Everyone is forgetful now and again, and as we age the occurrences may become even more frequent. Yet most people who have mild forgetfulness do not have Alzheimer’s disease. But when memory loss starts to interfere with daily activities, it may be time to consult with a physician.
Alzheimer’s disease is not a product of the natural aging process. Scientists do not know what causes the disease; however, age is a factor. The disease usually begins after age 60 and the risk goes up with the increase in age. Approximately five million Americans currently suffer from Alzheimer’s disease.
According to the National Institute on Aging, there are seven early warning signs of Alzheimer’s disease:
- Asking the same question over and over again.
- Repeating the same story, word for word, again and again.
- Forgetting how to cook, or how to make repairs, or how to play cards—activities that were previously done with ease and regularity.
- Losing one’s ability to pay bills or balance one’s checkbook.
- Getting lost in familiar surroundings, or misplacing household objects.
- Neglecting to bathe, or wearing the same clothes over and over again, while insisting that they have taken a bath or that their clothes are still clean.
- Relying on someone else, such as a spouse, to make decisions or answer questions they previously would have handled themselves.
The Stages of Alzheimer’s
Developed by Elizabeth Ostuni and Mary Jo Pietro, Lincoln, Nebraska, Chapter, Geriatric Care Managers
Early “Forgetful” Stages
- Gets along adequately in most social situations.
- Digresses from topic in conversation.
- Relies heavily on clichés.
- May ramble on and on.
- Tends to repeat self.
- Can still handle some casual social situations.
- Makes vague, empty, irrelevant conversation.
- Withdraws from difficult social situations.
- Does not initiate conversation.
- Repeats ideas over and over.
- Is excessively self-oriented.
- Asks fewer questions.
- Is no longer aware of social interaction or expectancies.
- Withdraws partially or completely from communication.
Although not everyone experiences the same symptoms in the same order or with the same time schedule, we can generally characterize the progress of the disease in six stages, which may last three to 20 years. Note that these represent stages of brain deterioration; they can be caused by diseases other than Alzheimer’s.
Very mild cognitive decline: For example, problems such as: subjective complaints about memory deficit such as placement of familiar objects, forgetting names once known well. There is no objective evidence of deficits in social or employment situations. Don’t assume that all confusion and memory loss signal Alzheimer’s. Reactions to medications can cause reversible delirium and other medical problems may cause dementia. If you are worried, get a medical diagnosis.
Early stage: Mild cognitive decline: For example, problems such as: getting lost when traveling to a familiar location; noticeably lowered performance level at work; trouble finding words and names; little retention from reading; little or no ability to remember names of new people; loss of a valued object; and trouble concentrating.
Late stage: Moderate cognitive decline: For example, problems such as: decreased knowledge of current and recent events; deficit in memory of personal history; decreased ability to handle travel or finances; and inability to perform complex tasks. Appropriate responsiveness to outside stimulation decreases sharply. Denial of any problem, and withdrawal from challenging situations are common.
Early stage: Moderately severe decline: For example, the person can no longer survive without some assistance. Patients can’t remember names of people or places in their lives. They may be disoriented about time and dates. However, they will require no assistance when using the bathroom or eating, but may need help in getting dressed.
Middle stage: Severe cognitive decline: For example, the person may forget name of spouse and be unaware of events in his or her life. He or she is entirely dependent on others for survival. He or she may have trouble sleeping in a regular pattern.
Late stage: Very severe cognitive decline: For example, all verbal abilities are lost and he or she needs help eating and using the bathroom. Eventually he or she loses the ability to walk; the brain appears to no longer be able to tell the body what to do.
Based on B. Reisberg, Clinical Presentation, Diagnosis, and Symptomatology of Age-Associated Cognitive Decline and Alzheimer’s disease. Alzheimer’s Disease: the Standard Reference, New York Free Press, 1983.
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