Alzheimer’s disease is a progressive neurological condition in which gradual shrinkage (atrophy) of the brain occurs, which leads to the death of brain cells, loss of memory, and cognitive decline.
Cognitive decline is also known as cognitive impairment, in this condition the person faces trouble remembering, learning new things, concentrating, or making decisions that affect their everyday life.
History of Alzheimer’s disease discovery
It is named after a German psychiatrist and neuroanatomist, Dr. Alois Alzheimer, who first described the condition to the 37th Meeting of South-West German Psychiatrists in Tubingen on November 3, 1906.
In this report, he described a case study of a 50-year-old woman, who has conditions of paranoia, progressive sleep and memory disturbance, aggression, and confusion.
Dr. Alois Alzheimer deeply observed and studied the conditions of this patient from the day of her admission to the Frankfurt Psychiatric Hospital for treatment to till her death and she died after 5 years of her admission.
After her death and autopsy, Dr. Alzheimer described histological alterations in her brain that later came to be known as amyloid plaques and neurofibrillary tangles.
Neurofibrillary tangles (NFTs) are aggregates of hyperphosphorylated tau protein that are most commonly known as a primary biomarker of Alzheimer’s disease.
Dr. Alzheimer published three further cases in 1909 and a “plaque-only” variant in 1911. Dr. Alzheimer died in 1915, aged 51, soon after gaining the chair of psychiatry in Breslau, and long before his name became a household word.
Usually, in a Progressive pattern, Alzheimer’s disease follows different stages but each person moves through the disease stages in his or her own way. Alzheimer’s disease tends to develop slowly and gradually worsen over several years.
Knowing these stages helps healthcare providers and family members make decisions about how to care for someone who has Alzheimer’s disease.
1. Preclinical stage
Alzheimer’s disease begins long before a person experiences any signs of the disease. This stage is called preclinical Alzheimer disease and it can last for years, possibly even decades.
The patients suffering from this disease won’t able to notice, as well as the people around of his or them. Nowadays, new imaging technologies can identify the changes in the brain i.e. deposits of a protein called amyloid-beta which is treated as a hallmark of Alzheimer’s disease.
2. Early-stage or Mild cognitive impairment (MCI)
Symptoms at this stage include mild forgetfulness i.e. mild changes in the patient’s memory and thinking ability. This may seem like the mild forgetfulness that often comes with aging as well as problems of making concentrating in a particular task or work.
However, these changes do not significantly affect work and relationships yet.
A person in this stage may still live and work independently, but may face problems:
- Remembering a name
- Recalling recent events
- Remembering where he or she put a valuable object
- Making plans
- Staying organized
- Managing money
- correctly judging the number or sequence of steps required to complete a task
- Taking headstrong decisions
The person, his or her family, friends, or neighbors may also notice these difficulties. However, not everyone with MCI has Alzheimer’s disease and is often diagnosed.
3. Moderate, or middle stage
This is typically the longest stage, usually lasting many years. More intensive supervision and care become necessary in this stage, which can be difficult for many spouses and families. Symptoms may include:
- Increased memory loss and confusion
- Increasing trouble remembering events
- Inability to learn new things
- Difficulty organizing thoughts and thinking logically
- The trouble with planning complicated or multi-step tasks, such as getting dressed or taking dinner
- Trouble remembering their own name, but no details about their own life, such as address and phone number
- Difficulty with language and problems with reading, writing and working with numbers
- Problems coping with new situations
As the disease progresses, the person may:
- Face problems in recognizing family and friends
- Lose track of time and place
- Need help choosing the right clothing, getting dressed, and with daily activities, such as brushing teeth
- Become moody or withdrawn, or have personality changes, such as hallucinations, delusions, and paranoia
- Become restlessness, agitation, anxiety, tearfulness, wandering—especially in the late afternoon or evening
- Be restless, agitated, anxious, or tearful, especially in the late afternoon or at night
- Inappropriate outbursts of anger
- Repetitive statements or movement, occasional muscle twitches
4. Severe, or late-stage
People with severe Alzheimer’s cannot communicate and are completely dependent on other persons for their care. Near the end, the person may be in bed most or all of the time as the body shuts down. Their symptoms often include:
At this stage, a person:
- Inability to communicate
- Weight loss
- Difficulty swallowing
- Groaning, moaning, or grunting
- Increased sleeping
- Loss of bowel and bladder control
- Is more likely to get infections, especially pneumonia
A common cause of death in Alzheimer’s patients is aspiration pneumonia and this type of pneumonia develops when a person is unable to swallow properly and takes food or liquids into the lungs instead of air.