Alzheimer’s - a journey, not a destination

Symptoms and daily life

The symptoms of Alzheimer’s are explained by the sites of damage. Global cellular degeneration causes an overall decline in ability. Damage to the hippocampal and temporal regions of the brain result in progressive memory loss and difficulty in decision making and self-awareness. Later degeneration of frontal regions alters logical reasoning.  Often these patients will become irrational and emotional to normal events. End-stage disease is characterised by incontinence, loss of appetite and gradual decline of physiological controls, including eating and drinking.  Progression varies and is determined by other disease and concomitant risk factors as described previously.

Patients may lose track of items, wander, become angry or scared, and begin to forget to eat or drink. They may become uncomfortable in unfamiliar surroundings or with new people, in travel or with accents.  Day to day tasks, especially those requiring a complex grasp of time and space, may begin to falter. This will worsen with time. Medications slow disease but produce side effects. By knowing these symptoms (table 1) and side effects (table 2), we can learn to adjust for them.

Symptoms

Early disease

·         Memory loss

·         Communication difficulties

·         Repetition of words and trouble finding words

·         Impaired judgement and forward planning

·         Rigidity and inflexibility to change

·         Increasing anxiety and low mood

·         Hiding items (including food).

Middle disease

·         Confusion, aggression, obsession and impulsive behaviours

·         Sleep disturbance, hallucinations and delusions

·         Further communication difficulties, including aphasia (stop speaking)

·         Problems with physical tasks.

Late disease

·         Swallowing difficulties, choking, pneumonia

·         Loss of appetite and significant weight loss

·         Loss of movement, becoming bed or chair bound

·         Incontinence, recurrent urinary infections

·         Death (table 1)

Medication side effects

·         Dizziness

·         Headaches

·         Diarrhoea

·         Constipation

·         Headache

·         Shortness of breath

·         Collapse (table 2)