Alzheimer's stages; From initial symptoms to disease progression

• March 7, 1403

Confirmed by Dr. Samane Abdullah Pour

The content of this article is only to increase the awareness of users. Before taking any action, consult the doctors of Afoz Roshan for treatment.

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Alzheimer's is one of the most common brain-destroying diseases that gradually impairs memory, thinking and the ability to perform daily activities. In the early stages, mild forgetfulness appears, but as the disease progresses, the person even forgets the names of their loved ones and becomes unable to do the simplest tasks.

This disorder makes independent life difficult and increases dependence on others. Behavioral changes, reduced concentration and difficulty in making decisions are other challenges of the sufferers. Although there is no definitive treatment for Alzheimer's, solutions have been provided to improve the quality of life of patients and reduce the rate of disease progression.

Ofog Roshan Physiotherapy By using advanced devices and the knowledge of its experts, it helps to improve the mobility, balance and brain function of patients so that they have more independence in performing daily activities. Contact the experts of this Tehran physiotherapy clinic to book a free consultation.

In the rest of the article, we are going to answer the questions "What is Alzheimer's?" and "What are the symptoms of Alzheimer's?" to answer It is a pleasure to accompany our article to the end.

What is Alzheimer's? The most common cause of dementia

Alzheimer is Alzheimer's in English, which refers to a progressive neurological disorder. This complication gradually reduces a person's cognitive abilities. Alzheimer's is the most common cause of dementia and usually presents first with problems remembering recent information. Sufferers may ask repetitive questions, lose things, or forget familiar names and directions. As the disease progresses, decision-making disorders, decreased concentration, and even behavioral and personality changes can be seen.

At the brain level, Alzheimer's is caused by damage to neurons and a decrease in communication between nerve cells. Amyloid plaques and tau proteins are deposited in the brain and cause gradual destruction of nerve networks. In addition to genetic factors, factors such as high blood pressure, diabetes, poor nutrition and a sedentary lifestyle also increase the risk.

Alzheimer's is not only limited to memory; Behavioral changes, anxiety, depression and movement problems are also seen in patients. There is no definitive treatment for this disease, but methods such as drug therapy, cognitive activities, and physical therapy can slow down its progress and improve the quality of life of patients.

Alzheimer's symptoms gradually intensify and affect the patient's cognitive and behavioral functions more over time. Research shows that this disease may begin a decade or even more before the first symptoms appear in the brain.

Alzheimer's is usually seen in people over 65 years old. But cases of infection at younger ages have also been reported. Early diagnosis and correct management can slow down the progress of the disease and improve the quality of life of patients.

At what age does Alzheimer's start?

Alzheimer's is one of the most common brain-destroying diseases that affects about 24 million people worldwide. This disease mainly affects people over 65 years old, so that one out of every 10 people in this age group is affected. With increasing age, the probability of getting it increases, so that almost one third of people over 85 years old get this disease.

In some rare cases, Alzheimer's appears before the age of 65, usually in the 40s or 50s, which is called early-onset Alzheimer's. This type of disease accounts for less than 10% of all cases and usually progresses more rapidly. Early identification of Alzheimer's symptoms and the decision of appropriate treatment strategies can be effective in reducing the speed of disease progression and improving the quality of life of patients.

Stages of Alzheimer's disease

Alzheimer's disease progresses gradually and its symptoms become more severe with time. Although people experience this disease at different rates, the general pattern of its progression is predictable. Medical organizations and professionals use different terms to describe these stages, but they all emphasize the same principle, Alzheimer's symptoms worsen over time, and each person may go through these stages differently. In general, the stages of Alzheimer's disease can be divided into two categories: partial and general.

A more detailed model that includes five steps:

• Preclinical stage: the beginning of brain changes without any symptoms in the person.
• Mild Cognitive Impairment (MCI) Problems with memory and concentration begin, but the person is still able to perform daily activities.
• Mild dementia: forgetfulness increases and the person has difficulty in doing complex tasks.
• Moderate dementia: dependence on others increases, behavioral changes and language problems become more severe.
• Severe dementia: the person loses the ability to communicate and needs full care.

