7 Progressive Stages of Alzheimer's Disease and Other Insights
Don't you sometimes forget your appointments or even fail to remember where you placed something important? Although most people would ignore and associate memory loss with aging, it can be worse than that. It can be Alzheimer's disease.
Do you know that Alzheimer's disease is in the 6th position among high fatality diseases in America? For every three deaths that occur to senior adults in American, one of them is caused by Alzheimer's.
September 21st is World Alzheimer's Day. The world has designated this day every year to raise awareness about Alzheimer's disease, which has become rampant. The day reminds people about Alzheimer's disease and honors those who lost their lives through the illness.
The burden of Alzheimer's disease lies heavily on the patients' family and caregivers. The patient may not be aware of what is happening, especially if the disease is in its mild to severe stages. Therefore, they may care less about anything.
It is essential to note when and how the disease starts. It is also necessary to know what puts you at risk of Alzheimer's disease. That way, you can have regular checkups if you are at risk of the disease to slow the disease's onset.
What is Alzheimer's Disease (AD)?
It is a form of dementia that develops and progresses by affecting the brain cells and causing the brain to shrink. As the disease continues to affect the brain, it causes both neurons and brain damage, leading to death.
Dementia is a term that covers many other cognitive diseases besides Alzheimer's. It means impaired cognition or loss of memory, thinking, and behavioral skills.
When the brain functions continue to decline, the person affected by Alzheimer's can fail to accomplish the usual daily activities. Some of these simple duties are bathing, dressing, comprehending the things happening around, or keeping up to a conversation.
Alzheimer's is a complicated form of dementia that researchers are still working hard to find out more about the underlying cause and how to cure it. More facts about the disease keep on unfolding as the research continues. The main target for the study is to discover how to inhibit its progression and to cure it.
Fundamental Facts About Alzheimer's Disease
Alzheimer's disease derived its name from one German doctor, Dr. Alois Alzheimer, who was the first to describe its symptoms. He did it after studying the brain of one of his patients, Auguste D., who had died of the disease in 1906.
However, it was not until the year 1910 when a German psychiatrist, Emil Kraepelin, in his book, referred to one cognitive disorder, senile cerebral sclerosis, as Alzheimer's disease. It is the same disorder Dr. Alzheimer had earlier on described its symptoms. From then on, the condition came to be Alzheimer's disease.
Approximately 50 million people worldwide have diseases related to dementia. About 60 to 70 percent of these patients have Alzheimer's disease, which is the most typical form of dementia.
In 2020, about 5.8 million American people aged 65 and above in America had Alzheimer's disease. Statistics projection is that the figure may increase to about 13.8 million in 2050.
The number of people living with Alzheimer's disease in America translates to about 10%, of which two-thirds of the number are women.
Alzheimer's disease progresses more rapidly in women and shortens their lifespan compared to men. The effect of the disease in females is also more critical compared to their male counterparts.
There is a likelihood of hormonal influences on cognitive and Alzheimer's disease risk in women. A decrease in estrogen levels during menopause may contribute to the risk of Alzheimer's disease. The question is, what is the role of estrogen in women's Alzheimer's disease?
Estrogen hormone is essential in its role of protecting the neural system before menopause. When the hormone declines during and after a menopausal period, a woman becomes exposed to various diseases such as dementia and Alzheimer's disease.
One study concluded that estrogen replacement therapy could delay Alzheimer's disease onset during the postmenopausal period.
There are various Alzheimer's disease risk factors, but one common risk factor is advanced age.
Despite several risk factors of Alzheimer's disease, it remains a mysterious disease with little known about its cause. Researchers suspect protein amyloid buildup in the brain contributes significantly to Alzheimer's disease.
How Alzheimer's Disease Affects the Brain
Do you know that Alzheimer's disease may start long before you begin to experience the impact or the symptoms? Yes, it can remain 'silent' for a decade or so before the first symptoms appear. The silent period of AD when there are no symptoms is called the preclinical stage.
Although the preclinical stage may seem silent and harmless, it is a dangerous state of silence. The two brain proteins, beta-amyloid, and tau build up significantly to form plaque and neurofibrillary tangles, toxifying the brain and the neurons.
When tau abnormally accumulates, the fiber entangles inside neurons and eventually spreads all over the brain. On the other hand, amyloids build up excessively to form plaques between neurons.
Due to abnormal buildup of the two proteins in the brain, both inside and between the neurons, the affected neurons eventually die, affecting message signals in the brain.
