As stated on other pages, Alzheimers symptoms and other types of dementia are subtle in the very early stages and may be attributed to a number of other causes.
It is only when the person begins to experience difficulties with daily living that the individual or loved ones and friends notice and become concerned. Alzheimer's is a progressive disease and currently, and cruelly, there is no cure.
Alzheimer's Disease is a disease that predominantly affects people in the later stages of life and that is normal after the age of 65. Concurrent with ageing, of course, is a decline in cognitive functions as we tend to lose the speed of response of our younger years.
Only about 4% of people who show the symptoms of Alzheimer's are in their 30s, 40s and 50s.
It is important for many important reasons that individuals who are resenting with the symptoms of Alzheimer’s or any other of the types of dementia seek or are guided to see their doctor. If the condition is suspected the individual will be referred to specialists for further tests (Alzheimer’s test and brain scans).
Being diagnosed with Alzheimer's can feel like receiving a terminal sentence, because as we know there is no cure for this dementia at present. However, it is vitally important to understand that memory loss and cognitive decline can also be caused by medical conditions, B12 deficiency, thyroid, stress and anxiety, for instance. So best that the condition be diagnosed as soon as possible.
The Alzheimers symptoms are generally mild to begin with, but they inevitably worsen over time and interfere with daily life.
On another page I have written about Mild Cognitive Impairment (MCI) and I would refer you there for attribution of symptoms that might mask or be confused with the early stages of dementia - particularly Alzheimer's Disease.
As I write there, not everyone who suffers from Mild Cognitive Impairment goes on to develop Alzheimer's or similar dementias, but almost everyone who goes on to develop Alzheimer's has suffered from MCI.
Everyone with Alzheimer's will experience symptoms in their own way, but certain changes are characteristic of the disease.
In the early days, it can sometimes be difficult to distinguish the symptoms of Alzheimer's from mild forgetfulness which is, for most of us, a normal part of ageing.
A persistent decline in memory is regarded as being the most prominent initial sign of concern, but this is not necessarily so in all cases of Alzheimer's disease. Age normally brings with it a decline in how our brain works, particularly our ability to take up, retain and act on new information. However, this is not always picked up as a dementia symptom.
As the dementia progresses, memory declines further and forgetfulness becomes more and more immediate as the person forgets what he or she has just said. The dementia sufferer may consequently repeat the same question again and again. There is also a strong tendency to forget recently received information, recent events and important fixed dates.
Long-standing memories will remain with many dementia patients; however, in the latter stages they will also fade away. The loss of the memories around which we establish our identity casts the person out in a sea without familiar reference points to navigate.
In order to take control of this decline the individual may tend to depend more and more on memory aids and on family members. As the memory declines progressively this will lead to confusion and distress. The distress for the individual will be marked but it can be very harrowing for family and friends who watch on.
It is the gradual loss of identity and struggle to retain it that causes most distress.
Because of the strained economic situation many more people will find themselves working later in life in order to make ends meet. Consequently, because the greatest risk factor Alzheimer's and other dementias is AGE, it is not unreasonable that many more people will find themselves suffering Alzheimers symptoms in and around their work place.
The loss of the fundamental skill of making plans and decision-making results from confusion caused by the dementia type. Work related skills and tasks that have become honed and ingrained over the years become strangely more and more difficult. Employment that requires consideration of new information for the development of skills on a regular basis will suffer. The person will lose the faculty for following step-by-step instructions.
The loss of the ability to concentrate or taking much longer to achieve what was previously an effortless act is significant and may be a symptom of Alzheimer’s. Any sudden or progressive decline in function in the workplace should be regarded as requiring immediate attention.
At home, the person suffering the early stages of Alzheimer's may forget to pay bills and there are severe consequences to this. Problems with dressing and carrying out carrying out until recently familiar tasks like following recipes or using electronic equipment. A person suffering from Alzheimer's disease will misplace familiar objects by putting them in unusual places.
