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The Progression Of Alzheimer’s Disease

Comparing Cumulative Incidence Of Ad Incidence Between Data Sets Using Simulations Of A Standardized Population Of Individuals

How Alzheimer’s Disease Progresses

We used our clinical trial simulator to explore how incidence rates predicted in each data set differed in a standardized population. We first created a virtual population by sampling demographic variables using the baseline distribution from those in the CHS study who were CN at baseline and remained in the study for 6 years. This study was not included in our estimation of transition probabilities . Following this, we calculated 12-month transition probabilities, adjusting for the known risk factors that were shared between the cohorts, and the results are presented in Supplementary Table 1. The 10-year cumulative AD incidence rates in the simulations range from 15.4% using AIBL-derived probabilities to 32.0% using probabilities derived from AddNeuroMed. The biggest variation in incidence rate predictions came from AddNeuroMed and BIOCARD, and the smallest came from AIBL, FHS, and NACC .

We then compared these results to the actual incidence rates in the CHS population from which the baseline demographics were derived . We found that the predictions made using the AddNeuroMed-derived transition probabilities overestimated the incidence rate in a generalized population. The best predictions were made using ADNI-, BIOCARD-, and FHS-derived transition probabilities, with NACC and AIBL both underestimating the incidence rate.

Stage : Very Mild Changes

You still might not notice anything amiss in your loved one’s behavior, but they may be picking up on small differences, things that even a doctor doesn’t catch. This could include forgetting words or misplacing objects.

At this stage, subtle symptoms of Alzheimer’s don’t interfere with their ability to work or live independently.

Keep in mind that these symptoms might not be Alzheimer’s at all, but simply normal changes from aging.

Mild Alzheimers Or Moderate Decline

Stage 4 lasts about 2 years and marks the beginning of diagnosable Alzheimers disease. You or your loved one will have more trouble with complex but everyday tasks. Mood changes such as withdrawal and denial are more evident. Decreased emotional response is also frequent, especially in challenging situations.

New symptoms of decline that appear in stage 4 may include:

  • losing memory of personal history
  • trouble with handling finances and bills
  • inability to count backward from 100 by 7s

A clinician will also look for a decline in areas mentioned in stage 3, but there will often have been no change since then.

Caregiver support: Itll still be possible for someone to recall weather conditions, important events, and addresses. But they may ask for help with other tasks such as writing checks, ordering food, and buying groceries.

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Learn The 7 Stages Of Alzheimer’s Plus: What Is Palliative Care Vs Hospice Care

Alzheimers disease, the most common form of dementia, is a degenerative process that begins with very mild, almost unrecognizable symptoms, and in almost all cases slides into an end-stage brain failure, leaving patients totally dependent upon others.

Very early on, we just cannot detect dementia, said Kevin Hargrave, M.D., a neurologist who is the medical director of the Neuroscience Center at Ochsner General Hospital in Lafayette. As a neurologist experienced in dementia, with a certification in neuroimaging, I can sometimes detect clues.

“However, if general radiologists read a brain scan, theyll tell you about tumors, but theyre not looking for subtle clues that may indicate, for instance, frontotemporal dementia , or indications of Alzheimers.

And, within the world of medicine, doctors dont go looking for ailments for which there is no viable treatment. So, doing a diagnostic brain scan would be rare, at best. And, diagnostic tests for Alzheimers are not covered by health insurance.

Tbss Analyses Between Groups And Post

Stages of Alzheimer

The TBSS analyses revealed widespread WM microstructure changes among the three groups. For reduced FA, the anatomical locations and clusters voxel were listed in Table 2, including the bilateral ATR, CST, IFOF, ILF, and unilateral for ma, for mi, right SLF, left UF, and CC. For each subject, the mean FA values across all voxels in each significant cluster were computed for further post-hoc analysis. Compared to the NC and aMCI groups, the AD group presented decreased FA values in the bilateral ATR, IFOF, ILF, and unilateral left CST, for ma, for mi, and CC . No significant differences in FA values were found between the NC and aMCI groups.

Table 2. Significant clusters of FA values among the three groups by TBSS analysis.

Figure 1. Clusters with decreased FA in AD patients by TBSS analysis. Significant clusters in axial views overlaid onto the group averaged FA skeleton and the MNI152 T1 template ATR, anterior thalamic radiation CST, corticospinal tract FMa, forceps major FMi, forceps minor IFOF, inferior fronto-occipital fasciculus ILF, inferior longitudinal fasciculus CC, corpus callosum L, left R, right. FA, fractional anisotropy.

Table 3. Significant clusters of MD values among the three groups by TBSS analysis.

Table 4. Significant clusters of RD values among three groups by TBSS analysis.

Table 5. Significant clusters of AxD values among three groups by TBSS analysis.