The brain part most affected is the hippocampus responsible for memory and learning. As the neurons continue to deteriorate, the brain becomes atrophied (shrink). In most cases, it affects most of the brain's functions such as memory, thinking, solving problems, and performing normal daily activities like bathing and dressing.
While beta-amyloid and tau are the main contributors to brain damage in Alzheimer's, other factors can affect the brain. These are:
- Neurons inflammation when astrocytes and microglia cells fail to protect them from microorganisms.
- Insufficient blood in the brain due to malfunctioning vascular of the circulatory system.
- Inadequate glucose due to low blood sugar probably from excess insulin in diabetes treatment.
At the Alzheimer's disease's final stage, the brain is significantly shrunk and damaged, leading to the patient becoming dependent on their caregiver entirely for everything, including feeding.
The disease progresses in stages at a different rate with every individual patient. The life expectancy of an Alzheimer's patient can be between three and eleven years after its onset.
The 7 Stages of Alzheimer's Disease
Alzheimer's disease progresses in stages, and it gets worse through stages:
Every Alzheimer's patient experiences the disease differently due to progression timings and the extent of severity. Although most patients may follow the typical progressive stages, others may have it differently, with some overlapping phases.
While some medical personnel summarize the stages to only three, which are early, moderate, and end, most others expound it to seven stages for better understanding. The following are the seven stages of Alzheimer's disease:
Stage 1 - Pre-clinical
Stage one has no symptoms and neither any evidence of Alzheimer's disease such as memory loss. Although nothing much may seem to be amiss, the brain might be going through extreme destructive changes.
Stage 2 - Early Stage
Age-related memory loss is normal for senior adults. But, when it affects daily activities, it can be an early symptom of Alzheimer's disease. Some signs like struggling to remember a friend's name or even asking the same question repeatedly should be a concern that all is not right.
If you notice such signs with your loved one, you can bring it up with care to avoid triggering anxiety and suggest seeking early treatment to inhibit progression.
Stage 3 - Mild
More cognitive issues may begin to show. The usual daily routine at this stage becomes affected by memory decline. If your loved one starts to drift out of conversation due to the limitation of common words and frequently forgetting recent conversations, it should be a sign that the condition is progressing.
Stage 4 - Moderate
At stage four, the memory loss is beyond the typical age-related dementia. It is now becoming critical and even a concern.
Your loved one may go through a decline in short-term memory, such as failing to remember whether they have had their lunch or not. Also, simple arithmetic, such as calculating the right change when shopping, can become challenging. Surprisingly, the patient can recall memories of the distant past more clearly and better.
Other symptoms would be changes in sleeping patterns during this period, such as sleeping during the day and experiencing restlessness at night. Wondering off and probably getting lost if no one is paying attention is another advanced Alzheimer's symptom.
Stage 5 - Moderately Severe
Regular tasks such as bathing and dressing now become difficult to perform unaided.
At this stage, cognitive functions or skills have declined significantly. They can sometimes struggle to recognize close relations such as husband/wife and children.
Personality and emotional changes may occur, such as hallucinations, paranoia, suspicions, depressions, anger, and mood swings during the moderately severe stage. It is essential to note such emotional changes and to know that anything negative from the patient is not intentional.
Stage 6 - Severe
At stage six, an Alzheimer's patient is dependent on the assistance of a loved one or a caregiver. By this time, the patient is unaware of the surroundings and anything happening around.
An Alzheimer's patient cannot communicate coherently, not even when in pain, discomfort, or hunger. It is up to the caregiver to read signs and know what they want at any given time.
The behavioral, personality, and emotional changes continue to worsen. Your loved one can either be calm or temperamental. Some music can improve their mood, such as when they are feeling low or temperamental.
If the patient loved music before the disease, music might be the best pass time activity. You may be surprised to know that Alzheimer's disease does not affect the brain's musical part.
An Alzheimer's patient can, at this stage, behave like a child. At times, the mind may drift back when as a young boy or girl and hence act like one. It is in this behavioral change that your loved one may lose control of the bowel and bladder.
Stage 7 - End Stage
By now, your loved one is solely dependent on your support in every activity, such as walking, feeding. Unless you encourage your patient to chew and swallow food, they remain with it in the mouth or spit it out.
The seventh stage is the end stage of Alzheimer's disease, and the brain cells are critically damaged by now, leading to limited body functions.
Despite severe brain damages, your loved one is capable of feeling pain. Be on the lookout for gestures, facial expressions, or any sound that could signify pain. Sometimes, they might gesture to the paining part of the body.
