Most people have probably heard of Alzheimer’s disease. However, very few have a clear understanding of the disease—what it really is and how it affects those who have been diagnosed with it.
Alzheimer’s is an irreversible disease that involves difficulties with thinking, problem-solving, or language and eventually leads to inability to carry out even the most simple of tasks. It is also known to be a subset of dementia. About 75% of all dementia cases are diagnosed as being Alzheimer’s, making it the most prevalent type of dementia.
To the average person, Alzheimer’s and dementia often seem like the same thing. Sometimes, the two terms are even used interchangeably. However, although the two are somewhat related, each condition has its own distinct differences.
Firstly, dementia is categorized as a ‘syndrome’, which means that it is a set of symptoms that occur together consistently. These symptoms include memory loss, difficulty with thinking and problem solving, and/or issues with language. Alzheimer’s is similar to dementia in that they share these symptoms and progresses in severity over time. This is why it is accepted to be one type of dementia among several others.
However, what sets these two conditions apart is that Alzheimer’s is a disease that destroys the brain while dementia can be caused by a number of other things that damages brain cells. Diseases such as Fronto-temporal Dementia, Lewy Body Dementia, Huntington’s, Parkinson’s, Creutzfeldt-Jacob, and other types of brain damage can also cause dementia.
Another major difference between the two conditions is that dementia is often diagnosed based the symptoms rather than the actual cause. Whereas, Alzheimer’s is diagnosed based on the exact cause of the symptoms. Also, in patients with Alzheimer’s it is not possible to reverse the symptoms, but some types of dementia can be reversed, such as those caused by nutritional deficiencies and drug problems.
To compare types of dementia's - visit our Compare Diagnosis Page or visit these diagnosis specific pages:
Obtaining a clear diagnosis for dementia is extremely difficult for physicians.
Misdiagnosis and undiagnosed is common in dementia because while brain imaging, blood testing, and comprehensive tests can help in the diagnosis, it is still not a perfect science. Physicians rely on the tests as well as the progressing deterioration and occurrence of different symptoms to make as best of a diagnosis and treatment plan as possible.
While there are many types of dementia, the four largest subset of dementias are Alzheimer's (estimated at 60%-80% of the cases), Fronto-temporal Lobe Dementia (estimated at 5-10% of cases), Lewy Body Dementia (estimated at 5-10% of cases), and Vascular Dementia (estimated at 10-20% of cases). Mixed dementia - or having multiple types of dementia (example: Alzheimers and Fronto-temporal Lobe) is also common in dementia patients, making it even more complex to diagnose and treat.
Alzheimer's specifically compared to other symptoms shows itself primarily with memory loss in the initial stages. Examples of this may be forgetting where they placed items, or losing their ability to remember where they are. By comparison, behavioral issues such as depression, aggression, hallucinations or physical symptoms such as loss of motors skills tend to be more common in the initial phases of other types of dementias such as Lewy Body or Vascular Dementia.
Towards the middle and later stages, wandering and progressed memory loss is more common in Alzheimer's patients. Difficulties with language such as word finding and word association is also more common in Alzheimer's than in other types of dementias. While the Alzheimer's patient may still be aware of their desire to communicate, they may be unable to find the appropriate words to use to communicate.
Being informed about the other types of dementias and symptoms experienced by those who have it, assists in the diagnosing and treating of the disease. It is extremely important to take note of the progressive changes of symptoms as this will enable the physician to make customized treatment and medication plans to counter the symptoms of the disease.
This chart compares the symptoms of the different types of diseases to show what types of symptoms are more or less in the various diseases.
Being a progressive disease, Alzheimer’s gradually, over time, destroys the brain’s capacity to functional normally. As more parts of the brain are damaged, more severe symptoms develop. In the initial stages, the disease begins to affect a person’s daily life and functioning and eventually progresses to a stage where the person becomes completely dependent on others for basic care and daily living.
It is important to remember that while there are general symptoms for Alzheimer’s, no two individuals experience the conditions in the same way and there is no one timeline. However, the progress of Alzheimer’s can be roughly categorized into four stages: Cognitive Impairment, Early Stages, Middle Stages and Late Stages.
Stage 1: Cognitive Impairment
One of the first parts of the brain that is affected is the hippocampus, which is the center for emotions and memories. This is why for most people, the very first signs of Alzheimer’s are memory loss, especially difficulty remembering new information and recalling recent events as well as mood changes. Usually at this point of the disease, patients may simply attribute these symptoms to the natural progression of old age. However, observers such as friends and family may be able to detect the changes more effectively.
Stage 2: Early Stages
Although the disease is still at an early stage at this point, individuals with Alzheimer’s tend to suffer from an increased frequency in memory lapses. For example, they may:
- Misplace items—unable to find keys, glasses, and other items around the house
- Unable to recall recent conversations or events—forgetting appointments and dates
- Have trouble recalling words, names, places, or objects
- Repeat themselves regularly, such as repeating a task or question
- Find it more difficult to make decisions
- Become more hesitant and less willing to try new things
The mood changes also can become heightened, where the person may often be agitated, confused, or depressed. They may become withdrawn and lose interest in activities and hobbies that they used to find exciting.