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Stage : Mild Dementia

The mild dementia stage is the point at which doctors typically diagnose Alzheimers disease. If people use a three-stage description of Alzheimers disease, this will be the early stage.

Problems with memory and thinking may become more noticeable to friends and family and also begin to affect daily life.

Symptoms of mild dementia due to Alzheimers disease include:

  • having difficulty remembering newly learned information
  • asking the same question repeatedly
  • having trouble solving problems and completing tasks
  • exhibiting reduced motivation to complete tasks
  • experiencing a lapse in judgment
  • becoming withdrawn or uncharacteristically irritable or angry
  • having difficulty finding the correct words to describe an object or idea
  • getting lost or misplacing items

Beyond Memory Loss: How To Handle The Other Symptoms Of Alzheimer’s

There is a lot of talk about the emotional pain patients and caregivers suffer when a loved one loses memories to Alzheimers. But what about the other symptoms? Here are tips from a Johns Hopkins expert on what to watch for and how to manage.

#TomorrowsDiscoveries: From Dysfunctional Cells to Disease Dr. Rong Li

Dr. Li and her team investigate how cells consolidate their damaged proteins and prevent them from spreading freely, in order to understand how to better treat diseases such as Alzheimers and ALS. Another of their interests is how chromosomes are divided up when one cell becomes two. Learning more about how the process can go wrong could lend insight into cancer development.

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Medications To Treat The Underlying Alzheimer’s Disease Process

Aducanumab is the first disease-modifying therapy approved by the FDA to treat Alzheimers disease. The medication helps to reduce amyloid deposits in the brain and may help slow the progression of Alzheimers, although it has not yet been shown to affect clinical outcomes such as progression of cognitive decline or dementia. A doctor or specialist will likely perform tests, such as a PET scan or analysis of cerebrospinal fluid, to look for evidence of amyloid plaques and help decide if the treatment is right for the patient.

Aducanumab was approved through the FDAs Accelerated Approval Program. This process requires an additional study after approval to confirm the anticipated clinical benefit. If the follow-up trial fails to verify clinical benefit, the FDA may withdraw approval of the drug. Results of the phase 4 clinical trial for aducanumab are expected to be available by early 2030.

Several other disease-modifying medications are being tested in people with mild cognitive impairment or early Alzheimers as potential treatments.

Moderate Dementia Or Moderately Severe Decline

Studying the Progression of Alzheimer’s Disease with Bradley Hyman MD PhD – Shiley Endowed Lecture

Stage 5 lasts about 1 1/2 years and requires a lot of support. Those who dont have enough support often experience feelings of anger and suspicion.

People in this stage will remember their own names and close family members, but major events, weather conditions, or their current address can be difficult to recall. Theyll also show some confusion regarding time or place and have difficulty counting backward.

Caregiver support: People will need assistance with daily tasks and can no longer live independently. Personal hygiene and eating wont be an issue yet, but they may have trouble picking the right clothing for the weather or taking care of finances.

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Stages Of Alzheimers Disease

Alzheimers disease is a progressive degenerative disease of the brain that typically advances in stages. These stages are generally referred to as early-, middle-, and late-stage Alzheimer’s disease.

Whether you have been diagnosed with Alzheimer’s disease or know someone who has, understanding the symptoms and challenges they pose is key for ensuring effective support for patients, caregivers and loved ones.

While there are tools and assessments used to determine Alzheimers disease progression, the patients ability to function daily will give clues as to the particular stage of the disease they may be in.

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

  • Staying organized

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.

Severe, late stage. At this stage, a person:

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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:

Other common causes of death among people with Alzheimers disease include dehydration, malnutrition, and other infections.

How Do You Know What Stage Of Alzheimer’s Disease A Loved One Is In

What Are the Symptoms and Stages of Alzheimerâs Disease?

The stages of Alzheimers disease presented in this post offer a reasonable framework from which to observe symptoms and understand the progression of the disease. Since there is no medical consensus for Alzheimers stages, as there is with cancer, it is important for caregivers to be aware of the individual symptoms and situation that their patient or loved one is experiencing. While healthcare providers may refer to a patients condition as late or early stage, any specific stage is less important than the context and understanding of what this means for care going forward.

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The First Stage: Mild Alzheimers Dementia

A person experiencing the earliest symptoms of Alzheimers disease may still be able to work, drive, take part in social activities, and otherwise live independently.

But they may begin to experience problems with memory or concentration. They may have trouble retaining new information remembering the name of someone theyve just met, for instance, or recalling material theyve just read.

Unfortunately, this symptom is often dismissed as a normal part of aging or the result of stress, delaying diagnosis and treatment.

