Stage : Moderately Severe Decline
During the fifth stage of Alzheimers, people begin to need help with many day-to-day activities. People in stage five of the disease may experience:
- Difficulty dressing appropriately
- Inability to recall simple details about themselves such as their own phone number
- Significant confusion
On the other hand, people in stage five maintain functionality. They typically can still bathe and toilet independently. They also usually still know their family members and some detail about their personal histories, especially their childhood and youth.
What I Wish I Knew Before My Mothers Alzheimers Death
As with many Alzheimers patients, it was the family who suggested my mother get her memory tested. She was 68 years old, repeating herself, losing things and occasionally paranoid and combative with my father, something we had never seen from her before. We thought she might be depressed, but the notion that she might have dementia crossed our minds. She was diagnosed with mild cognitive impairment, the earliest stage of forgetfulness, in 2008, but was not officially given the diagnosis of Alzheimers until 2010, when she had an epileptic seizure. After that, her memory and cognitive faculties deteriorated sharply.
This is not the story of an Alzheimers patient swinging between the ignorance of their forgetfulness and the panic of watching their own ongoing decline come into focus, nor the story of the fear, the bouts of irritability, and the deep sorrow felt by family members watching their loved one slowly disappear before their eyes. We went through all that, yes. But this is the story of the last three excruciating months of my mothers life. She died in her familys arms at the age of 76, having battled Alzheimers bravely for more than eight years.
Stage : Moderate Dementia
When a person has moderate dementia due to Alzheimers disease, they become increasingly confused and forgetful. They may need help with daily tasks and with looking after themselves. This is the longest stage and often lasts around 24 years.
Symptoms of moderate dementia due to Alzheimers disease include:
- losing track of the location and forgetting the way, even in familiar places
- wandering in search of surroundings that feel more familiar
- failing to recall the day of the week or the season
- confusing family members and close friends or mistaking strangers for family
- forgetting personal information, such as their address
- repeating favorite memories or making up stories to fill memory gaps
- needing help deciding what to wear for the weather or season
- needing assistance with bathing and grooming
- occasionally losing control of the bladder or bowel
- becoming unduly suspicious of friends and family
- seeing or hearing things that are not there
- becoming restless or agitated
- having physical outbursts, which may be aggressive
As Alzheimers progresses, a person may start to feel more restless toward evening and have difficulty sleeping. This is sometimes called sundowners syndrome.
During this stage, physical and mental functioning continue to decline.
If a person has severe dementia during the later stages of Alzheimers disease, they might:
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What Are The Benefits Of An Early Alzheimer’s Diagnosis
Early, accurate diagnosis is beneficial for several reasons. Beginning treatment early in the disease process may help preserve daily functioning for some time, even though the underlying Alzheimers process cannot be stopped or reversed.
Having an early diagnosis helps people with Alzheimers and their families:
How Is Alzheimers Disease Diagnosed
Doctors use several methods and tools to help determine whether a person who is having memory problems has Alzheimers disease.
To diagnose Alzheimers, doctors may:
- Ask the person and a family member or friend questions about overall health, use of prescription and over-the-counter medicines, diet, past medical problems, ability to carry out daily activities, and changes in behavior and personality.
- Conduct tests of memory, problem solving, attention, counting, and language.
- Carry out standard medical tests, such as blood and urine tests, to identify other possible causes of the problem.
- Perform brain scans, such as computed tomography , magnetic resonance imaging , or positron emission tomography , to support an Alzheimers diagnosis or to rule out other possible causes for symptoms.
These tests may be repeated to give doctors information about how the persons memory and other cognitive functions are changing over time.
People with memory and thinking concerns should talk to their doctor to find out whether their symptoms are due to Alzheimers or another cause, such as stroke, tumor, Parkinsons disease, sleep disturbances, side effects of medication, an infection, or another type of dementia. Some of these conditions may be treatable and possibly reversible.
In addition, an early diagnosis provides people with more opportunities to participate in clinical trials or other research studies testing possible new treatments for Alzheimers.
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Recognising When Someone Is Reaching The End Of Their Life
Read about some of the signs that a person with dementia is nearing their death, and how you can support yourself as a carer, friend or relative.
It is important to know when a person with dementia is nearing the end of their life because it can help in giving them the right care. However it can be difficult to know when this time is.
This uncertainty can have a big impact on how the persons family feel, and may also affect how they feel themselves.
There are symptoms in the later stages of dementia that can suggest the person is reaching the final stage of their illness. These include:
- speech limited to single words or phrases that may not make sense,
- needing help with most everyday activities,
- eating less and having difficulties swallowing,
- bowel and bladder incontinence,
- being unable to walk or stand, problems sitting up and controlling the head, and becoming bed-bound.
It is likely that a person with dementia is nearing the end of their life if they have these symptoms, along with other problems such as frailty, infections that keep coming back, and pressure ulcers .
