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Stages and Treatment of Alzheimer's Disease
Alzheimer’s disease (AD) is a type of progressive deterioration of the structure and function of the brain. In the prodromal stage, a person may function appropriately in his or her home and work environment, and abnormalities in cognition may be apparent only on detailed neuropsychologic testing.Eventually, cognitive deficits are noticeable.
A person with Alzheimer’s disease early on has difficulty with:
* short-term memory
* making lists
* keeping track of complicated appointments or social schedules
* organizing a vacation trip
* following directions using a map
* coordinating a multi-course holiday family dinner.
Later in the disease, there are often problemswith long-term memory, mood, apathy, agitation, and abnormal motor activity (e.g., pacing). Affected people have trouble using appliances—first, complex ones, such as the car or dishwasher; later, the telephone; and lastly even table utensils.
Not every memory problem becomes dementia, and not every cause of dementia is AD. Dementia means that there is a loss of memory and at least one other aspectof cognition, such as abstract thinking, personality, or executive (organizational) ability, and that the loss interferes with function. Dementia cannot be diagnosed when a person becomes suddenly ill, such as with a fever, infection, metabolic derangement, etc.
Alzheimer’s disease is the most common cause of dementia. However, stroke, alcohol, Parkinson’s disease, and other medical conditionscan cause dementia as well.
Alzheimer’s disease has both a genetic and an environmental component. The genetic component is very strong in those diagnosed with AD in their 40s or early 50s. However, these represent a small fraction of the AD population. Most people with Alzheimer’s disease develop symptoms in their 70s and 80s, and the genetic component is much weaker at this age. Only 50% ofidentical twins of older Alzheimer’s patients are diagnosed with Alzheimer’s disease.
Health and environmental factors, such as mental and physical activity, and treatment of medical conditions such as hypertension and diabetes play a strong role in postponing AD symptoms. Genetic testing for Alzheimer’s disease occurring after age 60 is not generally recommended.
Stages of Alzheimer’s diseaseProdomal: This stage is usually not diagnosed because people in this stage are functioning at a high level. Occasionally, they may report having more problems than usual with short-term memory, or remembering names or where they placed their belongings. However, they balance their checkbook, keep appointments, and continue to drive.
People compensate by giving themselves more time to adapt andperhaps by writing reminder notes. Some people may become anxious about their memory deficits. There is no specific treatment except for lifestyle.
Mild: In this stage, cognitive deficits are noticeable in demanding situations. The key to diagnosing mild dementia is that function at home or work is impaired, although slightly. Affected people begin to need help with complicated tasks such as planninga party or handling finances. They may have problems remembering life events (hospitalizations, medical conditions, educational/job milestones), have trouble concentrating, and may have trouble traveling, particularly to unfamiliar places.
Most people in the mild stage have no problem with familiar faces, are not disoriented with respect to time, and can usually travel to familiar places.However, people with Alzheimer’s tend to back away from dealing with difficult or challenging situations. Their mood may be a bit "flat." Most are not aware of the extent of their deficits. They may say they have the same memory problems everyone else their age has, but they really do not understand the extent of their loss.
Many persons with mild Alzheimer’s disease may still be driving. They should...