Patients may spend years in the early stages of Alzheimer’s disease. In fact, the earliest symptoms do not appear in a noticeable way until roughly 48 months into disease progression. The middle stage could be equally long, however, progression seems to be quicker. Symptoms build upon one another, so once a particular symptom appears, it will likely get worse instead of better.
Mental and Physical Preparation is Vital
This will be a confusing and frightening experience; understanding what will happen as the disease progresses can help you cope with some of the serious psychological symptoms. You have the ability now, to create contingency plans for upcoming symptoms.
Realizing that your needs will change as the disease progresses can help you organize caregivers effectively so when that time comes, you and your loved ones and/or caregivers are ready. It will also help you make decisions about how you want to be cared for. Do you want to avoid a certain type of medication? Would you prefer to remain living in your own home as long as possible? Do you want a specific person to care for you? Express these concerns now, research solutions, document your desires, attend support groups for both patients and caregivers. This simple preparation may significantly decrease the severity and likelihood of many psychological symptoms, such as depression and anxiety, because you're doing what you can.
Middle Stage Symptoms
Symptoms will vary depending on the individual, but some of the most common include:
• General Confusion
o Confuses past events with recent events
o Fails to recall recent events
o Repeats questions, stories, statements
o Lives largely "in the moment"
o Yesterday may not be clearly remembered
o Frequently talks about people from childhood
o Difficulty understanding other people
• Problems with judgment calls
o Does not always remember to take medication
o Does not handle money well (ex. giving large bills to the cashier or telling them to take what they need from a large cash pile or wallet)
o Needs help with decision making (what or where to purchase something, what to wear)
o Loss of impulse control
o Irrational decision making
• Restlessness or pacing
In addition to these symptoms, irritability and anger may also increase as you realize the tasks you are unable to perform. This emotional response is usually triggered by the frustration of being unable to perform tasks that you had no trouble performing before the disease. However, you may not be able to effectively communicate this frustration to others, and they may not understand why you are angry, unless you've both prepared for it beforehand.
For more information about what may happen as Alzheimer’s disease progresses, visit The Palm Beach Neurological Center’s blog at http://www.palmbeachneurological.com/blog/.
Jones, R. Alzheimer’s Disease. The Pharmaceutical J. 2000; June; 264(7099): 8946-850.
Hart, D.J., et al. A retrospective study of the behavioural and psychological symptoms of mid and late phase Alzheimer’s disease. International J. of Geriatric Psychiatry. 2003; Nov.; 18(11): 1037-1042.
561-694-1010 – Dr. Tuchman has maintained a private practice in Neurology in Palm Beach Gardens since 1983. His special areas of interest are memory disorders such as Alzheimer’s disease, Parkins