Life style

Understanding Alzheimer’s

Published

2 years ago

2024/09/22

Elders whose brains are stimulated are at a lower risk of developing the disease

World Alzheimer’s Day is marked on September 21 globally to raise awareness about Alzheimer’s disease and other forms of dementia. This year’s theme is ‘Know Dementia, Know Alzheimer’s’.Speaking to the Sunday Island, Dr . Kapila Ranasinghe, Senior Consultant Psychiatrist (with special interest in old-age psychiatry) at the National Institute of Mental Health remarks that Sri Lanka’s inherent social and cultural traits are a strength in addressing Alzheimer’s disease. Unlike in the west where many senior citizens with Alzheimer’s are institutionalized, our culture of caring and looking after the elderly is an advantage in managing the disease better.

BY RANDIMA ATTYGALLE

Be it an elderly parent, a grandparent or any other elderly loved one in your family forgetting important dates or events or repeatedly asking the same question may sound familiar. Some may even be confused with time and places. Very often you may attribute this behaviour to ‘normal ageing’ or old age. But you may be seriously mistaken…These behavioural traits could be early symptoms of Alzheimer’s disease.

In 1901 that German psychiatrist Alois Alzheimer identified the first case of what became known as Alzheimer’s disease, in a 50-year-old woman he called Auguste D. He described as a ‘peculiar disease’ one of profound memory loss and microscopic brain changes.

Commonest form of dementia

Alzheimer’s disease is the commonest form of dementia. Although laymen often consider Alzheimer’s and dementia to be synonymous, it is not so. Dementia is a term for several diseases that affect memory, thinking and the ability to perform daily activities. It results from a variety of diseases and injuries that affect the brain. “Although Alzheimer’s disease is indeed one of the most common forms of dementia, it’s important to note that not all dementia is Alzheimer’s,” explains Dr. Kapila Ranasinghe, Senior Consultant Psychiatrist (with special interest in old-age psychiatry) at the National Institute of Mental Health.

According to the World Health Organization (WHO), Alzheimer’s disease may contribute 60-70% of cases of dementia. The other common dementias are:

Vascular Dementia: Often caused by strokes or brain blood vessel diseases, leading to impaired judgment or difficulty in planning and organizing.

Lewy Body Dementia: Characterized by visual hallucinations, sleep disturbances and fluctuating cognitive abilities.

Frontotemporal Dementia: Affects personality, behaviour and language, often leading to socially inappropriate behavior or language difficulties.

Early signs

The presentation of Alzheimer’s is generally late here at home, observes Dr. Ranasinghe. This is largely due to lack of awareness and the common misconceptions related to the early signs signaling the condition, he says. “Very often it is only when an elderly parent or a loved one is causing some kind of disturbance at home with his/her behaviour such as wandering in the night, developing crying or anger swells that children or caregivers seek medical help. Otherwise, early signs of Alzheimer’s such as memory loss, misplacing their possessions etc. is often put down to ‘old age’ and inactivity after retirement.”

Reiterating that Alzheimer’s is not a normal characteristic of aging, the psychiatrist cites some key early signs to watch for and seek medical advice and support. They are:

Memory Loss: Forgetting recently learned information, important dates, or events. Repeatedly asking the same questions.

Difficulty in planning or solving problems: For example, struggling to follow a plan, work with numbers, or keep track of monthly bills.

Challenges completing familiar tasks: Trouble with daily tasks like driving to a familiar location, managing a budget, or remembering the rules of a favourite game.

Confusion with time or place: Losing track of dates and the passage of time. Sometimes forgetting where they are or how they got there.

Trouble in understanding visual images and spatial relationships: Difficulty in reading, judging distance and determining colour or contrast, which can affect driving.

New problems with words in speaking or writing: Trouble following or joining a conversation, stopping in the middle of a conversation, or repeating themselves.

Misplacing things and losing the ability to retrace steps: Putting things in unusual places and being unable to retrace steps to find them.

Decreased or poor judgment: Poor decision-making

Withdrawal from work or social activities: Avoiding social activities, work projects, or hobbies they once enjoyed.

Changes in mood and personality: Becoming confused, suspicious, depressed, fearful, or anxious.

Dr Kapila Ranasinghe

Risk factors

Alzheimer’s disease is influenced by a combination of genetic, medical and lifestyle factors. “The major risk factor is age and the majority of people with the disease are over 65 although a minority could experience it before 65,” explains Dr. Ranasinghe. The genetic risk factors include family history of having a first-degree relative (parent or sibling) with Alzheimer’s, genetic variants (the presence of the APOE-e4 gene is associated with a higher risk of developing Alzheimer’s) and early-onset of the condition (rare genetic mutations can cause early onset of Alzheimer’s, typically before 65 years).