A more general model that includes three main steps:

• Mild stage: Early in the disease, minor memory problems and occasional forgetfulness are seen.
• Middle stage: in the middle of the disease, the symptoms become more obvious and the person has difficulty in doing daily activities.
• Severe stage: the patient becomes completely dependent on others and even loses the ability to recognize his relatives.

What is preclinical Alzheimer's disease?

Alzheimer's preclinical stage is the first and most hidden stage of this disease, in which brain changes have begun, but no obvious symptoms can be seen in the person yet. During this period, amyloid plaques and tau proteins slowly accumulate in the brain and disrupt the communication between nerve cells, but the person still maintains cognitive abilities and daily functioning.

This stage can last for years, without the person or those around him noticing a change. For this reason, the diagnosis of Alzheimer's is usually not made at this stage, except in cases where a person voluntarily participates in scientific research or undergoes advanced brain tests for some reason.

The advancement of technology has made it possible to detect these changes early. Today, advanced brain imaging can detect the presence of amyloid plaques even before symptoms of the disease appear. Also, tests to examine cerebrospinal fluid changes and some biomarkers are being developed, which could help in early diagnosis in the future.

Knowing this stage is very important, because by changing lifestyle, exercise, healthy diet and controlling underlying diseases, it can help to slow down the progress of Alzheimer's.

Alzheimer's symptoms from mild to severe

Alzheimer disrupts brain function over time and causes problems in memory, thinking, behavior and performing daily activities. Early symptoms of mild Alzheimer's include short-term forgetfulness, difficulty doing everyday tasks, and minor problems with speaking or remembering. These symptoms may sometimes be confused with normal aging.

As the disease progresses, the symptoms become more severe and the person has more serious problems in memory, decision-making, and recognition of time and place. Symptoms of severe Alzheimer's at this stage include complete memory loss, the inability to communicate effectively, and the need for assistance with even the simplest of tasks. These changes can significantly reduce a person's quality of life, and they need constant care and support. In this section, we intend to examine each of the symptoms of Alzheimer's functionally and show how they affect a person's daily life with concrete and real examples.

Memory disorder

One of the first signs of Alzheimer's is frequent forgetting of new information. A person may not be able to remember recent conversations or forget important events in their life. Some patients repeatedly ask the same question to the people around them, while they have heard the answer but cannot remember it.

Also, losing things happens in unusual places, for example, a person may leave his keys in the refrigerator and after hours of searching, he cannot find them. In more advanced stages, the patient even forgets the names of his close people.

Difficulty doing everyday tasks

Activities that used to be done easily, gradually become difficult for the patient. A person who used to cook all the time may no longer be able to follow a recipe for a simple meal or forget the steps to pay bills and manage their bank accounts.

Driving also becomes challenging for patients, so that they get confused even on familiar everyday routes and may not find their way home. In some cases, patients leave electrical appliances such as gas stoves on and do not realize the dangers.

Disturbance in decision making and judgment

Alzheimer's patients sometimes make strange and unreasonable decisions. They may go out without a coat or shawl on a cold winter day or pay a lot of money for cheap items when shopping. Some people easily fall into the trap of phone scammers and give their money to people they don't know.

Losing time and place

These patients may have difficulty in diagnosis for days, months and even years. Sometimes they don't know what season they are in or what occasion they are in a certain place. In some cases, the person suddenly realizes that he is standing on the street but does not remember how he got there. He may even imagine that it is day at night and want to leave the house to do something.

Difficulty in speaking and understanding language

Language disorders are another common symptom of Alzheimer's. When speaking, patients find it difficult to find the right words and may stop mid-sentence because they cannot remember what to do next. Sometimes words are mistakenly replaced, for example "pencil" is called "fork". Also, it may be difficult for them to understand long conversations and they talk less in family gatherings.

Behavioral and personality changes

Behavior and emotions of Alzheimer's patients undergo changes. Some of them suffer from anxiety or depression and do not want to participate in social activities. Because mistrust and pessimism are also seen in these patients. For example, they may lose their belongings and think that others have stolen them. In some cases, the person gets angry for no reason or cries in an unexpected way.