Symptoms of Alzheimer's Disease
Each Alzheimer's case progresses and behaves differently, although the symptoms may be similar. The following are some of the typical Alzheimer's disease symptoms:
- Memory loss that progresses to interfere with daily activities
- Personality, behavioral, and emotional changes
- Challenges to handle regular tasks such as eating, bathing, and grooming
- Decreased concentration and attention span
- Sleep disorders such as disrupted sleep patterns
- Impaired judgment and reasoning
- Repeating information or questions
- Challenges paying bills or handling money
- Misplacing things in odd places
- Delusions, hallucinations, and paranoia
- Restlessness and wandering about
- Control loss of bladder or bowel
As Alzheimer's disease progresses, so are the symptoms, which become extreme. Additional symptoms for severe AD are:
- Inability to recognize close family members and friends
- Communication challenges
- Difficulties in chewing and swallowing
- Skin infections
- Increased sleep
What Causes Alzheimer's Disease?
The primary suspect cause of Alzheimer's disease are two proteins that buildup in and around the brain cells to form plaque and tangles.
One of the two proteins is amyloid, which creates plaque deposits around the brain cells. The other protein is tau, which makes neurofibrillary tangles that deposit within the brain cells.
The amyloid buildup is caused when molecules of a larger protein called amyloid precursor break down and accumulate and form plaque buildup.
Other suspected causes are:
- Chronic inflammation of the brain
- Neurons death and connection breakdown that causes brain atrophy
- Brain vascular problems
Alzheimer's Risk Factors
Although anyone can have Alzheimer's disease, some people are more prone to the disease than others. Some of the AD's risk factors are:
- Family history
- Gender - more women than men
- Head injuries
- Environmental - air pollution
- Lifestyle such as smoking, excessive alcohol consumption, and sedentary
- Other conditions such as diabetes, overweight, Down syndrome, and high blood pressure
Diagnosing Alzheimer's Disease
The best time to diagnose Alzheimer's disease would be when at its early stages, and the patient can answer questions. Early diagnosis would mean early treatment. Although Alzheimer's is a progressive disease, some medicines can slow the progression of the disease.
In the later stages, the caregiver would explain the symptoms and other details as the doctor requires.
Some of the diagnostic procedures for Alzheimer's disease are:
Health history: The first thing the doctor would do is to take personal records such as age. Next, it would be to note down symptoms either narrated by the patient or the caregiver.
Physical examination: The doctor may assess the muscle strength by a simple test such as sitting, standing, or walking around.
Neurological examination: The doctor would be attentive to study the patient's reflexes, balance, and coordination. The doctor may note the memory capacity, attention span, counting skill, and language when talking to the patient.
Medical tests: A lab technician may carry out blood and urine tests to rule out other conditions and to identify what might be responsible for the disease.
Imaging tests: A medical personnel would process some brain scans such as MRI (magnetic resonance imaging), CT scan (computed tomography scan), or PET (positron emission tomography).
The brain images would capture brain shrinkage due to Alzheimer's or other signs of a stroke, brain tumor, or brain injury, if any.
However, Alzheimer's diagnosis is not a one-time process, but it is repeated every half-year or yearly to note any changes.
Alzheimer's Disease Treatment
Alzheimer's is a chronic and complex disease with challenges in treating it. It is important to note that, so far, there is no cure for the disease. However, some medicines can help delay the disease's progression and enhance life quality while prolonging it.
The two primary drugs for treating Alzheimer's disease are:
Cholinesterase Inhibitors. Some nerve cells become less active in patients with Alzheimer's disease, which causes slow brain signals to the nerve cells. Therefore, cholinesterase inhibitors help convey timely signals between neurons.
Cholinesterase inhibitors also help to delay the disease's progression when in the early stages. There are various reports of Alzheimer's patients who had memory improvement while under any of the cholinesterase inhibitors medications. Donepezil, galantamine, and rivastigmine are the common cholinesterase inhibitors used for Alzheimer's disease.
The side effects of cholinesterase inhibitors are dizziness, nausea, vomiting, diarrhea, and appetite loss.
Memantine. For moderate to severe Alzheimer's disease, memantine is the standard medication that a doctor would prescribe. Memantine can effectively decrease Alzheimer's symptoms in later stages.
The medication can also help the AD patient restore the ability to perform some of the daily functions, such as using the bathroom unaided.
Memantine works by regulating glutamate, which, when in excess, can cause brain cell death. Glutamate is nerve cells' excitatory neurotransmitter in the brain that plays a significant role in maintaining memory and learning.