Certain medical conditions such as hypertension, diabetes and high cholesterol levels and having a history of traumatic brain injury can also increase the risk of Alzheimer’s in a person. Lifestyle risk factors would include poor diet, lack of physical activity, smoking and excessive alcohol consumption. “Many senior citizens whose brains are constantly stimulated either by reading, writing or other mental-stimulants such as regular social-interaction have a very low risk of Alzheimer’s as their cognitive engagement is high,” points out the psychiatrist who goes onto note that lower levels of formal education and less engagement in mentally stimulating activities are linked to a higher risk of developing the disease.

Multiple burdens of the disease

Between 2015 and 2050, the proportion of the world’s population over 60 years, according to the WHO data will nearly double from 12 % to 22%. In 2050 WHO predicts 80% of older people to be living in low and middle-income countries. “Sri Lanka already has a significant aging population and the double burden of Alzheimer’s disease, especially in the context of aging, is a significant concern. This burden can be individual as well as societal,” remarks Dr. Ranasinghe. Individual burdens would include health decline, emotional and physical impact and financial strains. “Alzheimer’s leads to progressive cognitive and physical decline, affecting the individual’s ability to perform daily activities and maintain independence. It could cause cause anxiety, depression and frustration for both the patient and their family members and care-givers. The cost of medical care, long-term care, and support services can be substantial, often leading to financial stress for families..”

The societal burden of Alzheimer’s too cannot be undermined. “The increasing prevalence of Alzheimer’s among the ageing population puts a significant strain on healthcare systems, requiring more resources to be mobilized for diagnosis, treatment, and care. The economic burden includes direct medical costs and indirect costs such as lost productivity of caregivers who may need to reduce work hours or leave their jobs to provide care. The condition also demands social services including support groups, respite care and community interventions to assist both individuals with Alzheimer’s and their care givers,” points out Dr. Ranasinghe who urges family members to seek early medical intervention for their loved ones suspected to be having the disease.

Seeking early care

Having an open discussion with parents and other elders suspected of early signs of the condition and seeking professional help is the key to managing the condition, maintains the psychiatrist. “Many children tend to hide the real situation from their parents and other elderly family members and this does more harm than good because the symptoms of Alzheimer’s worsen over time unless managed properly.”

Although Alzheimer’s cannot be cured, the progression of it could be slowed down with right interventions. “Today our state sector is also well equipped to address the disease both in terms of health care providers and other interventions. There are many non-pharmacological interventions such as memory assessments, cognitive function assessments etc. which will help in functional improvements of the person with Alzheimer’s. The good news is, not only can these interventions improve the quality of life of the person concerned but they are also relatively less expensive than other investigations and treatment modalities. Drugs for the disease are recommended only in severe and advanced stages,” Dr. Ranasinghe notes.

Alzheimer’s disease requires a holistic management or an inter-disciplinary approach to it. “When managing Alzheimer’s’ all aspects of a person’s life should be addressed; his/her physical and mental health, relationships and social life – all of this should be taken stock of. For example, non-communicable diseases (NCDs) such as diabetes, excessive cholesterol and high blood pressure should be kept at bay for optimum results,” says Dr. Ranasinghe who also warns against ‘over protection’ of parents and other elders. “We see some elders being over restricted with their social interactions and other physical activities which would be detrimental. Social interaction is vital to slow down the progress of the disease.”

When managing Alzheimer’s, caregivers too need to be looked after as it could be overwhelming to care for a loved one with the disease. “It could be very stressful for caregivers to look after a loved one with the disease and they too need support of other family members and friends and getting the support of health care providers is also critical to avoid burnout,” remarks the consultant.

Sri Lanka’s inherent social and cultural traits are a strength in addressing Alzheimer’s. “Unlike in the west where many elders with the disease are institutionalized, our elders with dementia and Alzheimer’s still enjoy better lives within their family units. The psychological support our system enables with the love and support of the immediate family cannot be undermined at any cost,” concludes Dr. Ranasinghe.

All News Advertisement

Life style

Nanda Malini Ascocenda: A flower that carries the name of a legendary voice

Published

21 hours ago

2026/08/30

Thilina Walpola

By Ifham Nizam

A flower named after one of Sri Lanka’s most celebrated voices has become a unique tribute to the country’s cultural heritage, with the Nanda Malini Ascocenda orchid carrying the name of veteran singer Dr. Nanda Malini.

