Institute of Neurological Sciences, are in the picture.

CHENNAI: Neurology experts on Sunday called for evolving better treatment protocols and more sensitive evaluation criteria for the management of stroke and dementia.

The forum on ‘A Double Whammy: When strokes and dementia coexist’ organised by the Neuro Sciences India Group also highlighted the enormity of the challenge that an association of the two disorders implied for populous societies in Asia.

Delivering the ‘Dr. Lakshminarayanan lecture,’ C. P. Chen, a Singapore-based neurologist, stressed the need for evolving better treatments, given the moderate efficacy of existing protocols. Terming dementia as a major public health issue, Dr. Chen said the condition held enormous economic consequences for countries with an ageing population.

“Alzheimerisation”

Differing with what he called the “Alzheimerisation” of vascular dementia, Dr. Chen pointed to studies that indicated that cognitive decline following a stroke was driven by micro infracts rather than the Alzheimer’s factor.

While some studies showed a correlation between anti-hypertensive treatment and dementia prevention, conclusive evidence is yet to emerge on this front, he said.

Cognitive impairment

The event was supported by the Indian Stroke Association, Alzheimer’s and Related Disorders Society of India and the Indian Medical Association-Chennai south branch. Delivering the ‘Appa Rao lecture,’ M. Doraiswamy, a U.S.-based neurologist, said some studies had shown how some kind of strokes did not result in cognitive impairment.

In fact, improvements in imagery had led surgeons to focus on salvaging the penumbra region around a stroke site.

Risk factors

Delivering the ‘Dr. Krishnamoorthy Srinivas lecture,’ R. Kalaria, a U.K.-based neurologist, pointed out that barring age and genes every other risk factor for dementia could be modified. A few studies had shown that controlling cardio-vascular risk factors could arrest progression of dementia, he said.

Ambidexterity

Neurologist G. Arjundas recommended exercises in developing ambidexterity (such as training to write with the left hand by right-handers and vice-versa) and “mornings of cracking crossword and solving sudoku puzzles” to expand cognitive reserves in the brain that could help survive a stroke in old age.

Public awareness

N. Ravi, editor, TheHindu, who presided over the oration awards and released a journal, stressed the importance of raising public awareness of stroke and dementia in India, which as a country was relatively new to ageing issues. The orations had helped demystify to an extent the arcane field of stroke and dementia that often evoked fear of the unknown and mitigated the sense of helplessness associated with these conditions, he said.

Community involvement

E. S. Krishnamoorthy, honorary secretary, Voluntary Health Services, said the neurology department at VHS had established the importance of involving the community and adopting a multi-disciplinary approach to neurological care.

Krishnamoorthy Srinivas, Chairman Emeritus, Institute of Neurological Sciences, said it was no small challenge for doctors to explain complex medical science in a language that the common man could understand.

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