Other common symptoms of mild Alzheimers include:

  • Misplacing items
  • Language problems, such as having trouble coming up with the right words
  • Trouble planning, organizing, or solving problems
  • Losing a sense of time
  • Vision-related problems, such as with depth perception and color contrast
  • Increasingly poor judgment leading to bad decisions
  • Mood and personality changes, such as becoming confused, anxious, irritable, or depressed
  • Difficulty completing familiar home, work, or leisure tasks, such as managing a budget
  • Withdrawal from work or social engagements

What Causes Alzheimers Disease

In recent years, scientists have made tremendous progress in better understanding Alzheimers and the momentum continues to grow. Still, scientists dont yet fully understand what causes Alzheimers disease in most people. In people with early-onset Alzheimers, a genetic mutation may be the cause. Late-onset Alzheimers arises from a complex series of brain changes that may occur over decades. The causes probably include a combination of genetic, environmental, and lifestyle factors. The importance of any one of these factors in increasing or decreasing the risk of developing Alzheimers may differ from person to person.

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The Second Stage: Moderate Alzheimers Dementia

In most cases of moderate Alzheimers dementia, the disease has spread to areas of the brain that control language, reasoning, sensory processing, and conscious thought, causing previous symptoms to become more pronounced.

Damage to the brain can make it difficult for people to say what theyre thinking or complete basic tasks, such as paying bills.

But they may still remember important details about their personal history.

This is typically the longest stage, potentially lasting for many years.

Symptoms of this period may include:

  • Increased memory loss and confusion, including forgetting names or personally significant events
  • Trouble recognizing family and friends
  • Inability to learn new things or cope with new situations
  • Hallucinations, delusions, and paranoia
  • Loss of impulse control, such as undressing at inappropriate times or using vulgar language
  • Repetitive statements or movements, such as hand-wringing or tissue-shredding
  • Trouble carrying out activities that require multiple steps, such as getting dressed
  • Difficulty reading, writing, or working with numbers
  • Behavioral problems, such as moodiness or inappropriate anger outbursts
  • Restlessness, agitation, anxiety, tearfulness, and increased risk of wandering, especially in the late afternoon or evening

Very Mild Impairment Or Common Forgetfulness

Understand Alzheimer’s Disease in 3 Minutes

Alzheimers disease mainly affects older adults over the age of 65. At this age, its common to have slight functional difficulties such as forgetfulness.

But for people with stage 2 Alzheimers, this decline will happen more quickly than it will for similarly aged people without Alzheimers. For example, a person may forget familiar words, a family members name, or where they placed something.

Caregiver support: Symptoms at stage 2 wont interfere with work or social activities. Memory troubles are still very mild and may not be apparent to friends and family.

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As The Leading Cause Of Dementia We Should All Be Aware Of The Progression Of Alzheimers Disease Know What To Expect With The Alzheimers Stages Timeline

More than 5 million American adults have Alzheimers disease, making it the most common cause of dementia it is also the sixth leading cause of death in the United States. As common as this condition is, many people still dont have a thorough understanding of the signs and symptoms, or even the course of progression for the disease. To protect yourself and your loved ones, take the time to learn about Alzheimers Stages Timeline so you can recognize the symptoms and seek treatment.

Stage #1: Preclinical Stage No Impairment

During the first stage of Alzheimers there are no noticeable symptoms and no impairment in day-to-day tasks. You may be aware of a family history of Alzheimers, or your doctor might identify certain biomarkers that indicate a higher risk for the disease, but you wont show any signs at this point.

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Stage #2: Very Mild Impairment

In this stage, you may experience a more rapid decline in memory than you would as a result of normal aging, but your symptoms wont have a significant impact on your work or social activity. Family members and friends wont notice the symptoms at this stage, as they are very mild.

Stage #3: Mild Impairment

Stage #4: Moderate Impairment

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Stage #5: Moderate Dementia or Moderately Severe Impairment

Stage #6: Moderately Severe Alzheimers

Stage #7: Severe Alzheimers

Alzheimer Disease Begins Long Before The First Symptoms

Alzheimers disease can begin a decade or more before the first symptoms. Despite a lack of outward evidence, changes are happening in the brain.

Researchers have identified a condition called mild cognitive impairment that in some but by no means all individuals may be the earliest indication of Alzheimers or another type of dementia.

MCI involves lapses in memory, language, thinking, and judgment that are noticeable to the person and his family and close friends yet are not serious enough to interfere with everyday life.

According the Alzheimers Association, approximately one-third of those with MCI develop dementia due to Alzheimers within five years.

Unfortunately, people with MCI who experience symptoms of memory loss or impairment are less likely to recognize their own difficulties than someone with MCI who does not experience such symptoms, which can lead to delays in diagnosis.

One of the highest priorities of Alzheimers research is understanding what happens inside the brain long before the first symptom. The hope is that these insights will lead to more effective treatments that slow or even prevent damage.

After the onset of symptoms, the disease progresses through three main stages: mild , moderate , and severe .

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