Alzheimer’s disease is an irreversible, progressive brain disease that slowly destroys memory and thinking skills, and eventually even the ability to carry out the simplest tasks. In most people with Alzheimer’s, symptoms first appear after age 60. Alzheimer’s disease is the most common cause of dementia among older people. Dementia is the loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities, to such an extent that it interferes with a person’s daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person’s functioning, to the most severe stage, when the person must depend completely on others for basic activities of daily living.
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What are the stages of Alzheimer’s?
There are five stages associated with Alzheimer’s disease: preclinical Alzheimer’s disease, mild cognitive impairment, mild dementia due to Alzheimer’s, moderate dementia due to Alzheimer’s and severe dementia due to Alzheimer’s.
1.Preclinical Alzheimer’s disease
Alzheimer’s disease begins long before any symptoms become apparent. This stage is called preclinical Alzheimer’s disease. You won’t notice symptoms during this stage, nor will those around you. This stage of Alzheimer’s can last for years, possibly even decades. Although you won’t notice any changes, new imaging technologies can now identify deposits of a substance called amyloid beta that have been associated with Alzheimer’s disease. The ability to identify these early deposits may be especially important as new treatments are developed for Alzheimer’s disease. 2.Mild cognitive impairment (MCI) due to Alzheimer’s disease People with mild cognitive impairment have mild changes in their memory and thinking ability. These changes aren’t significant enough to affect work or relationships yet. People with MCI may have memory lapses when it comes to information that is usually easily remembered, such as conversations, recent events or appointments. People with MCI may also have trouble judging the amount of time needed for a task, or they may have difficulty correctly judging the number or sequence of steps needed to complete a task. The ability to make sound decisions can become harder for people with MCI. Not everyone with mild cognitive impairment has Alzheimer’s disease. In some cases, MCI is due to depression or a temporary medical complication. The same procedures used to identify preclinical Alzheimer’s disease can help determine whether MCI is due to Alzheimer’s disease or something else.
3.Mild dementia due to Alzheimer’s disease
Alzheimer’s disease is often diagnosed in the mild dementia stage, when it becomes clear to family and doctors that a person is having significant trouble with memory and thinking. In the mild Alzheimer’s stage, people may experience:
Memory loss for recent events. Individuals may have an especially hard time remembering newly learned information and repeatedly ask the same question. Difficulty with problem-solving, complex tasks and sound judgments. Planning a family event or balancing a checkbook may become overwhelming. Many people experience lapses in judgment, such as when making financial decisions. Changes in personality. People may become subdued or withdrawn — especially in socially challenging situations — or show uncharacteristic irritability or anger. Decreased attention span and reduced motivation to complete tasks also are common. Difficulty organizing and expressing thoughts. Finding the right words to describe objects or clearly express ideas becomes increasingly challenging. Getting lost or misplacing belongings. Individuals have increasing trouble finding their way around, even in familiar places. It’s also common to lose or misplace things, including valuable items.
4.Moderate dementia due to Alzheimer’s disease
During the moderate stage of Alzheimer’s, people grow more confused and forgetful and begin to need help with daily activities and self-care. People with moderate Alzheimer’s disease may:
Show increasingly poor judgment and deepening confusion. Individuals lose track of where they are, the day of the week or the season. They often lose the ability to recognize their own belongings and may inadvertently take things that don’t belong to them. They may confuse family members or close friends with one another, or mistake strangers for family. They often wander, possibly in search of surroundings that feel more familiar and “right.” These difficulties make it unsafe to leave those in the moderate Alzheimer’s stage on their own. Experience even greater memory loss. People may forget details of their personal history, such as their address or phone number, or where they attended school. They repeat favorite stories or make up stories to fill gaps in memory. Need help with some daily activities. Assistance may be required with choosing proper clothing for the occasion or the weather and with bathing, grooming, using the bathroom and other self-care. Some individuals occasionally lose control of their urine or bowel movements. Undergo significant changes in personality and behavior. It’s not unusual for people with moderate Alzheimer’s to develop unfounded suspicions — for example, to become convinced that friends, family or professional caregivers are stealing from them or that a spouse is having an affair. Others may see or hear things that aren’t really there. Individuals often grow restless or agitated, especially late in the day. People may have outbursts of aggressive physical behavior.
5.Severe dementia due to Alzheimer’s disease
In the severe (late) stage of Alzheimer’s, mental function continues to decline and the disease has a growing impact on movement and physical capabilities. In severe Alzheimer’s, people generally:
Lose the ability to communicate coherently. An individual can no longer converse or speak coherently, although he or she may occasionally say words or phrases. Require daily assistance with personal care. This includes total assistance with eating, dressing, using the bathroom and all other daily self-care tasks. Experience a decline in physical abilities. A person may become unable to walk without assistance, then unable to sit or hold up his or her head without support. Muscles may become rigid and reflexes abnormal. Eventually, a person loses the ability to swallow and to control bladder and bowel functions.
Alzheimer’s disease is complex, and it is unlikely that any one intervention will be found to delay, prevent, or cure it. That’s why current approaches in treatment and research focus on several different aspects, including helping people maintain mental function, managing behavioral symptoms, and slowing or delaying the symptoms of disease.
Maintaining mental function
Four medications are approved by the U.S. Food and Drug Administration to treat Alzheimer’s. They may help maintain thinking, memory, and speaking skills, and help with certain behavioral problems. However, these drugs don’t change the underlying disease process, are effective for some but not all people, and may help only for a limited time.
Managing Behavioral Symptoms
Common behavioral symptoms of Alzheimer’s include sleeplessness, agitation, wandering, anxiety, anger, and depression. Scientists are learning why these symptoms occur and are studying new treatments—drug and non-drug—to manage them. Treating behavioral symptoms often makes people with Alzheimer’s more comfortable and makes their care easier for caregivers.
Slowing, Delaying, or Preventing Alzheimer’s Disease
Alzheimer’s disease research has developed to a point where scientists can look beyond treating symptoms to think about addressing underlying disease processes. In ongoing clinical trials, scientists are looking at many possible interventions, such as immunization therapy, cognitive training, physical activity, antioxidants, and the effects of cardiovascular and diabetes treatments.
http://www.alz.org/alzheimers_disease_what_is_alzheimers.asp http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-fact-sheet http://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers-stages/art-20048448?pg=1 https://www.alz.org/what-is-dementia.asp