General Overview Of Alzheimer Disease Stages
For those who are diagnosed with Alzheimers disease, symptoms typically manifest when a person reaches their 70s, but for those who develop early-onset Alzheimers disease , symptoms can develop as early as a persons 30s.
When it comes to Alzheimers disease, life expectancy can range from a few years to as many as 20. It really depends on the overall health of the individual and the severity of their symptoms. There is one factor, however, that has a major impact on life expectancy the age when symptoms appear. Those diagnosed at the age of 65 have a life expectancy of 8.3 years, whereas, someone at the age of 90 has a shorter life expectancy of 3.4 years.
In the typical progression of Alzheimers disease, the mild or early stages last approximately two to four years. The moderate or middle stages lasts anywhere from two to 10 years. And the severe or late stages typically last one to three years. Doing the math, you see that there is a wide range of years in which the disease can progress between five to 17 years for the typical progression of Alzheimers disease.
Alzheimers disease is the most common cause of dementia. In its early stages, Alzheimers disease may interfere with some day-to-day activities. As it progresses into the later stages, however, an individual with Alzheimers disease will be completely dependent on others to accomplish even the most basic tasks.
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Life Expectancy Following Diagnosis Of Alzheimers Disease Depends On Age At Diagnosis
The life span of people with Alzheimers disease depends greatly on the age of the person when Alzheimers disease is diagnosed, according to a study by researchers at the Johns Hopkins Bloomberg School of Public Health. Determining the survival following a diagnosis of Alzheimers disease is important in helping patients, families, and their caregivers deal with the illness. The findings are published in the November 18, 2002, edition of Archives of Neurology.
The duration of survival following a diagnosis of Alzheimers disease depends critically on the subjects age at diagnosis. The results of this study indicate that the median survival of patients with Alzheimers disease could range from nearly nine years for persons diagnosed at age 65 to approximately three years for persons diagnosed at age 90 years, said Ronald Brookmeyer, PhD, professor of Biostatistics at the Johns Hopkins Bloomberg School of Public Health.
Data for the study were collected from the Baltimore Longitudinal Study of Aging, which began in 1958 to monitor the effects of aging. The participants were asked to return for follow-up visits every two years to be examined and to answer questionnaires. From this study, Dr. Brookmeyer and his colleagues selected 921 participants who were age 55 or older in 1985 and had received some follow-up visits. Alzheimers disease was diagnosed using several neuropsychological tests and deaths were recorded through September 1999.
Stage : Preclinical Alzheimers Disease
Alzheimers disease begins long before any symptoms become apparent. An individual who is at the preclinical stage of Alzheimers disease is fully independent and may not even be aware they have the disease. They may not experience any symptoms and if they do, they will be very mild and considered to be normal everyday occurrences, especially for an older adult, such as minor memory lapses forgetting words or where things are kept, things we all forget from time to time. Even a medical examination may indicate no presence of dementia.
This stage is called preclinical because its usually identified only in a research setting. Research laboratories now have new imaging technologies able to identify the common amyloid-beta protein deposits in the brain a hallmark indicator of Alzheimers disease.
Symptoms wont be apparent to you or to those around you yet. This stage can last for many years, possibly even decades, before you notice any symptoms at all.
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Life Expectancy In Chei
The mean survival time in the ChEI-treated SATS participants was 6.3 years for patients < 75 years, 5.5 years for those aged 75-84 years, and 5.2 years for those aged 85 years at AD diagnosis. Brookmeyer et al. reported a median life expectancy of 6.0 years for untreated individuals < 75 years, 5.0 years for those aged 75-84 years, and 3.5 years for those aged 85 years at the time of AD diagnosis. Larson et al. observed a median life span of 7.5 years for untreated AD patients aged 75 years, 4.9-5.6 years for those aged 76-85 years, and 3.2 years for those aged > 85 years at diagnosis.
Alzheimer’s Disease And Dementia Life Expectancy
Researchers in 2016 estimated that there were 43.8 million people in the world with Alzheimer’s disease or other forms of dementia27 million women and 16.8 million men. These numbers are growing rapidly. In fact, it’s expected to more than double to 100 million by 2050. Here’s what you should know about Alzheimer’s disease and dementia life expectancy.
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What Happens If A Doctor Thinks It’s Alzheimer’s Disease
If a primary care doctor suspects mild cognitive impairment or possible Alzheimers, he or she may refer the patient to a specialist who can provide a detailed diagnosis or further assessment. Specialists include:
- Geriatricians, who manage health care in older adults and know how the body changes as it ages and whether symptoms indicate a serious problem
- Geriatric psychiatrists, who specialize in the mental and emotional problems of older adults and can assess memory and thinking problems
- Neurologists, who specialize in abnormalities of the brain and central nervous system and can conduct and review brain scans
- Neuropsychologists, who can conduct tests of memory and thinking
Memory clinics and centers, including Alzheimers Disease Research Centers, offer teams of specialists who work together to diagnose the problem. Tests often are done at the clinic or center, which can speed up diagnosis.
