Stages of Alzheimer's Disease: How to manifest themselves, duration
With the approach of senile age, a person can suffer not only memorization processes, but also mental abilities, cognitive reactions. A huge problem with this 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 quality of life of the patient, but also brings his death closer. Physicians are forced to state that the disease has become "younger", that is, to manifest itself at a younger age. Therefore, every person who cares about his health should imagine what are the stages of Alzheimer's disease, how to recognize them, and how to slow down their further development.
How many stages of Alzheimer's disease exist?
Not so long ago it was discovered that degenerative transformations in the brain tissues begin to form even 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 nonspecific and can go on undetected for a long time. Proceeding from this, it is rather difficult to clearly distinguish the initial stage of Alzheimer's disease.
A dozen years ago, it was accepted to distinguish only three stages of the disease, in which pathological symptoms were clearly traced. In general, specialists took into account the severity of the loss of self-service and the deterioration of the overall quality of life. Here are the stages:
The stage of a mild form of pathology: the patient is able to serve himself independently, but he periodically has intellectual difficulties: it is difficult for him to plan anything, to orient himself in unfamiliar conditions, to put things in order in papers, etc.
The stage of moderate form: the patient can serve himself in elementary things, but you can not leave him alone, because the ill can behave unpredictably.
The stage of severe Alzheimer's disease: the sufferer needs every minute attention and care.
To date, experts have somewhat expanded the classification and have added a number of stages that relate primarily to the early stage of Alzheimer's disease:
Stage of preclinical manifestations: there are no visible disorders in this period, however the pathological mechanism in the brain is already started.
Stage of low-grade disorders: patients pay attention to unpleasant shifts in memory and intellectual abilities. The close environment of the ill does not notice any changes.
Initial signs of mild Alzheimer's disease: certain symptoms become noticeable to others.
Some specialists, when describing the early stage of pathology, use the term "prednention" as a conditional period that precedes the early stage of Alzheimer's disease. However, not everyone agrees with this definition, so they are trying not to apply it officially.
Stages of Alzheimer's disease in old age
Alzheimer's disease, as a rule, is diagnosed in elderly and senile age. Since clear causes of the onset of the disease are not known to date, many specialists are inclined to such an explanation: old age is the main factor of pathology. Appearance of the first painful symptoms in 60-70-year-old people is not uncommon, and especially among those who during their lives paid little attention to intellectual activity, doing mostly manual labor.
At an early stage of Alzheimer's disease, the elderly often have such clinical signs:
a person loses the opportunity to remember the events that took place the day before;
ceases to recognize native people, the situation;
can not orient in unfamiliar surroundings;
emotional background becomes unstable - there are sharp changes from smiling to irritability;
people often become apathetic.
For the late stage of Alzheimer's disease, other symptoms are characteristic:
often disturbed by hallucinations, there is delirium;
a person does not recognize anyone - neither close ones, nor just acquaintances;
sometimes there are cramps;
a person loses the ability to think and even move independently;
the patient gradually loses the ability to communicate - often he just does not understand what is happening around him;
It is worth noting that very rarely relatives of the patient begin to sound anxiety in the early stages of Alzheimer's disease. In the overwhelming majority of situations, the first manifestations of pathology are taken as ordinary age signs.
The duration of stages of Alzheimer's disease
Specialists distinguish two varieties of the disease - senile and presenilnye forms.
Senile disease occurs in people older than 65 years. A similar form is provoked by a specific lipoprotein, a protein substance that is found only in Alzheimer's disease. Brain structures accumulate β-amyloid, which has a certain degree of toxicity. Along with this, mini-structural elements, called neurofibrillary glomeruli, form inside the cells. In turn, the glomeruli are formed by another type of protein substance - it is a tau protein.
Presumably, β-amyloid changes the processes of interconnection of nerve cells, which leads to functional brain failures. Neurons fade, and the condition is aggravated by the presence of neurofibrillary glomeruli.
Such a senile stage can last for 10-20 years, with a progressive sign of deteriorating memory becoming the base sign.
Presenile pathology proceeds more rapidly and begins its development in patients starting from the age of 50-60 years. This form can be found even in relatively young people with hereditary predisposition. The advanced stage of Alzheimer's disease is characterized by speech disorders, deterioration of visual memorization and working capacity. This stage lasts from eight to ten years.
Early stage of Alzheimer's disease
How to navigate in time and see the early stage of Alzheimer's disease? For this it is important not to overlook a number of characteristic features, which many, alas, notice not at once.
The loss of the ability to remember is a disorder of the processes of short-term and long-term memory. The problems develop according to an increasing schedule, gradually worsening during 6-12 months. In addition, the ability to self-criticism, to self-control may suffer: patients often forget about the appointment or the need to make a call, often lose something, etc.
Forgetfulness is also characteristic of normal age-related changes in the central nervous system. But we should not forget that the age-related signs of memory deterioration are formed very slowly, for years. At the same time, memory at an early stage of Alzheimer's disease deteriorates rapidly, over a period of six months.
In addition to memory, the thinking sphere suffers: any intellectual activity of patients wears out, mainly because of the emerging difficulties with concentration of attention, because of the inability to concentrate. Patients may show serious errors in banal calculations, they forget words, begin to form incorrect phrases, etc. Often close people notice a sudden change in priorities in a sick person: for example, if he used to enjoy reading scientific journals, he now prefers to view the unpretentious "Soap" series.
The ability to orientation in space in Alzheimer's disease is almost completely lost. The patient does not just forget the way if he knew her before. There are difficulties with orienting on the map, and even the clues of other people do not solve the situation - a sick person still can not determine the right route.
