What Should You Do In The Early Stages Of Dementia
When in the early stages of Dementia, you should meet with your doctor to develop an action plan that can help you and your loved one living with dementia. If you and your loved one reside in Texas, you can also contact me at Your Dementia Therapist. I am an Occupational Therapist consultant who specializes in dementia, and I can help you address your primary areas of concern when caring for your loved one.You will also want to talk with your loved ones and develop a plan for the future while they are still able to do so. This includes assigning a power of attorney and advance decision and advance statements to ensure that all their wishes and preferences can be known in the future.
Symptoms Of Mild Cognitive Impairment
Some people have a condition called mild cognitive impairment, or MCI. It can be an early sign of Alzheimers. But, not everyone with MCI will develop Alzheimers disease. People with MCI can still take care of themselves and do their normal activities. MCI memory problems may include:
- Losing things often
- Forgetting to go to events or appointments
- Having more trouble coming up with words than other people the same age
Learn more about Alzheimer’s disease from MedlinePlus.
Stage : Major Memory Loss
In this stage, damage to the brain often affects things other than memory. Language, organization, and calculation skills may all be impacted. Because of this, completing everyday tasks can be difficult.1
Stage 4 can last many years. Major memory problems occur in this stage. People usually remember important details from their life better than everyday details.
For example, they might be able to recall the state where they live or their spouses’s name. But their memory of the distant past will usually be worse than their memory of things from today.1
Other challenges in stage 4 include:1,2
- Being confused about where they are or what day it is
- Getting lost or wandering off
- Sleep problems, like sleeping more during the day and trouble sleeping at night
- Problems choosing the right clothing for the weather
Your loved one might have a tough time with situations that require a lot of thinking. Social gatherings might be especially frustrating. Those in this stage might be:1
- On edge
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Problems Writing Or Speaking
The person may also have difficulty with words and communication. They could find it hard to follow or contribute to a conversation, or they may repeat themselves. The person may also have difficulty writing down their thoughts.
They could stop in the middle of a conversation, unable to figure out what to say next. They may also struggle to find the right word, or label things incorrectly.
It is not uncommon for people to occasionally struggle to find the right word. Typically, they eventually remember it and do not experience the problem frequently.
Key Points About Early
Alzheimer disease commonly affects older people, but early-onset Alzheimer disease can affect people in their 30s or 40s.
It affects memory, thinking, and behavior.
Although there is no known cure, early diagnosis and treatment can lead to better quality of life.
Stay healthy with a good diet and regular exercise.
Avoid alcohol and other substances that may affect memory, thinking, and behavior.
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Stage : Age Associated Memory Impairment
This stage features occasional lapses of memory most frequently seen in:
- Forgetting where one has placed an object
- Forgetting names that were once very familiar
Oftentimes, this mild decline in memory is merely normal age-related cognitive decline, but it can also be one of the earliest signs of degenerative dementia. At this stage, signs are still virtually undetectable through clinical testing. Concern for early onset of dementia should arise with respect to other symptoms.
Stages Of Alzheimer Disease
The stages of Alzheimer disease usually follow a progressive pattern. But each person moves through the disease stages in his or her own way. Knowing these stages helps healthcare providers and family members make decisions about how to care for someone who has Alzheimer disease.
Preclinical stage. Changes in the brain begin years before a person shows any signs of the disease. This time period is called preclinical Alzheimer disease and it can last for years.
Mild, early stage. Symptoms at this stage include mild forgetfulness. This may seem like the mild forgetfulness that often comes with aging. But it may also include problems with concentration.
A person may still live independently at this stage, but may have problems:
Remembering a name
The person may be aware of memory lapses and their friends, family or neighbors may also notice these difficulties.
Moderate, middle stage. This is typically the longest stage, usually lasting many years. At this stage, symptoms include:
Increasing trouble remembering events
Problems learning new things
Trouble with planning complicated events, like a dinner
Trouble remembering their own name, but not details about their own life, such as address and phone number
Problems with reading, writing, and working with numbers
As the disease progresses, the person may:
Physical changes may occur as well. Some people have sleep problems. Wandering away from home is often a concern.
Tests To Diagnose Alzheimers Disease
Currently, there is no single, reliable test to diagnose Alzheimers disease accurately. However, if you are referred to a specialist trained in brain and mental health conditions at a hospital or memory clinic, they will conduct a full neuropsychological assessment using several different questionnaires and tools to obtain an accurate diagnosis.
The specialist tests will assess your mental and cognitive capabilities such as memory, concentration, attention span, problem solving, and language skills.
In addition to a series of clinical assessments, the specialist may also want to have a closer look at what is happening inside your brain and may recommend a CT scan or an MRI scan. These scans take detailed images of the inside of your brain and will help the specialist assess whether there is any damage to the brain and, if so, where it is. This is important because an accurate diagnosis will determine the best course of treatment and support required. It may also help predict any future issues that may develop.
Stage : Moderate Cognitive Decline
In the first three stages of Alzheimers disease, the individual isnt considered to have dementia yet. However, by stage four, the individual is categorized as having early-stage dementia.
