Stages of Alzheimer's disease: how they manifest themselves, duration

As a person approaches old age, not only the processes of memorization may suffer, but also mental abilities and cognitive reactions. A huge problem in this case is the annual increase in the number of patients with Alzheimer's disease - this is the so-called age-related dementia, which not only significantly worsens the patient's quality of life, but also brings his death closer. Doctors are forced to state that the disease has become "younger", that is, it manifests itself at a younger age. Therefore, every person who cares about their health should understand what stages of Alzheimer's disease exist, how to recognize them, and how to slow down their further development.

How many stages of Alzheimer's disease are there?

It has been recently discovered that degenerative transformations in brain tissue begin to form one and a half to two decades before the first clinical symptoms of Alzheimer's disease. But, even talking about the first painful signs, they are often non-specific and can remain unnoticed for a long time. Based on this, it is quite difficult to clearly identify the initial stage of Alzheimer's disease.

Just a decade ago, it was common to distinguish only three stages of the disease, in which pathological symptoms were clearly visible. Basically, specialists took into account the severity of the loss of the ability to independently care for oneself and the deterioration of the overall quality of life. These are the stages:

1. Mild stage of the pathology: the patient is able to take care of himself independently, but he periodically experiences intellectual difficulties: it is difficult for him to plan anything, navigate unfamiliar conditions, put papers in order, etc.
2. Moderate stage: the patient can take care of himself in basic things, but he can no longer be left alone, as the patient may behave unpredictably.
3. Severe Alzheimer's disease: the sufferer requires constant attention and care.

Today, experts have somewhat expanded the classification and added a number of stages that relate primarily to the early stage of the development of Alzheimer's disease:

1. Preclinical stage: there are no visible disorders in this period, but the pathological mechanism in the brain has already been launched.
2. Stage of mild disorders: patients notice unpleasant shifts in memory and intellectual abilities. The patient's immediate environment does not yet notice any changes.
3. Early signs of mild Alzheimer's disease: Certain symptoms become noticeable to others.

Some specialists use the term "pre-dementia" when describing the early stage of the pathology; this is a conditional period that precedes the early stage of Alzheimer's disease. However, not everyone agrees with this definition, so they try not to use it officially.

Stages of Alzheimer's Disease in the Elderly

Alzheimer's disease is usually diagnosed in old and senile age. Since the exact causes of the disease are currently unknown, many specialists are inclined to the following explanation: old age is the main factor in the pathology. The appearance of the first painful symptoms in 60-70-year-old people is not uncommon, and especially in those who have paid little attention to intellectual activity throughout their lives, being engaged mainly in physical labor.

In the early stages of Alzheimer's disease, older adults often experience the following clinical signs:

• a person loses the ability to remember events that happened the day before;
• stops recognizing family members and surroundings;
• cannot find his way around in unfamiliar surroundings;
• the emotional background becomes unstable - there are sharp transitions from smiling to irritability;
• the person often becomes apathetic.

Other signs and symptoms characteristic of late-stage Alzheimer's disease include:

• hallucinations are often experienced, delirium is observed;
• the person does not recognize anyone - neither close ones, nor just acquaintances;
• sometimes convulsions are observed;
• a person loses the ability to think and even move independently;
• the patient gradually loses the ability to communicate - often he simply does not understand what is happening around him;
• urinary incontinence develops.

It is worth noting that it is extremely rare for a patient's relatives to start sounding the alarm at the early stages of Alzheimer's disease. In the vast majority of situations, the first manifestations of the pathology are taken for normal age-related signs.

Duration of Alzheimer's disease stages

Experts distinguish two types of the disease: senile and presenile forms.

Senile disease manifests itself in people over 65 years of age. This form is provoked by a specific lipoprotein – a protein substance that is found only in Alzheimer's disease. β-amyloid, which has a certain degree of toxicity, accumulates in the brain structures. Along with this, mini-structural elements called neurofibrillary tangles are formed inside the cells. In turn, the tangles are formed by a protein substance of another type – tau protein.