Stage 3: Middle Stages
By this stage of Alzheimer’s, people begin to lose the ability to care for themselves and would need support to accomplish daily tasks such as eating, dressing, washing, and even using the toilet. This is mainly caused by their worsening memory problems. Some of the obvious symptoms at this stage are:
- Not being able to remember names of people they know, including family and friends
- Getting lost or wandering or losing track of time due to increased confusion and disorientation
- Repetitive behavior—forgetting that they’ve eaten a short while ago and start to eat again
- Hallucinations and becoming suspicious of family members or having delusions about them
- Speech and language difficulties
- Frequent changes in mood—may go from being excited to depressed in a short time
- Reduced spatial recognition
Stage 4: Late Stages
During the final stages of the disease, the symptoms become severe and causes much distress for both the person with the condition as well as their caretakers, family, and friends. In some cases, they may become extremely violent and suspicious of those around them. Hallucinations and delusions also tend to be severe at this point. Other extreme symptoms in this stage include:
- Inability of difficulty eating and swallowing
- Inability to change position or move around without assistance
- Either considerable weight loss or weight gain - some people eat too much because they forget that they've had their meals while others eat too little because they think they've already eaten
- Loss of control over urinary and bowel movements
- Gradual loss of speech
- Severe memory problems—both short term and long term memory
At this stage, most people would require full time caretakers to assist them with their daily activities such as eating, moving, and using the toilet.
It is important to note that the rate of progression of Alzheimer’s in each person is different. No two people’s symptoms develop the same way or within the same time frame. Therefore it is difficult to predict exactly how quickly or slowly a person may deteriorate. In general, people diagnosed with Alzheimer’s live an average of eight years after their symptoms become noticeable. However, depending on the rate of progress, survival can range from as little as four years to a couple of decades. This also depends on the age of onset and other health factors.
This infographic summarizes symptoms experienced at each stage of Alzheimer's Disease. Symptoms in bold are more common in Alzheimer's than in other types of dementia:
For more detailed information about Alzheimer's disease including it's causes, how to detect and diagnose the disease, treatments, care options, and important resources for families caring for a loved one, check out our Alzheimer's Guide at this link!
Care Tips on dealing with every aspect of Alzheimer's Disease (AD) care including how to keep your loved one safe, how to choose the right care home or tips on how to keep them at home and independent as long as possible.
Find assistive products for Alzheimer's in our Alzheimer's Disease Products page. Sort by stage and symptoms to find the best products for you or your loved one.
Products by Stage:
Products by Symptom:
In terms of care arrangements for Alzheimer's patients, there are generally two types of options that the patient’s friends and family can opt for: in-home care or out-home care.
During the initial stages, while the patient is still able to function independently, most people may prefer to remain at home, where they are most familiar with their surroundings.
After initial diagnosis, the primary caregiver may still be able to handle the tasks of looking after the patient. But as the symptoms progress to the early and middle stages, they can opt for in-home care arrangements. There are several types available in this category:
- Companion services – to help with supervision and recreational activities.
- Personal carers – to help with various personal care tasks such as bathing, dressing, eating, and exercising.
- Homemaker services – to help with housekeeping, cooking, or shopping.
- Medical carers – to help with medical needs, physical, and/or mental therapies
Another option for patients who are still able to function relatively independently, is Adult Day Care Centers. These facilities provide a safe environment for dementia patients to pursue activities, interests, and socially interact with people. This type of care arrangement can give the patients a sense of freedom while dealing with their diagnosis. They are also likely to have counselling, health services, meal services, personal care, behavior management, therapy, and other related services available.
During the last stages of dementia, when the patient is unable to fend for themselves, the best choice often will be residential care in the form of Personal Care Homes, Assisted Living, Nursing Homes with special care or memory units. There, they can receive specialized care and treatment to ease their situation. Each of these facilities will offer different levels of care. Selecting one will depend on the patient’s needs and progression of Alzheimer's. Read our detailed guides on each one to assess which may be the best fit for you or your loved one.
Hospice Care and Geriatric Psychiatric Facilities are two lesser talked about short-term arrangements for patients with dementia. These systems assist with end of life comfort measures (hospice) and medication rebalancing (Geriatric Psychiatric Unit), both of which are crucial to maintaining the patient’s dignity and safety for them and their caregivers.
Hospice Care services are available with any care arrangement and are attached to the patient wherever they go as long as the organization providing the services is able to provide services.
Geriatric Psychiatric Facilities are meant to be a resource for when a patient is experiencing severe behavioral changes that need to be adjusted for with medication in order to ensure the patients, and his/her caregivers safety.
For more information on the differences, how to find a care facility and on commonly experienced issues with each care arrangement, visit the following pages:
- Care at Home
- Adult Day Care
- Assisted Living
- Nursing Home
You are NOT alone. Rest assured, there are many out there who have been in your shoes and who want to help you through this tough time. Here are a couple of resources available to connect with others who are going through what you are going through:
- Seek your local Alzheimer's Association chapter for support groups.
- Online Forums & Chat Rooms:
For family members and friends who would like to educate themselves further on the details of Alzheimer’s, its symptoms, treatments, and challenges, you should seek the assistance of local or national Alzheimer’s Association.
Alzheimer’s Foundation of America
Other websites to obtain more detailed information on Alzheimer’s:
For a list of providers close to your area, follow this link and follow the prompt asking for location information.
Alzheimer’s is an illness that has many facets to it, which both doctors and scientists around the world are still in the process of unveiling. Various research and clinical trials are done every day. Below are some examples of clinical research and their aims:
- Treatment trials—to test new treatments for the purpose of reducing symptoms, slowing or stopping the progression entirely.
- Diagnostic studies—to find new tests and methods for diagnosing Alzheimer’s
- Prevention trials—to investigate methods to prevent the onset of Alzheimer’s
- Quality of life studies—to look at different ways and how to improve the quality of life for individuals with Alzheimer’s, their caregivers, and family members.
For more information on research currently being conducted on Alzheimer's Disease, the following are great resources and tools that can help shine light on progress being made.
In the News: Alzheimer's Disease Research
Alzheimer's Society: Research
Alzheimer's Association: Research