Decreased motor skills and coordination

As the disease progresses, muscle coordination decreases and it becomes difficult for a person to do simple tasks such as covering clothes or using spoons and forks. The patient may lose his balance while walking and fall more often. Some also find it difficult to recognize the distance of objects, so that when they pick up a glass, their hand hits it and drops it.

Alzheimer's symptoms in women; From hormone changes to mood changes

Alzheimer's symptoms are more severe in women due to hormonal changes and longer lifespan than men. Being aware of these symptoms and seeing a doctor early can help manage the disease better.

Symptoms of Alzheimer's in women Descriptions Severe memory impairment Forgetting important events, repeatedly asking the same questions and losing things in unusual places Decreased concentration and organization Difficulty in doing daily tasks such as managing finances or following the steps of a recipe Difficulty searching for words Forgetting the names of objects and people, long pauses in conversations or replacing incorrect words Severe mood changes and increased anxiety, depression or sensitivity to the surrounding environment Impaired decision-making in making purchases Irrationality, lack of attention to personal needs such as nutrition and hygiene, confusion in time and place, forgetting dates, seasons, and even getting lost in familiar paths, not recognizing familiar faces, inability to recognize friends and family members, forgetting one's own face in the mirror even in advanced stages, decreasing interest in social activities, withdrawing from friends, family, and social events due to feeling powerless or confused, movement and balance problems, difficulty in walking, frequent falls, and loss of coordination Insomnia disorder, frequent awakenings at night and confusion in distinguishing between day and night

Alzheimer's symptoms at 40 years old; Warning signs

Early-onset Alzheimer's, which usually occurs under the age of 65, can have similar symptoms to older Alzheimer's, but the changes may be slightly different and more complex. One of the first symptoms is memory disorders. People with early-onset Alzheimer's may experience frequent forgetfulness, such as forgetting dates or the names of important people. In addition, problems remembering everyday information or performing routine tasks such as shopping or paying bills may occur.

Difficulties in planning and organizing are other common changes. Some of these people may have problems in performing complex activities or managing their time. Decision-making is also clearly affected, so that the person is unable to make simple and rational decisions. In addition, mood and personality changes such as depression, anxiety and irritability can appear strongly in these people.

Another symptom of early Alzheimer's is language disorder, where a person may have difficulty finding the right words or sentences. Affected people may show less desire to communicate with others and avoid social activities. Finally, problems in managing financial issues and financial decisions can also be one of the warning signs. For timely diagnosis and treatment of this disease, it is necessary to consult a doctor.

Genetics

Genetics is one of the main factors in Alzheimer's disease. The presence of certain genes, such as apolipoprotein E4 (ApoE4), increases the risk of developing this disease. People with a family history of Alzheimer's disease are more likely to develop the disease. In fact, if a parent or even a grandparent has Alzheimer's, a person's risk increases. However, having certain genes does not mean that you will have Alzheimer's, but only increases the risk.

Old age

Aging is one of the most important factors that increase the risk of Alzheimer's disease. Usually, this disease is observed after the age of 65, and with increasing age, the probability of its occurrence increases. For example, after age 65, the risk doubles, and the risk increases in older people. Natural changes in the brain that accompany aging can lead to the accumulation of amyloid beta plaques and damage to brain cells.

Biochemical disorders of the brain

In Alzheimer's disease, certain biochemical changes occur in the brain, which disrupt the function of nerve cells. Amyloid beta plaques and tau fibers are among the main factors involved in this process. These plaques gradually accumulate among brain cells and disrupt nerve communication. As a result, brain cells are damaged and the person's cognitive function gradually decreases. For this reason, memory and thinking problems in these patients become more severe over time.

Environmental factors

Environmental factors also play an important role in the development of Alzheimer's. Exposure to chemicals, air pollution, and heavy metals can increase the risk of developing this disease. For example, research has shown that people who live in chemically contaminated environments, or are exposed to environmental damage, may be more likely to develop Alzheimer's. Also, brain injuries caused by trauma or accidents may trigger the onset of Alzheimer's symptoms.