Since memantine and cholinesterase inhibitor drugs are essential in treating Alzheimer's diseases and work differently, the doctor might prescribe both of them.
The side effects of memantine are coughing, dizziness, confusion, headache, constipation, and diarrhea.
The Future Treatments for Alzheimer's Disease
Almost all medical eyes and ears are towards the FDA (Food and Drug Administration) for the long-awaited approval of the upcoming Alzheimer's treatment called aducanumab. The FDA expects to approve the new medicine any time soon.
Aducanumab is an artificial antibody made to stick on the amyloid molecule responsible for plaque formation. Plaque buildup and tau tangles occur due to protein accumulation, which is responsible for brain cell damage.
When aducanumab sticks to the amyloid plaque, it activates the immune system to expel the plaque. Once the immune system removes the plaque, the brain cells recover and improve brain functions.
However, few people would afford aducanumab treatment as it would be exorbitantly priced.
Alzheimer's Disease Alternative and Natural Treatment
Since there is no standard treatment that can reverse Alzheimer's disease or inhibit its progression, more cases are expected to rise by 2050. The current standard treatment may be useful in slowing the progress of Alzheimer's disease. However, the treatments have dire side effects that may affect the patient's overall health.
Moreover, conventional treatment may also overburden the patient's family economically, while others may not afford the treatment.
Some natural remedies can help manage Alzheimer's disease. However, if the patient is on standard treatment, it would be better to consult the doctor to approve the use of alternative medicine.
The following are some of the alternative and natural treatment for Alzheimer's disease:
Brahmi (Bacopa monnieri): Brahmi is an ayurvedic herb of Asian folklore medicine. It is an ancient natural medicine for treating disorders such as insomnia, epilepsy, anxiety, memory enhancement, Alzheimer's disease, and other neurological disorders.
Turmeric: The yellow spice is an overall health remedy. Besides its many benefits, the molecule in its curcumin compound can bind to beta-amyloid to prevent its accumulation and to form tau tangles.
Ginkgo biloba: Ginkgo is another ancient folklore medicine among the Chinese for cognitive disorders. The plant extract contains various compounds that effectively enhance body and brain cells for better performance. One study on the treatment of 404 AD patients with Ginkgo extracts (EGb 761) resulted in cognitive function enhancement and improved symptoms.
Acupuncture: Acupuncture is a treatment method in Chinese traditional medicine practices. Although it dates back many centuries, it is becoming popular in the current complementary and alternative treatment.
Acupuncture treatment for AD enhances cerebral blood flow in the prefrontal lobe and hippocampus, most affected by Alzheimer's disease.
Natural Remedies for Alzheimer's disease
Many doctors may not recommend natural remedies, probably because some can interfere with the prescribed treatment. However, some alternative therapies do not interfere with Alzheimer's disease treatment, which includes:
Acutherapy. Acutherapy differs from Acupuncture. It simultaneously produces mechanical, thermal, and electrical stimuli which work together to create a chain of electro-chemical reactions. This sets off a chain of electro-chemical reactions that stimulates the production of neuro-transmitters. Then, messages are sent to the brain to organize the proper peptides to restore the body to its homeostatic (physical and chemical) state.
Acutherapy produces mechanical, thermal and electrical stimuli that stimulate the production of neuro-transmitters.
Other natural remedies for Alzheimer's disease are:
- Cannabidiol (CBD)
- Ginseng (Panax ginseng)
- Ashwagandha (Withania somenifera)
- N-acetylcysteine (NAC)
- Vitamins A, B, C, D, and E
- Stress management
- Regular exercising
Alzheimer's disease is projected to escalate in the future. Therefore, it is essential to take care of your cognitive health, especially if you are approaching a precarious age of Alzheimer's disease.
At Island Healthworks Natural Clinic, we are open to discussing Alzheimer's disease and the available treatment procedures. It is essential to receive treatment early in the stage.
I dedicate this article to two noble matriarchs, Mary and Naomi, who braved Alzheimer's disease to the end. Keep resting in peace, dear moms, till we meet again.
Island Healthworks offers in-person and virtual consultations for assessment of your specific needs, with health & lifestyle coaching, featuring the best of integrative natural health care. To book your consultation, please call 250-468-7685!
This article is intended for educational purposes and the information contained within is not intended to treat, diagnose or cure any disease or health problem. Please seek appropriate medical attention for any health complaints. We cannot take responsibility for your health care decisions. Our intent is only to offer health information to help you with your search for better health.