Not recognising familiar faces. A sad tale demonstrates this cruelly. A husband and wife were sat next to each other. The wife in the early stages of Alzheimer’s turned to her husband and asked, "Where's Roger?" The husband's name was Roger.
In the later stages of her dementia Mam thought I was her husband. I neither said nor did nothing to dispel that belief. If Mam was calm and psychologically comfortable believing that, then who was I to cause distress and confusion for her?
With Alzheimer's Disease this decline in functioning in the work place will be gradual and distressing. For people living alone the consequences of memory loss can cause a desperate sense of isolation. Forgetting to do the shopping and paying electricity bills compound the situation further.
While there is no cure for Alzheimer's or any dementia, early intervention is vitally important in seeking to allay the early impact of Alzheimers symptoms for as long as possible.
As the amyloid protein plaques migrate across the brain, much damage is done to intellectual and physical abilities.
We make most of our decisions about the world though the information that comes in through our senses. The death of brain cells in the perception and optical regions create the circumstances for further cognitive decline by confusing the real meaning of signals and view of the world.
Vision brings in information to be processed for significance, consideration and action. But when those signals coming in through the eyes in particular become distorted then the brain will still attempt to give a meaning to those signals, thus resulting in misperceptions of the real world.
Alzheimer's patients will see the world differently, will misidentify familiar objects or may not be able to distinguish food on a plate from the plate itself. Most worryingly, and I have not seen this myself, the patient may look at a reflection of him or her in a mirror and believe that he is looking at another person.
There is also difficulty in perceiving distances and with reading.
What exists in the real world does not reach the perceptual processing centres undistorted. There are medical conditions that can cause this, such as strokes. Therefore it is important to carry out brain scans to discover whether it is a stroke, disease or Alzheimers symptom.
Anxiety and agitation frequently accompany Alzheimers symptoms . One must always remember that in the early stages in particular there is an awareness of a decline in memory and cognitive skills. For many dementia patients this causes enormous distress and can cause rapid and unexpected behavioural changes.
In the very early stages of Alzheimer's or dementia sudden mood swings can be an indicator of the dementia at worst. Although, mental health problems can cause similar outbursts, but if no mental aberration has been noticed before and there is no medical history then one possible diagnosis is dementia.
The Alzheimer's patient can become very fearful and upset for no apparent reason. Finding him or herself in unfamiliar situations, such as being removed from home to an Alzheimer’s care or nursing home.
As the disease progresses it becomes more and more difficult to explain a changed situation to the Alzheimer’s patient because of the inability to understand and follow thoughts to a conclusion. The patient only knows fear and this may manifest as paranoia and a growing doubt of the motives of those closest.
Agitation, anxiety and confusion worsen with fatigue. The person may pace around all day with a purpose of seeking familiar objects or sight. In Mam's case, she would wander about all day and as the sun set in winter or just after five o'clock in the summer months she would become distressed and extremely fearful. This is called 'Sundowning'. The dark was the cause of great distress.
An Alzheimer's patient may also become disinhibited in his or her behaviour and make inappropriate advances on friends and say inappropriate things. This can be very embarrassing for the partner.
Alzheimer’s patients lose the ability to engage in extended conversations and understand the complexity of Language is one of the main Alzheimers symptoms. The patient may begin a conversation, lose the thread halfway through and then repeat the same words or phrase over and again, being unable to hold a single thought to its conclusion when speaking.
There is loss of vocabulary or confusion over words. A person will struggle to find the right word and use an incorrect word or refer to a familiar object in a descriptive manner, such as Dog may be referred to as That four legged thing.
There is a loss of coherence as the dementia patient switches from one topic to another in the middle of a conversation. This is a consequence of damage caused as brain cells die because of the proliferation of amyloid plaques.
Each individual suffers Alzheimer's or any other type of dementia in his or her own specific way as the progress of the cell death varies from person to person. Loss of ability to communicate is a sign of Alzheimers symptoms when it is occurs in a constellation of other symptoms. It is the persistent, progressive decline that confirms a major problem exists.