Lifestyle

Lifestyle is one of the most important risk factors for Alzheimer's. Factors such as unhealthy diet, lack of physical activity, high blood pressure, and diabetes can increase the likelihood of developing this disease. Consuming too much sugar and trans fats increases inflammation in the brain and therefore impairs its function. Also, people who do not exercise regularly and have an inactive lifestyle reduce the blood flow to the brain and this contributes to the erosion of brain cells.

Lack of sleep and depression

Lack of sleep and depression are closely related to Alzheimer's. Insufficient sleep can increase the accumulation of amyloid-beta plaques in the brain, which is one of the main features of Alzheimer's. On the other hand, depression also increases the risk of Alzheimer's disease. Research has shown that people with depression and sleep disorders are more likely to get Alzheimer's than others. In fact, sleep problems and depression can mutually affect each other and increase the risk of developing the disease.

How long do people who get Alzheimer's live?

The lifespan of people with Alzheimer's disease depends on several factors, including age, health status, and severity of the disease. On average, after a diagnosis of Alzheimer's, a person lives between 8 and 12 years, but this period can vary from 3 to 20 years. Patients who develop Alzheimer's at a younger age, under the age of 65, usually progress more slowly and may live longer. On the other hand, people who get Alzheimer's disease at an advanced age, for example after the age of 85, usually have a shorter life span due to the coexistence of this disease with other chronic problems.

In advanced stages, patients often lose the ability to perform daily tasks and require full care. The main cause of death in people with Alzheimer's disease is usually secondary problems such as lung infections (pneumonia caused by inability to swallow), urinary tract infections, pressure ulcers, or malnutrition. Although there is no definitive treatment for this disease, proper care, healthy nutrition, and rehabilitation programs such as physical therapy can improve the patient's quality of life and slow down the process of brain degeneration.

The difference between dementia and Alzheimer's; Two different names with a common problem

Dementia is a set of cognitive disorders that affect abilities such as memory, reasoning and decision making. Undoubtedly, these cases disturb the daily life of a person. Alzheimer's is one of the most common types of dementia. For a better understanding, dementia can be compared to an umbrella under which various diseases are placed, and Alzheimer's is one of them. Just as heart diseases have different types, dementia also includes different disorders.

The cause of dementia is different depending on its type. Stroke, Parkinson's disease or brain injuries are among the causes of dementia. But in Alzheimer's, the abnormal accumulation of proteins such as amyloid and tau causes gradual destruction of brain cells.

In stroke dementia, a person may suddenly have speech or movement problems. While in Alzheimer's, the process of brain decay begins slowly and first minor forgetfulness appears, such as losing things or forgetting people's names.

Some types of dementia can be treated or controlled. For example, cognitive impairment caused by vitamin B12 deficiency or thyroid problems can improve with proper treatment. But Alzheimer's is a progressive disease and with the passage of time, the patient's cognitive abilities and daily functions decrease drastically. A person who in the early stages of Alzheimer's only has trouble remembering memories, in the advanced stages he loses even performing simple tasks such as dressing or eating.

In short, dementia is a general term to describe cognitive decline, while Alzheimer's is one of the most common types. Recognizing the difference between the two helps to correctly identify the disease and choose appropriate treatment and care methods.

Alzheimer's test through medical methods

Diagnosis of Alzheimer's requires careful medical examinations. Using different methods, doctors try to evaluate a person's cognitive function and check the possibility of this disease. Some of the most important medical methods for Alzheimer's diagnosis include the following:

1. Clinical examination and cognitive assessment: The doctor asks the patient questions about memory, problem-solving ability, concentration, and performing daily tasks. He may also perform standardized cognitive tests such as the MMSE for better diagnosis.
2. Brain imaging: MRI and CT scan help doctors examine structural changes in the brain and rule out other causes of cognitive problems. In some cases, more advanced methods such as "PET Scan" are used to observe the accumulation of abnormal proteins in the brain.
3. Blood and cerebrospinal fluid tests: These tests help identify Alzheimer's biomarkers, such as amyloid and tau proteins.

