T he Alzheimer Society is very good at putting out education and helpful tips for those who have Alzheimer’s disease in their family, as well as for caregivers and those who want to do their best to avoid succumbing to
T
he Alzheimer Society is very good at putting out education and helpful tips for those who have Alzheimer’s disease in their family, as well as for caregivers and those who want to do their best to avoid succumbing to this widespread and devastating disease.
The society has published a step-wise format to teach people about the progression of Alzheimer’s disease and I think it is good for everyone to be aware of the signs and symptoms and how abilities of those with Alzheimer’s disease change over time.
Not everyone will progress at the same rate, but the information here is based on the work of Barry Reisberg, the clinical director of the New York University School of Medicine’s Silberstein Aging and Dementia Research Center. Some stages may overlap.
In the early stages of Alzheimer’s disease there is no memory loss and a medical professional would not note any dementia. In the second stage of the disease, the individual may feel that they are having memory issues. They may forget familiar words or where they put something, but a medical examination would not reveal anything, and family and acquaintances would not notice any signs of dementia.
In the third stage of Alzheimer’s disease, some people may be diagnosed with mild cognitive impairment, whereas others may not. Family and acquaintances begin to notice some cognitive difficulties, and during a detailed medical examination, a health care professional may be able to detect memory problems or concentration issues. At this stage of the disease, a person may have problems with the right word or name, trouble remembering names when introduced, may forget something they have just read, might start misplacing valuables, have increased difficulty with planning and difficulty at work.
By the fourth stage, someone with Alzheimer’s disease has very clear symptoms that will be obvious at a medical examination. Some issues are forgetting recent events, lack of ability to perform challenging mental arithmetic, difficulty with complex tasks such as paying bills or managing the finances, and moodiness, especially when challenged with difficult tasks or in social contexts.
The fifth stage is called moderate or mid-stage Alzheimer’s disease. In this stage the gaps in memory and cognition (thinking) are noticeable, and many people need help to manage their day-to-day activities.
Some of the markers of this stage are being unable to remember one’s own address, or telephone number, or the school they attended, becoming confused about what day it is, having trouble with easy arithmetic, needing help to select proper attire. Most people at this stage can still remember significant details about themselves and their family and still can eat and use the bathroom without assistance.
Stage six is moderately severe cognitive decline, wherein the memory continues to decline and personality changes begin to take place. At this stage, many people need extensive help with their daily activities. They may not know where they are, and may not remember something that just happened. They remember their name, but their personal history is compromised.
The person with stage six Alzheimer’s disease can distinguish between familiar and unfamiliar faces but may have difficulty remembering the name of their caregiver or their spouse.
They need help to dress and sleep disruptions occur, so that they may sleep during the day and be up at night.
Assistance is needed in the bathroom to properly cleanse themselves and flush, and they may have trouble controlling their bladder and bowels.
At this stage people with Alzheimer’s disease may experience behavioral and personality changes including becoming suspicious and compulsive. They also may wander (Sundowner’s syndrome).
The final stage is severe or late-stage Alzheimer’s disease. At this point people do not respond to their environment, they do not respond to conversational prompts although they may still say words or phrases, and eventually they lose the ability to control their movement.
At this stage people with severe cognitive decline need assistance eating, using the toilet and most other facets of their life. Their muscles become rigid, swallowing is impaired, they lose the ability to smile and are unable to sit up or hold their heads up. Reflexes become abnormal.
Next week, I’ll talk about the link between Alzheimer’s disease and diabetes. This is information that is vital for you to know and to do something about.
• Jane Riley, M.S., B.A., C.P.T., Certified Nutritional Adviser, can be reached at janerileyfitness@gmail.com, 212-1451 or www.janerileyfitness.com.
