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Karpagam Anand
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ALZHEIMER'S DISEASE AND ITS STAGES

7 October 2021

1. What is Alzheimer’s Disease?

Alzheimer’s disease is a progressive, irreversible, neurodegenerative disorder that affects the brain cells. It is the most common form of dementia, gradually worsens memory and other mental functions including behavioral and social activities.

Alzheimer’s is not the normal part of aging but a major risk factor for AD is increasing age. The most common pathology involved is the formation of beta-amyloid plaques and neurofibrillary tangles in nerve cells. There is no reversible cure for Alzheimer’s disease but research is going on to delay the clinical progress of AD.

2. What are the types of Alzheimer’s Disease?

There are totally 7 stages of Alzheimer’s disease. They are

Stage 1: Normal outward behavior/ preclinical Alzheimer’s disease

Stage 2: mild cognitive impairment

Stage 3: mild dementia

Stage 4: moderate dementia

Stage 5: moderately severe dementia

Stage 6: severe dementia

Stage 7: Very severe dementia

Stage 1 - Normal outward behavior/preclinical Alzheimer’s disease

This is the early but long phase of Alzheimer’s disease. Initially, the patient will not have any clinical symptoms oriented to the disease. Only the imaging techniques like PET scans can identify the spots of plaques and tangles in the nerve cells which can confirm the diagnosis of AD.

Stage 2 – Mild cognitive impairment

Mild cognitive impairment is a common term that may even occur with a normal part of aging but it occurs more severe in AD patients. It is not that everyone with mild cognitive impairment develops AD only 10 to 15 % of people with mild cognitive impairment develop AD. Changes in thinking and remembering things are the first noticeable changes in persons with mild cognitive impairment. These changes will not affect their day-to-day life and usual activities but it usually takes more time to remember the names and words.

The symptoms of mild cognitive impairment include forgetting the names often, inability to make conversation, decisions, judgments. Sometimes people with mild cognitive impairment can have depression. Anxiety and confusion.

Stage 3 – mild dementia

Only at this stage usually, physicians diagnose Alzheimer’s disease. The memory problems and thinking difficulties during this stage gradually start to affect the daily life of the patient. Symptoms of mild dementia in Alzheimer’s disease include

· Inability to remember the newly read words or newly met people’s name

· Facing difficulties in solving the problems and in completing the daily tasks

· Lacking of motivation and judgments skill

· Facing difficulties in remembering or finding the correct words for an object or things

· Chances of getting lost or forgetting the way to home

Stage 4 – moderate dementia

At this stage, the person with stage 4 moderate dementia needs assistance to perform daily activities. They become more confused about the activities and more forgetful. Symptoms of moderate dementia include

· Failing to recall the date, day, season, or climate

· Inability to find the way in very similar places and starts wandering around

· Confusing the names of family members and strangers as family members

· Need assisting in daily activities like brushing, bathing, and grooming

· Being restless, feeling agitated, and sometimes hearing voices

Stage 5 – moderately severe dementia

During this stage, a person with moderately severe dementia tends to seek help more often for usual activities like eating. They tend to hear more related voices and start reacting to them. The common symptoms that moderately severe dementia include

· Keep on repeating favorite memories and making up irrelevant stories

· Forgetting personal information like mobile number, address, education, and working status

· Need help in daily and usual activities

· Hearing voices often

Stage 6 – severe dementia

At this stage, the people start confusing their own name and the person near to them. They often confuse their wife/husband as their mother/father. They might remember faces but tend to forget their name. delusions are commonly seen in this stage and they start to assume that they need to go to work even though they don’t have any job.

They might need to assist to go to the bathroom. At this stage, they feel difficulty in speaking or connecting the word to make a sentence but anyhow they tend to fill in similar words and make a sentence that might be understandable.

People with AD love to listen to music or looking through old photos sometimes.

Stage 7 – very severe dementia

At this stage mental functions and movement functions both can start to decline, for example, normal activities like eating, sitting, standing, and walking start fading a lot.

Symptoms of very severe dementia include

· Difficulty in swallowing, eating, and chewing.

· Inability to control bladder and bowel movements

· Inability to speak properly and communicating the exact words

· They need complete assistance in eating, bathing, toileting, grooming, and other personal activities

· Inability to sit or stand due to rigid muscles and abnormal reflexes.

There is no absolute cure or to stop/delay the progression of Alzheimer’s disease. Researchers are still working on developing disease modifying drugs to delay the progression in early stages. A person with Alzheimer’s disease does not die directly they often die due to pneumonia, a lung infection that may be due to difficulty in swallowing during eating, where the food particles enter into the lungs and cause infections. Other causes of death include kidney failure, malnutrition, or dehydration.

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