Alzheimer’s is the most common form of dementia which is defined as a “deterioration of intellectual function and other cognitive skills, leading to a decline in the ability to perform activities of daily living” (Merck Manual of Geriatrics). Alzheimer’s dementia is a progressive neurological disorder and usually occurs in old age. A decline in cognitive functions such as remembering, planning and reasoning may be signs of onset Alzheimer’s.
Alzheimer’s disease is named after a German physician, Dr. Alois Alzheimer, who discovered changes in the brain tissue of a deceased mental patient. He saw abnormal “clumps” and tangled “bundles of fibers” which today are known as amyloid plaques and neurofibrillary tangles. Later research into Alzheimer’s disease found the death of nerve cells that control memory and areas of thinking. Also, chemicals that carry messages back and forth appear to be at lower levels in the brains of people with Alzheimer’s. Scientists believe approximately 4 million Americans suffer from Alzheimer’s disease. Risk increases with age, but Alzheimer’s is not a normal part of aging.
Symptoms of Alzheimer’s (7 Stages)
Although each person with Alzheimer’s is different, most progress through a series of stages, each of which is characterized by more serious Alzheimer’s symptoms. Scientists and physicians have developed seven stages of Alzheimer’s symptoms to describe how you or your loved one will change over time.
- Stage 1 of Alzheimer’s (Unaware of Impairment)
No problems with memory, daily activities, communication or judgment are noticed. Normal adult functions are still in effect.
- Stage 2 of Alzheimer’s (Low Awareness of Impairment)
Experiences of cognitive problems or memory lapses may be detectable. Medical examination does not reveal any problems during this stage.
- Stage 3 of Alzheimer’s (Increased Awareness of Impairment)
Mild changes in communication patterns, memory, or behavior may be more recognizable by family members and friends. Common Alzheimer’s symptoms during this stage include: a decline in planning or organizational skills, frequently misplacing objects, difficulties functioning in social settings, pronunciation problems, and difficulty finding the right words for objects.
- Stage 4 of Alzheimer’s (Mild Alzheimer’s)
Cognitive decline is more apparent. Alzheimer’s symptoms noted in stage 3 are more evident. Other problems may develop such as difficulty performing mathematical exercises, moodiness and mood swings, and social withdrawal.
- Stage 5 of Alzheimer’s (Moderate Alzheimer’s)
Some assistance with daily activities is required. Memory loss and cognitive decline is degenerating. Disorientation to time or place, diminishing attention to personal care, and an inability to remember key details about one’s personal history can occur. However, people with this stage of Alzheimer’s still know their own name and the names of key family members and can still perform normal daily functions such as eating and bathing without assistance.
- Stage 6 of Alzheimer’s (Moderate to Severe Alzheimer’s)
A difficult stage for loved ones and caregivers due to the changes in behavior and personality in the Alzheimer’s patient. Memory and cognitive skills continue to decline, and assistance is required for most daily activities. The Alzheimer’s symptoms associated with this stage are repetitive behavior, wandering, paranoia, suspicion, incontinence, afternoon restlessness and agitation (aka soundowning), and problems recognizing one’s spouse and other family members.
- Stage 7 of Alzheimer’s (Severe Alzheimer’s)
Responding to the surrounding environment is no longer possible. Words or short phrases may be spoken, but communications is limited. Motor coordination and the ability to swallow begin to shut down. Around the clock care is required.
The above stages of Alzheimer’s are simply a blueprint and used to understand Alzheimer’s symptoms and prepare for their accompanying challenges. Since no two people with Alzheimer’s has the exact same experiences, Alzheimer’s symptoms may occur at different stages. It is not unusual for caregivers to report that their Alzheimer’s patient seems to be in two or more stages at once. For in home care assistance during stages 5 through 7, contact A Better Living Home Care.
Causes of Alzheimer’s Disease
The causes of Alzheimer’s is still not completely understood. It helps to understand risk factors that affect a person’s likelihood of developing Alzheimer’s which include protein build‑up in the brain, age and family history.
- Tangles & Plaques: Protein Build‑Up
Extensive autopsy studies reveal that Alzheimer’s dementia is characterized by the build‑up of proteins in the brain. The build‑up accumulates in the spaces between nerve cells from amyloid plaques and inside nerve cells from neurofibrillary tangles. Most people develop some plaques and tangles; however, people with Alzheimer’s develop far more than those who do not develop the disease. Scientists are still studying how plaques and tangles relate to Alzheimer’s. One theory is that plaques and tangles impair the cells’ ability to communicate with each other, making it difficult for the cells to survive.
The number one risk factor for developing Alzheimer’s is age. The probability of being diagnosed with Alzheimer’s disease nearly doubles ever five years after age 65. One out of eight people over the age of 65 has Alzheimer’s disease, and almost one out of every two people over the age of 85 has Alzheimer’s.
- Family History
Although no obvious family patterns have been seen, people who have parent or sibling that developed Alzheimer’s disease are two to three times more likely to develop the disease than those with no family history of Alzheimer’s. If more than one close relative has been affected, the risk increases even more.
In order to diagnose Alzheimer’s, doctors first need to rule out several other conditions and conduct psychological testing. Even though the earliest stage of Alzheimer’s disease can be difficult diagnose, early diagnosis allows for information and planning that can smooth the path for the ensuing years. Early diagnosis also allows Alzheimer’s patients to change their home environment and begin formulating routines to follow which will help them down the road relearn and reinforce behaviors.
Contact your doctor if you are experiencing any of the following:
- Memory loss
- Difficulty performing familiar tasks
- Problems with language
- Disorientation to time and place
- Poor or decreased judgment
- Problems with abstract thinking
- Misplacing things
- Changes in mood or behavior
- Changes in personality
- Loss of initiative
Magnetic resonance imaging (MRI) is sometimes used to help assess the possibility of Alzheimer’s and rule out such things as brain tumors, strokes, and hemorrhages. Doctors also provide neuropsychological tests to compare skill levels of people who may have Alzheimer’s with those of people at the same age and education level.
Alzheimer’s is a progressive disease that first manifests itself with problems usually related to memory. Over time, people have more difficulty with tasks. By the end of the disease process, Alzheimer’s is pretty easy to recognize. The goal is to find out from family and friends as quickly as possible when something is abnormal in order to do something about it.
Caring for an Alzheimer’s Patient
There is no way to prevent or cure Alzheimer’s. Current care treatments focus on helping people maintain mental function, managing behavioral symptoms; and slowing, delaying, or preventing Alzheimer’s disease.
Familiarity and repetition in daily activities benefits the Alzheimer patient by reducing confused or disoriented behavior. Sudden changes in routine and environment may adversely affect the patient and create a downward turn into more severe stages of Alzheimer’s.
Learn how to communicate with an Alzheimer’s patient. Try not to pay attention only when the Alzheimer’s patient displays problem behaviors. Be supportive of positive behavior. Acknowledge requests and respond to them. Don’t argue or try to change the person’s mind, even if you believe the request is irrational. Do your best to be patient, kind, flexible, supportive, and calm.
Set up home care provided by qualified caregivers. Because sudden changes in environment can adversely affect the Alzheimer’s patient, home care can be a great way to maintain the patient’s current environment while providing him with the care he needs. Caregivers can hone communication skills and make changes to the home environment in anticipation of the problems of mid‑stage Alzheimer’s disease.
Get emotional support for yourself. As a caregiver to an Alzheimer’s patient, your lifestyle may radically change and you may face several unexpected challenges. Be sure to reach out to community resources, supportive organizations, family and friends. Get plenty of rest and time for yourself. Lastly, remember you are not alone.