The orchid was named in honour of Nanda Malini, recognising her outstanding contribution to Sri Lankan music and culture. She is among the country’s most acclaimed singers, with a career spanning several decades and a repertoire deeply rooted in Sri Lankan social and cultural experiences.

The striking illustration, released by the Ministry of Environment on August 21, features the veteran singer surrounded by colourful orchids and musical notes, bringing together two important elements of Sri Lankan identity — the country’s rich natural heritage and its musical tradition.

The Nanda Malini Ascocenda is particularly significant because it represents an unusual meeting point between art and nature. Orchids have long been associated with Sri Lanka’s botanical wealth, while the naming of individual hybrids after distinguished personalities provides a lasting link between the country’s natural and cultural heritage.

According to published accounts, the Nanda Malini Ascocenda was named in 2004 in recognition of the singer.

A recent profile described her as possibly the only Sri Lankan artiste to have an orchid named after her by the Orchid Circle of Sri Lanka.

Nanda Malini’s contribution to music has been recognised through numerous awards. She has also performed internationally and remains one of the most recognised figures in Sri Lankan music.

Her association with songs reflecting social realities, human emotions and national identity has given her a special place in the country’s cultural landscape.

The orchid, therefore, represents more than a botanical curiosity. It is a living tribute to an artiste whose voice has accompanied generations of Sri Lankans.

The Ministry of Environment’s presentation also serves as a reminder that conservation is not limited to forests, wildlife and ecosystems. Sri Lanka’s natural heritage is closely intertwined with its history, culture, art and the people who have enriched the nation’s identity.

As the colourful blooms of the Nanda Malini Ascocenda evoke the beauty of Sri Lanka’s orchid heritage, the name attached to them ensures that the contribution of one of the country’s most distinguished musical voices continues to live on in an entirely different form — through nature itself.

Life style

The Best of Malkoha celebrates half a century of Sri Lankan ornithological writings

Published

21 hours ago

2026/08/30

Thilina Walpola

Distinguished gathering

By Ifham Nizam

The launch of The Best of Malkoha: Half a Century of Ornithological Writings marked a significant milestone in Sri Lanka’s birdwatching and conservation history, as the Field Ornithology Group of Sri Lanka (FOGSL) celebrated its Golden Jubilee at the Faculty of Science, University of Colombo.

The book, drawn from five decades of writings published in Malkoha, the FOGSL newsletter, brings together a rich record of observations, discoveries and experiences that helped shape modern field ornithology in Sri Lanka.

The launch formed part of FOGSL’s first-ever Founders’ Day, held on August 22, a date chosen to coincide with the 76th birthday of Vidyajothi Emeritus Professor Sarath Kotagama, one of the Organisation’s founding figures and its enduring source of inspiration.

The occasion brought together academics, conservationists, naturalists, birdwatchers, students, young birders and members of FOGSL, reflecting the broad community that the organisation has cultivated since its establishment in 1976.

Section of the invitees

Biodiversity expert Dr. Rohan Pethiyagoda, delivering the Golden Jubilee Founders’ Day Oration, used the occasion to reflect on five decades of biodiversity research and conservation in Sri Lanka, while paying tribute to Professor Kotagama and the role played by FOGSL in taking birdwatching beyond a small circle of specialists.

Pethiyagoda said the organisation’s greatest achievement had been its ability to make knowledge of birds and nature accessible to ordinary people.

He recalled how, in the early 1990s, Professor Kotagama had proposed producing an affordable field guide so that birdwatching would no longer be restricted by the high cost of existing publications.

That resulted in the publication of A Field Guide to the Birds of Sri Lanka in 1994, which Pethiyagoda published and which subsequently became a bestseller.

The collaboration later produced Sri Lanka Kurulu in Sinhala, making serious bird identification and knowledge available to an even wider audience.

Pethiyagoda recalled a particularly emotional encounter that demonstrated the lasting impact of that work.

During a recent visit to Talangama to accompany Australian birdwatchers, he encountered two boys, aged around 12 and 14, carrying a battered copy of Sri Lanka Kurulu and using it to identify birds.

“I just started crying,” Pethiyagoda said, describing the moment as evidence of how knowledge had been passed from one generation to another.

: Prof Nihal Dayawansa

: Dr. Pethiyagoda

: Prof Kotagama

: Birthday celebration

He said the achievements of the past 50 years should not be underestimated. Sri Lanka has witnessed major advances in health, education, infrastructure and conservation, while the country’s protected-area network has expanded considerably.

