Alzheimer's disease

Alzheimer's disease is irreversible and destroys brain cells, causing thinking ability and memory to deteriorate. Alzheimer's disease is not a normal part of aging.

What is Alzheimer’s disease?
Dr. Alois Alzheimer first identified the disease in 1906. He described the two hallmarks of the disease: "plaques," which are numerous tiny, dense deposits scattered throughout the brain that become toxic to brain cells at excessive levels, and "tangles," which interfere with vital processes, eventually choking off the living cells. When brain cells degenerate and die, the brain markedly shrinks in some regions.

The image below shows that a person with Alzheimer's disease has less brain tissue (right) than a person who does not have the disease (left). This shrinkage will continue over time, affecting how the brain functions.

MRI brain scan of Alzheimer's disease

MRI images courtesy of Sunnybrook and
Women's College Health Sciences Centre

The effects of Alzheimer’s disease
Alzheimer’s disease is a fatal disease that eventually affects all aspects of a person’s life: how they think, feel, and act. Each person is affected differently. It is difficult to predict symptoms, the order in which they will appear, or the speed of their progression.

The following are some of the changes you may expect as the disease progresses.

Cognitive and functional abilities: a person’s ability to understand, think, remember and communicate will be affected. This could impact a person’s ability to make decisions, perform simple tasks, or follow a conversation. Sometimes people lose their way, or experience confusion and memory loss, initially for recent events and eventually for long-term events.

Emotions and moods: a person may appear apathetic and lose interest in favourite hobbies. Some people become less expressive and withdrawn.

Behaviour: a person may have reactions that seem out of character. Some common reactions include repeating the same action or words, hiding possessions, physical outbursts and restlessness.

Physical abilities: the disease can affect a person’s coordination and mobility, to the point of affecting their ability to perform day-to-day tasks such as eating, bathing and getting dressed.

Treatment
There are several medications that can help with symptoms such as memory decline, changes in language, thinking abilities and motor skills. Although there is still no cure for Alzheimer's disease, those who respond to these treatments can experience improvements in their quality of life for several years.

 

Stages of Alzheimer's disease
Alzheimer's disease is a brain disease where brain cells progressively degenerate. Alzheimer's disease typically follows certain stages which will bring about changes in the person's and family's lives. Because the disease affects each individual differently, the symptoms, the order in which they appear, and the duration of each stage vary from person to person. In most cases, the disease progresses slowly, and the symptoms of each stage may overlap, often making the move from one stage to another quite subtle.

There is currently no cure for Alzheimer's disease nor can its progression be reversed. Present treatment options and lifestyle choices, however, can often significantly slow the progression of the disease.

Early stage
The term “early stage” refers to individuals of any age who have mild impairment due to symptoms of Alzheimer’s disease. Common symptoms include forgetfulness, communication difficulties, and changes in mood and behaviour. People in this stage retain many of their functional capabilities and require minimal assistance. They may have insight into their changing abilities, and, therefore, can inform others of their experience of living with the disease and help to plan and direct their future care. 

Middle stage
This stage brings a greater decline in the person’s cognitive and functional abilities. Memory and other cognitive abilities will continue to deteriorate although people at this stage may still have some awareness of their condition. Assistance with many daily tasks, such as shopping, homemaking, dressing, bathing and toileting will eventually become necessary. With increasing need to provide care, everyone involved will need help and support. 

Late stage
The late stage of Alzheimer’s disease may also be called “severe” or “advanced” stage. In this stage, the person eventually becomes unable to communicate verbally or look after themselves. Care is required 24 hours a day. The goal of care at this stage is to continue to support the person to ensure the highest quality of life possible. 

End of life
People in the final months of dementia will experience increased mental and physical deterioration and eventually need care for 24 hours per day. The progressive nature of dementia means symptoms will ultimately worsen over time. How quickly this occurs varies from person to person.

When the person nears death, comfort measures become the focus. As in the care of any person living with a terminal illness, physical as well as emotional and spiritual needs must be carefully considered and attended to, focusing on quality of life and comfort. 

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Last Updated: 02/12/2018