It is believed that β-amyloid alters the way nerve cells communicate, leading to functional brain failure. Neurons die out, and the condition is aggravated by the presence of neurofibrillary tangles.

This senile stage can last for 10-20 years, with the basic symptom being progressive memory deterioration.

Presenile pathology progresses faster and begins to develop in patients starting from the age of 50-60. This form can be detected even in relatively young people with a hereditary predisposition. The presenile stage of Alzheimer's disease is characterized by speech disorders, deterioration of visual memory and performance. This stage lasts from eight to ten years.

Early stage Alzheimer's disease

How to get your bearings in time and recognize the early stage of Alzheimer's disease? To do this, it is important not to miss a number of characteristic signs that many, unfortunately, do not notice right away.

• The loss of the ability to remember is a disorder of short-term and long-term memory processes. Problems develop on an increasing schedule, gradually worsening over 6-12 months. Additionally, the ability to self-criticism and self-control may suffer: patients often forget about an appointment or the need to make a call, often lose something, etc.
• Forgetfulness is also typical for normal age-related changes in the central nervous system. But we should not forget that age-related signs of memory loss develop very slowly, over the course of years. At the same time, memory in the early stages of Alzheimer's disease deteriorates rapidly, over the course of six months.
• In addition to memory, the mental sphere also suffers: any intellectual activity tires patients, mainly due to the difficulties with concentration, due to the inability to concentrate. Patients can demonstrate serious errors in trivial calculations, they forget words, begin to form phrases incorrectly, etc. Often, close people note a sudden change in priorities in a sick person: for example, if he used to like reading scientific journals, now he prefers watching simple "soap" series.
• The ability to orientate in space is almost completely lost with Alzheimer's disease. The patient does not simply forget the road if he knew it before. Difficulties with orientation on the map arise, and even hints from other people do not solve the situation - the sick person still cannot determine the correct route.
• Sudden mood swings, emotional instability at an early stage indicate the presence of intellectual distress. Many patients develop a persistent depressive state, excessive anxiety, psychosis, apathy. Such pathologies often have the form of specific crises caused by a specific reason - for example, a change of residence, repair work in the apartment, etc. It is possible to develop delusional states with obsessive ideas of damage or persecution: the sick person does not recognize relatives, accuses them of attempted robbery, etc.

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Early Alzheimer's Disease Symptoms

The clinical picture in the early stages of Alzheimer's disease is almost always noticeable, but many simply do not pay much attention, or associate the symptoms with other diseases or conditions.

There is such a thing as Ribot's law, or progressive amnesia. The sick person does not remember recent events, but tells in detail about incidents that took place decades ago.

In addition, many patients with Alzheimer's disease are unable to orient themselves in assessing the time period - that is, they cannot answer how long ago this or that event occurred. Gradually, periods of forgetfulness are replaced by confabulatory situations: a person invents "missing" plots, which sometimes have a rather fanciful and implausible appearance.

As the early stage of Alzheimer's disease moves on to later stages, the patient loses all the knowledge acquired throughout life. Professional skills are lost, foreign languages are forgotten, and much information acquired before the disease is "cancelled". The "fixed" information, which includes knowledge of the native language, hygiene skills, etc., remains the longest.

Early Diagnosis of Alzheimer's Disease

At an early stage, patients very rarely seek medical help. Experts believe that the main reasons for this phenomenon are people's lack of awareness of the symptoms and consequences of Alzheimer's disease, as well as their reluctance to seek psychiatric help - until the disease has progressed too far.

Early stages of Alzheimer's disease, with its inherent memory loss, increasing indifference and depression in the patient, often cause a standard reaction in those around them: most people classify such symptoms as normal for this age period.

However, there are special techniques for diagnosing Alzheimer's disease at an early stage - for example, tests to assess the quality of abstract, logical thinking, as well as to track the mechanisms of memorization.