At the same time, however, he warned that biodiversity research and conservation continue to face serious institutional challenges.

Pethiyagoda pointed to habitat fragmentation, climate change, inadequate scientific research and restrictions on field research as major challenges facing the next generation of conservationists.

He said climate change would increasingly force species to move towards cooler, higher elevations, but fragmented habitats could prevent them from making such movements.

“Our challenge now is to connect up those little fragments so that plants and animals can migrate across these landscapes,” he said, stressing the importance of restoring ecological connectivity.

He also called for greater investment in ex-situ conservation for species facing extinction and urged the establishment of conservation facilities across Sri Lanka’s different climatic zones.

Pethiyagoda placed particular emphasis on citizen science, arguing that Sri Lanka possessed an enormous reservoir of public enthusiasm for biodiversity.

He noted that more than 20,000 Sri Lankans were now involved in citizen science through platforms such as iNaturalist, with Sri Lankan users generating significant biodiversity data.

“The appetite for science, the appetite for conservation, for exploration, for discovery is there in the people,” he said.

Pethiyagoda also paid an emotional tribute to Professor Kotagama, describing him as the constant force behind much of Sri Lanka’s modern conservation movement.

“In future generations, we will talk of conservation in this country as before Kotagama and after Kotagama,” he said.

He also acknowledged Professor Kotagama’s wife, Namali, for being the “bedrock” of his household and for supporting his decades-long contribution to conservation.

The Golden Jubilee celebrations also looked back at the origins of FOGSL.

The Organisation was founded on October 10, 1976, when four passionate bird enthusiasts—the late P. B. Karunaratne, Professor S.U.K. Ekaratne, Professor Sarath Kotagama and Rex I De Silva —came together with a shared objective of making birdwatching accessible beyond the relatively exclusive group that had traditionally dominated the field.

FOGSL was subsequently formally recognised by the University of Colombo and developed as a platform bringing together birdwatchers, researchers, students, educators and nature enthusiasts.

Its philosophy was simple: one did not need an academic qualification to become a member. Enthusiasm, careful observation, recording and sharing knowledge were enough.

That principle continues to define the Organisation.

FOGSL has since become Sri Lanka’s BirdLife International partner and has played an important role in bird research, conservation, environmental education, field studies, school programmes and citizen science.

Its work has extended from research on endemic birds and migratory species to biodiversity monitoring, conservation education and programmes aimed at children and young people.

Speaking at the event, FOGSL President Professor Nihal Dayawansa said the organisation’s founding vision remained relevant even after half a century.

The Organisation, he noted, was created not simply as a birdwatching club but as a platform through which people could study and conserve Sri Lanka’s birds while inspiring the wider public to appreciate nature.

The Founders’ Day itself was described as an opportunity to honour those who established and shaped the Organisation while celebrating the contribution of generations of members.

Professor Mayuri Wijeyasinghe, Head of the Department of Zoology and Environmental Sciences, said FOGSL had given ornithology a new meaning in Sri Lanka by taking birdwatching beyond an elite community and making it accessible to ordinary people and schoolchildren.

She noted that Sri Lanka, as a tropical island with a remarkable diversity of birds and a high level of endemism, had a special responsibility to understand and conserve its avifauna.

The Dean of the Faculty of Science, Professor I.M.K. Fernando, meanwhile, said that although his own field was physics, he recognised the common foundation shared by all branches of science—curiosity.

He congratulated FOGSL on reaching 50 years and praised its contribution to research, education, student development, wetland conservation, public awareness and science-based advice on development projects.

“The work goes far beyond publishing,” he said, noting the Organisation’s lectures, school programmes, research projects and conservation initiatives.

He also paid tribute to Professor Kotagama, describing him as a legend whose influence had extended well beyond ornithology.

Professor Kotagama, speaking after receiving tributes from colleagues and friends, said the Organisation’s foundations had been laid with a belief that people could make a difference.

He stressed the importance of taking decisions based on scientific knowledge and criticised excessive bureaucratic barriers that, in his view, prevented scientists from carrying out important field research.

Reflecting on his own period as Director of Wildlife Conservation, he said he had sought to transform the Department into a scientific institution.

“For me and for us who were working in the Mahaweli environment programme at that time, we knew that if not for science, you cannot go forward in conservation,”

Professor Kotagama said, stressing that conservation required both natural and social sciences.

He recalled the challenges faced by the Department, including inadequate staffing structures and poor career progression for wildlife officers, and said efforts had been made to introduce a more professional and scientifically grounded system.