In the early stages of Alzheimer’s, the person will be aware of his or her decline. This will be traumatic. This is an understatement.
As Alzheimer's disease or most dementias progress the dementia patient will invariably lose interests in topics and hobbies about which he or she was previously deeply passionate. The person may become depressed and withdraw from normal social situations.
We fix ourselves in the world according to our identity and relationships which are formed with specific references to people, places and our skills and expertise. As a consequence of memory loss and problems with skills we begin to lose those references. This can be the cause of depression and frustration.
It is estimate that about 40% of people suffering from Alzheimer's disease are depressed but this is difficult to diagnose. Awareness of fading agency and confusion over what is real and unreal would inevitably lead to depression.
A normally very active person can become the very opposite. The loss of skills and confidence are primary drivers for apathy and lethargy, as stated above.
The Alzheimer's patient may make decisions based on irrational thinking inappropriate to circumstances. The decisions may be based on delusions (false beliefs) that are a great distance removed from any the person might previously made.
It will be difficult to persuade the person that the decision is incorrect. Imagine the damage that impaired judgement can have on a person's finances if irrational decisions to spend or withhold money occur.
People presenting with the early stages of Alzheimer’s can be easy victims of telephone financial scams.
A Hallucination is a visual misrepresentation of something in the person's environment. This can be something as harmless as transforming a hospital patient hoist. However, objects and shadows can be transformed into horrifying entities. These episodes can last quite a while and the patient cannot be reassured.
In the most extreme cases this might require medical intervention with sedatives or long term with the use of antipsychotics. It must be remembered that antipsychotics can be very harmful for some dementia patients. In fact, they can be fatal.
In my experience a hallucination is when the lady in the hospital bed next to my mother confused a hoist across the ward used for raising frail patients from their beds for a horse. She admonished all and sundry for leaving the gate open.
For her, a foot stool beside had become a dog, who was further admonished for being useless. Yet, when she looked at me and the nurses and health care workers she saw people. What she thought of those nurses was unique to that lovely lady.
Hallucinations can also arise from hearing and misperceiving.
A Delusion is a false belief that gains traction enough to cause a behavioural change. A dementia patient may develop a delusion that his or her partner is being unfaithful, that someone is stealing items of clothing or important objects that the person has misplaced him or herself.
In the progressive stages of Alzheimer's disease, as with other dementias, there will seem to be a purposeless to the behaviour of some patients. However, what seems purposeless to the viewer is not true for the person who continuously opens and shuts drawers and cupboards. The patient has a purpose in mind, albeit unfathomable to viewers.
A person may wander up and down a corridor in a care home all day. A beautiful elderly lady I met in Mam's Alzheimer’s care home would state an intention of going down to the gate to find out why someone had left bags of potatoes there. She would reach the end of the corridor and return with a different purpose.
Purpose reflects a need to give meaning to an activity. Conversely, a repetitive activity can be used to try and find purpose. Best to allow the patient to pursue this activity or it can cause agitation and even aggression. Physical activities will cause fatigue and exhaustion, which will cause agitation.
Alzheimer’s patients on a mission tend not to want to eat or drink. I have seen Alzheimer’s caregivers walk alongside a dementia patient for a long time handing them pieces of sandwiches and savouries.
Dehydration can become a major problem in the later stages of Alzheimer's and all dementias.
In the early stages of Alzheimer’s, prior to when behaviour and physical risks to self and others might arise, a substantial number of dementia patients (around 60%) will feel the need to walk off, seemingly aimlessly. However, there is always a purpose albeit unknown possibly to the dementia sufferer him or herself.
Completely unaware of time, a friend would get up at two o'clock in the morning to be found eventually at his church, confused as to why the door was locked.
Others may wander lost in familiar locations, unable to recognise anything that was once a concrete reference point in personal geography. The person will continue to wander seeking something familiar.
The concept of Home changes. Home becomes something more abstract as the person forgets the details of his or her own home. Home may be a place of security in memory that no longer physically exists.
Return to Symptoms of Dementia Page