Alzheimer's test at home

If you are concerned about Alzheimer's symptoms and want to check your or your loved ones' condition before going to the doctor, you can use some simple home tests. These tests are not a substitute for a medical diagnosis, but they can help you better understand early symptoms:

1. Short-term memory test: Choose a few unrelated words (eg apple, sea, light) and ask the person to recall them after five minutes. If this task was difficult for him, it may be a sign of cognitive impairment.
2. Evaluation of ability to perform daily tasks: Decreased ability to manage money, remember appointments, or use common devices such as telephones and televisions can indicate a problem.
3. Language ability test: Tell the person a short story and ask him to retell it in detail. Difficulty in expressing or forgetting important parts of the story can be a sign of Alzheimer's.

If you see alarming symptoms, it is necessary to see a doctor for more detailed tests. Early diagnosis can have a great impact in managing the disease and improving the quality of life.

Trancopin and Alzheimer's tablets; Management of psychological changes

Trancopin tablets are one of the drugs that are prescribed for the treatment of some mental and nervous disorders. This drug helps to reduce anxiety and stress by affecting the central nervous system. In certain cases, doctors prescribe this drug to relieve psychological symptoms associated with diseases such as Alzheimer's, although this drug is not designed to directly treat Alzheimer's.

In connection with the drugs used for Alzheimer's, trancopine may be used as an adjunctive drug to relieve psychiatric symptoms, but the main treatment of Alzheimer's is dedicated to drugs that help improve brain function and slow down the process of neurodegeneration. These drugs are usually prescribed with the aim of improving memory and attention.

The use of Alzheimer's drugs should be done under the supervision of a doctor and with a strict prescription. Timely and appropriate treatment can help reduce symptoms and improve patients' quality of life.

In recent years, new drugs have been introduced for the treatment of Alzheimer's disease, which improve the quality of life of patients by slowing down the progression of the disease. One of these drugs is Leqembi, which was approved by the US Food and Drug Administration (FDA) in 2023. As a monoclonal antibody, this drug targets beta amyloid protein and prevents the accumulation of brain plaques. As a result, the process of cognitive decline slows down in Alzheimer's patients.

Besides Leqembi, another latest Alzheimer's drug named "Kisunla" was also approved by the FDA in 2023 for the treatment of early stages of Alzheimer's disease. This drug also works with the aim of removing amyloid beta plaques and is prescribed as a intravenous injection every four weeks. Studies have shown that the use of Kisunla can be effective in reducing the speed of thinking and memory loss in patients.

Although these drugs can help improve the patient's condition, they may have side effects such as swelling or bleeding in the brain. Therefore, their use should be done carefully under the supervision of a specialist doctor.

What foods are harmful for Alzheimer's?

Some foods can help worsen Alzheimer's symptoms because they increase inflammation and oxidative stress in the brain. High consumption of sugar, trans fats and processed foods can speed up the disease process. The consumption of the following foods is not recommended for people with Alzheimer's disease.

• Foods rich in sugar
• Trans fats
• Canned foods
• Sweet and carbonated drinks
• meats like hamburgers
• salty foods
• Fast food and take-out
• Dairy products with high fat

From prevention to treatment of Alzheimer's; Key points to improve the quality of life

Alzheimer's disease is a progressive brain disorder that reduces cognitive, memory and decision-making abilities over time. In the early stages, symptoms include short-term forgetfulness, difficulty remembering names and dates, and difficulty performing everyday tasks.

But as the disease progresses, a person has more serious problems in doing simple tasks, communicating with others, and even recognizing time and place. Factors such as aging, genetics, brain biochemical disorders and lifestyle can play a role in Alzheimer's disease. Also, stress, depression and sleep problems are other factors that can increase the speed of disease progression.

Considering the complexity and gradual progress of Alzheimer's, medical treatments and rehabilitation in this field can have a great effect on improving the quality of life of patients. Physiotherapy, especially in different stages of the disease, can help maintain motor function and improve the quality of life of patients. At Ofoq Roshan, Tehran Physiotherapy, specialized and therapeutic services are provided for people with Alzheimer's to prevent the progression of symptoms and improve the quality of life of these loved ones.

To receive advice and book an appointment, call 02188686800. It is also a pleasure to share your experiences and questions. Experts will respond as soon as possible.

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