Sudden mood swings, emotional instability at an early stage indicate the presence of intellectual ill-being. Many patients develop a persistent depressive state, there are excessive anxiety, psychosis, apathy. Such pathologies often have the appearance of peculiar crises caused by a certain cause - for example, changing their place of residence, repairing the apartment, etc. It is possible to form delusions with obsessive ideas of harm or persecution: the sick person does not recognize relatives, accuses them of trying to rob, P.
Symptoms of Alzheimer's Disease at an Early Stage
The clinical picture at an early stage of Alzheimer's disease is almost always noticeable, but many simply do not pay much attention, or connect the symptoms with other diseases or conditions.
There is such a thing as Ribeau's law, or progressive amnesia. The ill person does not remember the recent events, but in details he tells about the incidents that took place decades ago.
In addition, many patients with Alzheimer's disease are not able to orient in the evaluation of the time period - that is, they can not answer how much time ago an event occurred. Gradually, periods of forgetfulness are replaced by confabulation situations: a person makes up "missing" stories, which sometimes has a rather pretentious and implausible appearance.
As the early stage of Alzheimer's disease goes on to subsequent periods, the patient disappears all knowledge obtained during life. Professional skills are lost, foreign languages are forgotten, many information received before the disease is "canceled". The longest remain "fixed" information, which includes knowledge of the native language, hygienic skills, etc.
Diagnosis of Alzheimer's disease in the early stages
At an early stage, patients rarely seek medical help. The main reasons for this phenomenon, experts believe, are insufficient awareness of people about the symptoms and consequences of Alzheimer's disease, as well as the reluctance to consult psychiatric practitioners - until the disease goes too far.
The early stage of Alzheimer's disease with its inherent memory impairment, increasing indifference and depression in the patient often causes a standard reaction in others: most people attribute such symptoms to the norm of this age period.
However, for the diagnosis of Alzheimer's disease at an early stage, there are special techniques - for example, tests to assess the quality of abstract, logical thinking, and also to trace 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, the slowness of thinking is noticeable, the patient hardly chooses the necessary word, or replaces it with another (often inappropriately). Depression of different depths often develops.
The earliest stage of the disease has little effect on self-service capabilities. The patient can still serve himself in everyday life and communicate with relatives. However, the presence of the above, even not particularly pronounced signs should be the reason for contacting the doctor - first, for the diagnosis. The doctor will do everything necessary to timely recognize Alzheimer's disease: he will collect anamnesis, perform the testing, assign laboratory tests and a number of instrumental studies.
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 similar in clinical manifestations. Only after that he will proceed to medical appointments. If such treatment is adequate and literate, it will significantly prolong the life of the patient, as well as improve its quality - at the moment there are medications that can preserve the functionality of the brain for as long as possible. Thus, the patient will be able to independently service himself and lead a habitual way of life for him.
Of course, relatives and loved ones of the sick person should be prepared for the fact that eventually his brain structures will still be affected: Alzheimer's disease can not be stopped. Physicians are only able to slow down the destructive processes and slow the growth of symptoms.
In the late stages, along with the ongoing medical treatment, the doctor necessarily gives recommendations for caring for the patient, provides feasible psychological support.
The last stage of Alzheimer's disease
At the last stage of Alzheimer's disease, the loss of banal skills associated with self-care is steadfast. The patient can no longer eat, go to the toilet alone: practically all patients in this period suffer from incontinence of feces and urine.
The last stage is manifested by the loss of ability to meaningful communication - the elderly person sometimes utters words or phrases, but they practically do not carry any semantic load. There are gross changes in the gait, most suffering people need help to move around the apartment.
Shortly after the onset of the last stage of Alzheimer's disease, the diseased person mainly lies, the person does not express any emotions, there is muscle rigidity, and swallowing becomes more complicated.
Lethal outcome is especially frequent due to infection: a significant depletion of the body does not allow him to cope with the disease. The most common conditions that lead to the death of people with Alzheimer's disease are septic complications or pneumonia.
How long does the last stage of Alzheimer's disease last?
On average, elderly people diagnosed with Alzheimer's disease at the stage of clinical manifestations can live for about 7-12 years. However, this value does not reflect the full picture: one can not discount the individual characteristics of the organism, as well as many factors that also affect the life expectancy of the ill person. Such factors include: the attitude of people close to the suffering person, the availability of adequate care, the strength of the patient's immunity, living conditions and much more.
Statistics indicate that after a person loses the ability to move and self-control - that is, it is the last stage of the disease that is meant, he lives for about six months. As a rule, the cause of death is infectious complications, thromboembolism, somatic disorders, etc.
How many live in the last stage of Alzheimer's disease?
The duration of the last stage does not depend on one factor. It is difficult to predict the duration of this period, because in most cases it is not possible to determine when the disease "originated" - because the first signs are found much later than the true beginning of the pathology.
Nevertheless, experts have identified a number of features of Alzheimer's disease that affect its duration:
if the pathology "was born" before the age of 60, then from this moment the sick person can live for another 16-18 years;
if the disease was found between 60-75 years, the further life period may be limited to one decade;
if the disease manifested itself after 85 years, the patient will live for about 4-5 years;
persons with a minimal "set" of chronic diseases even in the presence of Alzheimer's disease live longer;
the sick women die later than the sick men.
It is worth noting that at any stage of Alzheimer's disease, close people of the ill should show the greatest possible understanding, patience and mercy. Of course, this is sometimes very difficult. But at the moment, medicine can not offer effective treatment of the disease. Medications can only extend the human life a little, increasing its qualitative side.
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Medical expert editor
Portnov Alexey Alexandrovich
Education: Kiev National Medical University. A.A. Bogomolets, Specialty - "General Medicine"