“Identifying the Stages of Alzheimers”

By Phil Aaron

    In her 1998 book, Committed to Memory, biologist Rebecca Rupp wrote, “We are what we remember”.  Our memories are important to us; as we age many of us develop a loss of memory.  In the condition known as Alzheimers disease, there is an inability to learn new things.  People with Alzheimers cannot keep track of the date, or remember recent conversations, or where they set something down, and they often repeat themselves in conversation.  All these types of difficulties are commonly described as short term memory loss.

    The key difficulty of Alzheimers disease is in acquiring or learning new information.  Failure to learn results in difficulty recalling or relating information a few minutes later.  Alzheimers disease is accompanied by impairment of at least one of the following: language, abstract reasoning, executive functioning, and visual spatial processing.  This memory loss interfere with social or occupational activity, and generally results in the dependence on others for carrying out at least some necessary daily affairs.

    We find a significant decline from a previous level of functioning.  The early course of Alzheimers disease is difficult to diagnose because early signs may go unnoticed even by the patient’s closest associates.  Impaired memory, difficulty with problem solving, preoccupation  with long past events, decreased spontaneity and inability to respond to the environment with the patient’s  usual speed and accuracy are all signs of Alzheimers disease.  Patients may forget names, misplace household items, or forget what they are about to do.  Because memory loss is usually most obvious for newly acquired material, the patient tries to avoid unfamiliar activities.  The patient is usually seen by a physician when confusion, aggression, wandering or some other socially undesirable behavior ensues.

    Sometimes the patient turns to the spouse or family member to answer questions posed during history taking.  In the late state of Alzheimers disease, the physical and mental effects are marked.  Disorders or gait, seizures, extremity numbness and urinary incontinence are seen.  The patient is often unable to walk.  The aimless wandering of patients who have moderate Alzheimers disease in later stages is replaced by a mute, bedridden state.

    Alzheimers disease occurs in approximately 8% of the United States population older than 65 years.  The number of affected patients exceeds four million.  It is uncommon in persons younger than 65 years, but its prevalence doubles every five years from then on.  As many  as 40% of persons older than 85 years old have Alzheimers disease. 

    The most common risk factors for developing Alzheimers disease are advancing age and a family history of dementia.  Cardiovascular disease and Diabetes mellitus both appear to be associated with an increased risk of Alzheimers disease.