Alzheimer's Disease
.jpg){kind=small}
|
Alzheimer's Disease |
|
|
Introduction
Signs and Symptoms
|
Signs and Symptoms The signs and symptoms of AD occur progressively. The rate at which symptoms progress varies from patient to patient. In some cases, there may be a rapid decline, but in most it is a slow insidious process. People with AD live with the disease an average of 7-10 years. The Alzheimer’s Association describes ten warning signs of the disease. They are: 1.
Memory loss that affects job skills 2. Difficulty performing familiar tasks 3. Problems with language 4. Disorientation to time and place 5. Poor or decreased judgment 6. Problems with abstract thinking 7. Misplacing things 8. Change in mood or behavior 9. Change in personality 10. Loss of initiative Once a diagnosis of “probable AD” is made, changes our patients experience can be classified as early, middle or late stages of the disease. Recognition of the early stage of AD is a relatively new phenomenon and many AD patients have been identified in this early stage (Shenk, 2001). I recently had lunch with a friend who felt she was getting more forgetful. She sought counsel from a geriatrician and completed the battery of tests described earlier. She was given a “probable AD” diagnosis. She started on Aricept and currently keeps copious notes and calendar reminders. She is getting her legal and financial concerns in order. She is looking at some assisted living facilities “for the future.” Her early diagnosis has provided her the chance to quickly plan for the future, something most of us don’t do well. It is hard to imagine how it must feel to recognize that you have a mind robbing disease, and to recognize that you will one day be unable to remember you have it. Signs and symptoms in the early stage may be difficult to appreciate since they can be so subtle. This stage may last 2-3 years. Mild short-term memory loss and time disorientation can be demonstrated during this stage. The person may forget the names of friends, appointments or recent events. Behavioral or personality changes may be seen such as a lack of initiative or a decreased interest in family, work or play. The patient may have changes in mood and become depressed or anxious. Middle stage AD is characterized by increased problems with memory and orientation. Word finding becomes more difficult and the patient frequently loses their train of thought. Coping with new situations becomes more difficult. Psychomotor behaviors of wandering, restlessness and sundowning may occur. The patient’s affect may change and they may become agitated, suspicious or paranoid. In the final stage of AD, the patient is disoriented to person, place and time. Memory is extremely poor and the patient is unable to recognize significant others. The patient is dependent in their ADL’s. They lose the ability to chew and swallow and eventually become bedridden. Neurologist Barry Reisberg has made some interesting observations about the disease’s symptom progression. He found that the progression of AD is an inverse relationship to the phases of child development in many areas, such as motor skills, language and cognitive abilities. He calls this phenomena “retrogenesis” meaning back to birth (Shenk, 2001). It appears that in the AD patient the brain works in reverse order from where it started as an infant. For example, a child has the ability to hold up its head and smile from the ages of 1-4 months. Two abilities lost very late in the AD process is the ability to hold up the head and to smile. |