Study: Alzheimers Disease A Much Larger Cause Of Death Than Reported
The American Academy of Neurology is the world’s largest association of neurologists and neuroscience professionals, with 36,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease and epilepsy.
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Stage : Mild Cognitive Impairment
Mild cognitive impairment often occurs before the more severe decline of dementia. Some 1218% of people aged 60 years or older have MCI, but not all will develop dementia. According to the National Institute on Aging, around 1020% of people over the age of 65 with MCI will develop dementia within any 1-year period.
A person with MCI may notice subtle changes in their thinking and ability to remember things. They may have a sense of brain fog and find it hard to recollect recent events. These issues are not severe enough to cause problems with day-to-day life or usual activities, but loved ones may start to notice changes.
Many people become more forgetful with age or take longer to think of a word or remember a name. However, significant challenges with these tasks could be a sign of MCI.
Symptoms of MCI include:
How Alzheimer’s Causes Death
In late-stage Alzheimer’s disease, people become extremely confused and disoriented. The behavior of someone with late stage Alzheimer’s may become more agitated and restless, while other persons experience withdrawal and apathy. Sometimes, people with later stage dementia cry and call out. Eventually, they lose the ability to communicate, and they may not respond at all.
Additionally, people in the late stages are unable to care for themselves, becoming bedbound and completely dependent on others for their activities of daily living. Their ability to be continent of bowel and bladder declines.
Their appetite decreases as well, and eventually, they lose the ability to swallow, leading to poor nutrition and a high risk of aspiration. Aspiration, where a person’s food goes “down the wrong tube” when they swallow it, greatly increases the risk of pneumonia developing because they’re not able to fully cough and clear the food out of their esophagus and then it settles into their lungs.
Under these difficult conditions, it’s not hard to imagine how vulnerable people with late-stage dementia become, sometimes succumbing to infections, pressure sores, and pneumonia. One study found that half of all people with dementia admitted to a hospital for pneumonia or a hip fracture died within six months of leaving the hospital.
Other factors that impact the death rate in Alzheimer’s disease include advanced age, increased falls, and delirium.
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Do You Die From Dementia
The forgetfulness, confusion and communication problems of dementia are caused by increasing damage to cells in the brain. But the brain doesn’t just control memory and thought it is also the control centre for the body. Progressive brain cell death will eventually cause the digestive system, lungs, and heart to fail, meaning that dementia is a terminal condition. Studies suggest that, on average, someone will live around ten years following a dementia diagnosis. However, this can vary significantly between individuals, some people living for more than twenty years, so it’s important to try not to focus on the figures and to make the very most of the time left.
Causes Of Death In People With Alzheimer’s Disease
Claudia Chaves, MD, is board-certified in cerebrovascular disease and neurology with a subspecialty certification in vascular neurology. She is an associate professor of neurology at Tufts Medical School and medical director of the Lahey Clinic Multiple Sclerosis Center in Lexington, Massachusetts.
The Alzheimer’s Association notes that Alzheimer’s disease is the sixth leading cause of death in the United States. It also points out that out of the top 10 causes of death, it’s the only one without an effective treatment or cure.
The Centers for Disease Control and Prevention also highlights Alzheimer’s as a significant cause of death, pointing out that between 1999 and 2014, deaths attributed to Alzheimer’s rose by 55%.
One of the challenges in tracking deaths from Alzheimer’s is that Alzheimer’s disease is not always identified as the cause of death on a death certificate. Sometimes, the conditions that develop from Alzheimer’s are listed instead as primary on the death certificate. In other cases, Alzheimer’s may have never been officially diagnosed. These challenges in tracking Alzheimer’s deaths are demonstrated in one study that found that deaths from Alzheimer’s in people over the age of 75 may be as high as six times the count officially recorded.
Average life expectancy for people living with Alzheimer’s is four to seven years after diagnosis, although some people may live as much as 20 years or more.
Caring For Those With Dementia
Researcher Murna Downs, PhD, says most people don’t recognize that dementia is a disease people live with, and not just a death sentence.
Downs’ research focuses on quality-of-life issues among dementia patients.
“People with dementia live a long time, and we now know that there is a lot of awareness,” she says. “People assume that if someone doesn’t know where they are they have no other capacity for thinking and feeling. But people with dementia continue to think and to laugh and to feel the rain on their faces, and to try to make sense of their world.”
She adds that patients are often isolated because family members or other caregivers fail to recognize their need for interaction and stimulation.
“The therapeutic potential of human contact cannot be underestimated,” she says. “You would never put a small child in a chair and let them sit there all day with nothing to do. Children need stimulation and human contact and so do people with dementia.”
SOURCES: Xie, J. BMJ Online First, Jan. 11, 2008. Carol Brayne,professor, lecturer in epidemiology, department of public health and primarycare, Institute of Public Health, University of Cambridge, England. MurnaDowns, PhD, professor in dementia studies, Bradford Dementia Group, Universityof Bradford, England Ferri, C.P. Lancet, 2005 vol 366: pp2112-2117.