At this stage, all previous symptoms become more severe. The individual experiences increased forgetfulness even with recent events, has difficulty with concentration and problem-solving. Complex tasks, organizing and expressing thoughts all become challenging. However, the person can usually still remember some things, such as their home address.
A person experiencing the symptoms of stage four may:
- Struggle with putting the right date or amount on a check when paying bills
- Forget the current month or season
- Struggle with traveling to unfamiliar areas alone
- Have difficulty cooking or even ordering off of a menu
- Have trouble with simple arithmetic
- Develop issues with short-term memory, such as difficulty remembering what they had for their last meal
- Forget details about their life history
Often in stage four, the individual may be in denial about their symptoms. They may unconsciously start to withdraw from conversations and avoid tasks they find challenging so they can stay in denial longer, and as socialization becomes more difficult, the person may even begin to intentionally withdraw from friends and family. Emotional flattening, where the person seems uninterested and emotionally unavailable, may begin at this point.
The average duration of stage four is approximately 2 years.
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Stage : Severe Symptoms
In stage 6, people with Alzheimer’s will have symptoms that will impact their ability to manage their care. They will be more dependent on others for help.1
It can be difficult to communicate with your loved one at this stage. They may still use words and phrases, but it can be hard for them to express specific thoughts. For example, they may be unable to tell you where exactly they are feeling pain.1
Your loved one’s personality may significantly change in stage 6. They might have more:1
- Frustration with you or those around them
Not everyone with Alzheimer’s disease will have severe behavioral changes. But if your loved one is experiencing such changes, try not to take it personally. Their frustrations are part of the disease’s progress and not a reflection on you.1
Preclinical Alzheimers Or No Impairment
You may only know about your risk of Alzheimers disease due to your family history. Or a doctor may identify biomarkers that indicate your risk.
If youre at risk of Alzheimers, a doctor will interview you about memory difficulties. However, there will be no noticeable symptoms during the first stage, which can last for years or decades.
Abnormal accumulation of a type of protein called tau in the fluid around your brain and spinal cord is associated with the development of Alzheimers disease. Changes in the levels of this protein can occur about 15 years before symptoms start.
Caregiver support: Someone in this stage is fully independent. They may not even know they have the disease.
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What Are The Seven Stages Of Alzheimer’s
The seven stages of Alzheimers disease are:
Stage 1. Preclinical stage or stage of normal observable behavior: In this stage, the person has a normal outward behavior. They do not show any symptoms related to changes in memory, mood, behavior or personality. At this stage, the presence of the disease can only be detected by specialized imaging techniques that show how the areas of the brain function.
Stage 2. Very mild changes: In this stage, the person shows subtle symptoms such as forgetting a word or losing/misplacing things. These signs may not be noticeable by others including the doctor. They may also face difficulty in focusing or concentrating on their tasks. The symptoms are too mild to interfere with the persons everyday life and they can live or work on their own. Such subtle symptoms are nonspecific for Alzheimers and may also occur with aging.
Stage 3. Stage of mild cognitive impairment : This is the stage when the signs of Alzheimers become apparent to the closed ones. The common signs at this stage are:
- The person repeatedly asks the same questions
- They forget something they just read
- They have trouble staying organized
- They find it difficult to make and execute plans
- They tend to forget names
- The person may find it hard to meet the requirements of their job or occupation. Taking retirement at this stage is advisable to manage the disease along with reducing the stress.
What Are The Symptoms Of Alzheimers
Recognizing the signs of Alzheimers early in the course of the disease can sometimes be difficult. Weve all misplaced our keys or forgotten someones name. Thats common and shouldnt necessarily be a cause for concern. The first symptoms of Alzheimers vary from person to person. For many, decline in non-memory aspects of cognition, such as word-finding, vision/spatial issues, and impaired reasoning or judgment may signal the very early stages of the disease.2 This disease affects all sorts of things, from memory and mood swings, to the ability to complete everyday tasks. Signs of Alzheimers include:3
- Getting lost in familiar places
- Having trouble finding words to describe objects or express thoughts
- Difficulty concentrating and thinking
- Making poor or uncharacteristic choices
- Forgetting how to carry out basic tasks, like dressing or bathing
- Personality changes
If youve noticed some of these behaviors in yourself or a loved one, schedule a visit with your doctor. These symptoms can reflect signs of early Alzheimers or signs of early dementia.
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Who Gets Early Onset Ad
Although AD isnt an expected part of advancing age, youre at increased risk as you get older. More than 32 percent of people over age 85 have AD.
You may also have an increased risk of developing AD if a parent, sibling, or child has the disease. If more than one family member has AD, your risk increases.
A showed that African Americans, Native Americans, and Native Alaskans are at higher risk for developing early onset AD compared to white people.
Prevalence of early onset AD
Early onset AD affects approximately
The exact cause of early onset AD hasnt been fully determined. Many researchers believe that this disease develops as the result of multiple factors rather than one specific cause.
