Alzheimer’s disease challenges doctors and scientists. On the other hand, there are efforts to identify the causes of the disease – in order to seek early treatment. At the other extreme, experts seek to describe what happens at each stage of Alzheimer’s disease to understand the behavior of the disease in the human body and to support patients and their families.
Research from the University of Coimbra in Portugal this week identified an area of the human brain as the area where the first changes caused by Alzheimer’s disease occurred. The study opens avenues for further research that may point to treatment options.
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According to scientists, in the posterior cingulate, three symptoms typical of the early stages of the disease occur: neuritis, accumulation of amyloid proteins (insoluble in the human body) and apparently compensatory neuronal activity, in which a region of the brain is trying to do. Work to compensate for the deficit in performance provided by another person. The disease is known to show symptoms only after years of protein buildup, which raises the challenge of diagnosing it before it becomes visible.
The stages of Alzheimer’s disease were identified by Dr. Barry Riesberg, director of the disease research and education program at New York University School of Medicine. This division is used by experts all over the world, and sometimes it is simplified into five or even three stages.
Seven stages of Alzheimer’s
Stage 1 – no symptoms of dementia
Regardless of age, anyone can be mentally healthy. Possible lapses in memory are normal in all age groups. As we age, it is normal for these lapses to occur more often and do not necessarily indicate a more serious problem.
Stage 2 – subjective amnesia/age-related forgetfulness
Many people over 65 years of age complain of cognitive and/or functional difficulties. Older adults with these symptoms complain that they cannot remember names as easily as they did five or ten years ago. They also complain about not being able to remember where to put things often. Several terms have been proposed to define this condition, but subjective cognitive decline is the most widely accepted terminology today.
In general, relatives and friends do not immediately notice this problem. But people with these symptoms regress faster than others of the same age who do not have similar complaints. Research shows that this stage can last up to 15 years in people who have no other symptoms.
Otilo Correa dos Santos Filho, MD, of Rio State University (UERJ), principal investigator in the Brazilian part of the international study “Davos Alzheimer Collaborative” explains. “At this preclinical stage, there are no symptoms, and daily life is not affected.”
Stage 3 – Moderate cognitive effect
People at this stage show a slight helplessness, but people close to them have already noticed it. They tend, for example, to repeat the same question over and over. Your ability to perform certain functions becomes compromised. It is common among those who have not yet retired to show a decline in their professional role. Those who need to learn new tasks face obvious difficulties. For those in strategic positions, it may be time to start planning for retirement. This can actually be described as early stage Alzheimer’s disease and can last for seven years. However, it is essential to seek medical advice and expert diagnosis to understand how other health conditions affect these conditions.
Stage 4 – Mild cognitive decline/mild dementia
Alzheimer’s disease can be diagnosed at this stage quite accurately. The most common functional disability at this stage is a reduced ability to perform more complex tasks in daily life, affecting their ability to live independently. For example, it can be difficult to deal with monthly bills, pay rent, go to the market for shopping, and choose a dish at a restaurant. People who used to cook now face difficulties in preparing food.
Symptoms of amnesia become quite evident at this point. Recent important events such as a party or a visit from a relative can be forgotten. In general, this stage lasts for about two years.
“People begin to have small changes in memory, lose a little sense of time, have difficulties managing finances, doing calculations, but the impact on daily activities is still not significant,” explains the specialist from Uerj.
Stage 5 – Mild cognitive decline/moderate dementia
In this stage, people have symptoms that prevent them from living an independent life. The main functional change at this stage is the difficulty in performing basic daily activities, for example, choosing clothes that are most suitable for weather and occasion conditions, eating alone, paying bills, maintaining hygiene conditions of the house and clothes. They may also have behavioral problems, such as tantrums and lack of confidence.
From a cognitive point of view, they are often unable to remember major events or important aspects of their daily life, such as their address, the name of the president, and the weather. This stage lasts for a year and a half.
“At this point, the patient begins to engage in so-called atypical behaviors, such as going outside in pajamas, putting on the jacket but forgetting to wear the shirt,” the doctor explains.
Stage 6 – Severe cognitive decline/moderate dementia
At this point, patients lose the ability to get dressed, shower, brush their teeth, or go to the bathroom on their own. They begin to confuse or not recognize other people, even those closest to them. They can not remember the names of the schools where they studied, the main political leaders of the country. At some point, they started having trouble speaking. From a behavioral point of view, tantrums can be frequent. This stage can last from two to three years.
“The patient is already unable to perform basic daily activities, and already has significant motor impairment and difficulty recognizing people,” said Otilo Correa dos Santos Filho. “Hallucinations are not very common in Alzheimer’s disease, but they can occur at this point.”
Stage 7 – severe cognitive decline/severe dementia
At this point, patients seek help with basic daily activities and for their own survival. The ability to speak is increasingly restricted until it is completely lost. The patient also loses the ability to walk alone and even sit. Joint stiffness is increasingly common, preventing basic movements and leading to physical deformities. Pneumonia is a common cause of death, precisely because of increased difficulty swallowing. This stage usually lasts from one to three years. “It is the saddest and most distressing phase of the disease, as people suffer from severe dementia, are completely dependent on daily activities and are bedridden,” the expert said. He concluded his speech by saying: “It is the last stage of the disease.”
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