Signs and symptoms

Overview

Alzheimer disease (AD) is an acquired disorder of cognitive and behavioral impairment that markedly interferes with social and occupational functioning. It is an incurable disease with a long and progressive course. In AD, plaques develop in the hippocampus, a structure deep in the brain that helps to encode memories, and in other areas of the cerebral cortex that are used in thinking and making decisions. Whether plaques themselves cause AD or whether they are a by-product of the AD process is still unknown. See the image below.

Coronal T1-weighted magnetic resonance imaging (MRI) scan in a patient with moderate Alzheimer disease. Brain image reveals hippocampal atrophy, especially on the right side.

Signs and symptoms

Preclinical Alzheimer disease

A patient with preclinical AD may appear completely normal on physical examination and mental status testing. Specific regions of the brain (eg, entorhinal cortex, hippocampus) probably begin to be affected 10-20 years before any visible symptoms appear.

Mild Alzheimer disease

Signs of mild AD can include the following:

· Memory loss

· Confusion about the location of familiar places

· Taking longer to accomplish normal, daily tasks

· Trouble handling money and paying bills

· Compromised judgment, often leading to bad decisions

· Loss of spontaneity and sense of initiative

· Mood and personality changes; increased anxiety

Moderate Alzheimer disease

The symptoms of this stage can include the following:

· Increasing memory loss and confusion

· Shortened attention span

· Problems recognizing friends and family members

· Difficulty with language; problems with reading, writing, working with numbers

· Difficulty organizing thoughts and thinking logically

· Inability to learn new things or to cope with new or unexpected situations

· Restlessness, agitation, anxiety, tearfulness, wandering, especially in the late afternoon or at night

· Repetitive statements or movement; occasional muscle twitches

· Hallucinations, delusions, suspiciousness or paranoia, irritability

· Loss of impulse control: Shown through behavior such as undressing at inappropriate times or places or vulgar language

· Perceptual-motor problems: Such as trouble getting out of a chair or setting the table

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Severe Alzheimer disease

Patients with severe AD cannot recognize family or loved ones and cannot communicate in any way. They are completely dependent on others for care, and all sense of self seems to vanish.

Other symptoms of severe AD can include the following:

· Weight loss

· Seizures, skin infections, difficulty swallowing

· Groaning, moaning, or grunting

· Increased sleeping

· Lack of bladder and bowel control

In end-stage AD, patients may be in bed much or all of the time. Death is often the result of other illnesses, frequently aspiration pneumonia.

Дата добавления: 2015-07-26