At the earliest stage, self-criticism and long-term memory suffer less than other processes: the patient recalls what happened many years ago without problems. However, slowness of thinking is noticeable, the patient has difficulty finding the necessary word, or replaces it with another (often inappropriately). Depression of varying depth often develops.

The earliest stage of the disease has little effect on self-care capabilities. The patient can still take care of himself in everyday life and communicate with relatives. However, the presence of the above-mentioned, even not particularly pronounced signs should be a reason to contact a doctor - first, to conduct diagnostics. The doctor will do everything necessary to recognize Alzheimer's disease in a timely manner: collect anamnesis, perform testing, prescribe laboratory tests and a number of instrumental studies.

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Treatment of Alzheimer's disease at an early stage

After performing all the necessary diagnostic procedures, the doctor will be able to exclude other pathologies that are similar in clinical manifestations. Only after this will he begin to prescribe treatment. If such treatment is adequate and competent, it will help to significantly extend the patient's life, as well as improve its quality - at the moment, there are medications that can maintain the functionality of the brain for as long as possible. Thus, the patient will be able to independently take care of himself and lead his usual way of life.

Of course, relatives and friends of a sick person should be prepared for the fact that over time, his brain structures will still be affected: Alzheimer's disease cannot be stopped. Doctors can only slow down the destructive processes and slow down the progression of symptoms.

In the later stages, along with the drug treatment, the doctor will definitely give recommendations for patient care and provide all possible psychological support.

Late stage Alzheimer's disease

In the last stage of Alzheimer's disease, the loss of basic skills related to self-care is persistently observed. The patient can no longer eat or go to the toilet on his own: almost all patients in this period suffer from fecal and urinary incontinence.

The last stage is manifested by the loss of the ability to communicate meaningfully - the elderly person sometimes pronounces words or phrases, but they carry virtually no semantic load. There are gross changes in gait, most sufferers require assistance to move around the apartment.

Soon after the onset of the last stage of Alzheimer's disease, the patient predominantly lies down, the face does not express any emotions, muscle rigidity occurs, and swallowing movements become difficult.

Fatal outcome is especially common due to infection: significant exhaustion of the body does not allow it to cope with the disease. The most common conditions that lead to death in people with Alzheimer's disease are septic complications or pneumonia.

How long does late stage Alzheimer's disease last?

On average, elderly people diagnosed with Alzheimer's disease at the stage of clinical manifestations can live another 7-12 years. However, this value does not reflect the full picture: individual characteristics of the body cannot be discounted, as well as many factors that also affect the life expectancy of the patient. Such factors include: the attitude of loved ones to the suffering person, the availability of adequate care, the strength of the patient's immunity, living conditions, and much more.

Statistics show that after the patient loses the ability to move and control himself - that is, the last stage of the disease - he lives for about six months. As a rule, the cause of death is infectious complications, thromboembolism, somatic disorders, etc.

How long do people live with late stage Alzheimer's disease?

The duration of the last stage depends on more than one factor. It is quite difficult to predict the duration of this period, because in most cases it is impossible to determine when exactly the disease “began” – after all, the first signs are detected much later than the true onset of the pathology.

However, experts have identified a number of features of Alzheimer's disease that affect its duration:

• if the pathology “emerged” before the age of 60, then from that moment the patient will be able to live for another 16-18 years;
• if the disease is detected between 60-75 years of age, then the further life period may be limited to one decade;
• if the disease manifests itself after 85 years, the patient will live another 4-5 years;
• people with a minimal “set” of chronic diseases, even if they have Alzheimer’s disease, live longer;
• Women who become ill die later than men who become ill.

It is worth noting that at any stage of Alzheimer's disease, the patient's loved ones should show the greatest possible understanding, patience and compassion. Of course, this can sometimes be very difficult. But at the moment, medicine cannot offer an effective treatment for the disease. Medicines can only slightly prolong human life, increasing its quality.