Researchers have discovered rare genes that may directly cause or contribute to AD. These deterministic genes are:
- amyloid precursor protein on chromosome 21
- presenilin-1 on chromosome 14
- presenilin-2 on chromosome 1
These genes may be carried from one generation to the next within a family. Carrying these genes can result in adults younger than age 65 developing symptoms much earlier than expected.
Mutations in these genes account for only 5 to 10 percent of all Alzheimers cases but a majority of early onset AD cases.
Apolipoprotein E is another gene associated with AD. Its more commonly a factor in people who develop AD after age 65.
Lifestyle changes that help reduce risk include:
- regular physical activity
Stage : Mild Cognitive Impairment
Persons at this stage manifest deficits which are subtle, but which are noted by persons who are closely associated with the person with mild cognitive impairment. The subtle deficits may become manifest in diverse ways. For example, a person with mild cognitive impairment may noticeably repeat queries. The capacity to perform executive functions also becomes compromised. Commonly, for persons who are still working in complex occupational settings, job performance may decline. For those required to master new job skills, such as a computer or other machinery, decrements in these capacities may become evident.
MCI persons who are not employed, but who plan complex social events, such as dinner parties, may manifest declines in their ability to organize such events. This may be an early stage of Alzheimers, however, it is important for the person to seek medical help as soon as possible, to determine if a broad variety of medical conditions may be causing or contributing to the persons difficulties. Blood tests and an MRI of the brain should be obtained to assist in determining if the individual has MCI due to Alzheimers and whether there are other causes or contributing conditions to the persons cognitive decline.
Some MCI persons may manifest concentration deficits. Many persons with these symptoms begin to experience anxiety, which may be overtly evident.
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What Are The Early Signs Of Alzheimers Disease
One of the earliest signs of Alzheimers is memory loss. Individuals may become more forgetful than usual. Examples include forgetting important dates, events, or recent conversations. Someone with the early symptoms of Alzheimers might ask for the same information several times and rely on memory aids like sticky notes and reminders on mobile phones.
Stage : Very Severe Decline
Many basic abilities in a person with Alzheimer’s, such as eating, walking, and sitting up, fade during this period. You can stay involved by feeding your loved one with soft, easy-to-swallow food, helping them use a spoon, and making sure they drink. This is important, as many people at this stage can no longer tell when they’re thirsty.
In this stage, people with Alzheimer’s disease need a lot of help from caregivers. Many families find that, as much as they may want to, they can no longer take care of their loved one at home. If thatâs you, look into facilities such as nursing homes that provide professional care day and night.
When someone nears the end of their life, hospice may be a good option. That doesn’t necessarily mean moving them to another location. Hospice care can happen anywhere. Itâs a team approach that focuses on comfort, pain management and other medical needs, emotional concerns, and spiritual support for the person and their family.
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Stage : Mild Cognitive Decline
In stage three, individuals start to experience increased forgetfulness, difficulty with focus and trouble concentrating. The disease symptoms are beginning to advance to the point that they may result in decreased work performance. Those who arent working may experience decreased performance with ordinary household tasks, such as paying bills and cleaning.
Some of the symptoms a person may exhibit in stage three are:
- Getting lost sometimes
- Struggling with finding the right words when communicating
- Forgetting something they just read
- Asking the same question repeatedly
- Finding it challenging to make plans or organize
- Inability to remember names when meeting new people
- Losing items frequently, including valuables
In stage three, performance on a memory test would be affected, and a physician may detect impaired cognitive function.
The average duration of stage three is approximately 7 years before the onset of dementia.
What Causes Alzheimers
While there isnt a known cause of Alzheimers, experts believe several factors contribute to its development including genetics, lifestyle, and environment. The biggest risk factor is age, but its not a direct cause of Alzheimers. Family history is another factor. People who have a close family member with the disease are more likely to get it themselves. Many people ask, Is Alzheimers genetic? While genes may increase your chance for getting the disease, they dont guarantee it.7
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Talking With A Doctor
After considering the persons symptoms and ordering screening tests, the doctor may offer a preliminary diagnosis or refer the person to a Cognitive Dementia and Memory Service clinic, neurologist, geriatrician or psychiatrist.Some people may be resistant to the idea of visiting a doctor. In some cases, people do not realise, or else they deny, that there is anything wrong with them. This can be due to the brain changes of dementia that interfere with the ability to recognise or appreciate the changes occurring. Others have an insight of the changes, but may be afraid of having their fears confirmed.One of the most effective ways to overcome this problem is to find another reason for a visit to the doctor. Perhaps suggest a check-up for a symptom that the person is willing to acknowledge, such as blood pressure, or suggest a review of a long-term condition or medication.Another way is to suggest that it is time for both of you to have a physical check-up. Any expressed anxiety by the person is an excellent opportunity to suggest a visit to the doctor. Be sure to provide a lot of reassurance. A calm, caring attitude at this time can help overcome the person’s very real worries and fears.Sometimes, your friend or family member may refuse to visit the doctor to ask about their symptoms. You can take a number of actions to get support including:
- talking with other carers who may have had to deal with similar situations
- contacting your local Aged Care Assessment Team