The 50-year journey of FOGSL is closely intertwined with the development of modern field ornithology in Sri Lanka.

From the early days when birdwatching was largely confined to a small group of specialists, the Organisation helped create a culture in which students, schoolchildren, amateur birdwatchers and citizen scientists could contribute to the understanding of the country’s biodiversity.

The launch of The Best of Malkoha, therefore, served as more than the unveiling of another publication. It was a record of that transformation.

The writings collected in the volume represent five decades of observations and experiences, documenting how Sri Lankan field ornithology evolved through the work of generations of birdwatchers, researchers and conservationists.

As theOorganisation enters its next half century, the message emerging from the Golden Jubilee celebrations was clear: the future of conservation will depend not only on institutions and scientists but also on an informed and empowered public.

FOGSL’s enduring motto—”Once a member, always a member”—perhaps best captures that legacy: a lifelong connection with birds, nature, scientific observation and the responsibility to protect Sri Lanka’s extraordinary natural heritage.

Life style

Heart that beats for humanity

Published

21 hours ago

2026/08/30

Thilina Walpola

Dr Rajitha Y de Silva: Healing hearts, saving lives

Dr. Rajitha de Silva

By Zanita Careem

Dr. Rajitha Y. de Silva, Consultant Cardiothoracic Surgeon and Consultant at Sri Jayewardenepura General Hospital, has built a distinguished career around one of medicine’s most demanding discipline – surgery of the heart. With his expertise, precision and pioneering spirit, he has become closely associated with the advancement of Minimally Invasive Cardiac surgery in Sri Lanka. He joined Sri Jayewardenpura General Hospital in 2013 and is today recognised as a pioneer of Minimally Invasive Cardiacs procedures in the country.

He is particulary recognised as a pioneer of mimimallyinvasive surgery in Sri lanka,with experience in procedures including minimally invasive coronary surgery and mitral valve repair. He is recognition as a leading figure in the advancement of modern cardiac surgery in the country. With years of specialised training and experience behind him, Dr de Silva has built a reputation in cardiothoracic surgery while remaining deeply conscious of the human story behind every patient who enters the operating theatre. For him, the beating heart is more than an organ to be repaired – it represents a life, a family, a future and a second chance.

His commitment to patients extends well beyond the operating theatre. Having witnessed the financial hardships faced by heart patients who desperately needed surgery but could not afford it. Dr de Silva, together with Senior Cardiologist Dr. Ruwan Ekanayake, co-founded the Heart to Heart Trust Fund.

The initiative was created with a powerful objective, that no patient should be denied life saving cardiac treatment simply because of financial difficulties.

Perhaps one of the most striking aspects of Dr de Silva’s personality is that his concern for patients does not end when the operation is over. His vision has included creating initiatives that make the difficult journey of cardiac patients more humane, giving them encouragement, dignity and hope during a period when they are often at their most vulnerable. Abayadhana was born from a simple but powerful conviction that every patient deserves a chance to live.

Through the Abayadhana programme, he represents his compassionate approach to caring for people who need not only medical attention, but also understanding, encouragement and support. What makes this initiative particularity meaningful is the personal commitment behind it. It reflects his belief that healing is not only about medicine, but about reaching out to people when they are most vulnerable.

Away from the intensity of the operating theatre, Dr. Rajitha de Silva finds another kind of joy – his passion for cricket over the years; he has taken the field in numerous matches, playing alongside and against many well known personalties.

Dr. Rajitha de Silva’s journey is guided by compassion and success anchored in humanity. From pioneering milestones in cardiac surgery to the Heart to Heart Trust Fund and the Abayadhana initiative, he has continued to give back to the people whose lives he touches. His love for cricket, his warmth and generosity reveal the heart behind the healing hands.

A surgeon by profession, a humanitarian by choice and a cricketer by heart, Dr. Rajitha’s greatest legacy may not be measured only by the operations he has performed, but by the lives he has changed, the hope he has restored and the hearts he has touched.

The trustees of the Heart to Heart Trust Fund stand united behind the mission of saving lives and giving hope. Their collective commitment helps turn the Trust’s vision into meaningful support for patients and families in need

The Executive Director, Heart to Heart Trust Fund, Shanti Fernando, plays a hands on role in turning the Trust’s vision into action, coordinating efforts, and bringing hope where it is needed.

Behind Dr. Rajitha de Silva’s demanding life is his wife, Dr. Arunie, and children, who has been his strength and support.