Alzheimer's Disease Causes, Stages, and Symptoms (cont.)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Alzheimer's disease facts
- What is dementia?
- What is Alzheimer's disease?
- Who develops Alzheimer's disease?
- What are the symptoms of Alzheimer's disease?
- Ten warning signs of Alzheimer's disease
- What causes Alzheimer's disease?
- What are risk factors for Alzheimer's disease?
- How is the diagnosis of Alzheimer's disease made?
- What treatment and management options are available for Alzheimer's disease?
- Cholinesterase inhibitors (ChEIs)
- Partial glutamate antagonists
- Non-medication based treatments
- Treatment of psychiatric symptoms
- What is the prognosis for a person with Alzheimer's disease?
- Caring for the caregiver and Alzheimer's disease resources
- Alzheimer's Disease FAQs
- Find a local Geriatrician in your town
Ten warning signs of Alzheimer's disease
The Alzheimer's Association has developed the following list of warning signs that include common symptoms of Alzheimer's disease. Individuals who exhibit several of these symptoms should see a physician for a complete evaluation.
- Memory loss
- Difficulty performing familiar tasks
- Problems with language
- Disorientation to time and place
- Poor or decreased judgment
- Problems with abstract thinking
- Misplacing things
- Changes in mood or behavior
- Changes in personality
- Loss of initiative
It is normal for certain kinds of memory, such as the ability to remember lists of words, to decline with normal aging. In fact, normal individuals 50 years of age will recall only about 60% as many items on some kinds of memory tests as individuals 20 years of age. Furthermore, everyone forgets, and every 20 year old is well aware of multiple times he or she couldn't think of an answer on a test that he or she once knew. Almost no 20 year old worries when he/she forgets something, that he/she has the 'early stages of Alzheimer's disease,' whereas an individual 50 or 60 years of age with a few memory lapses may worry that they have the 'early stages of Alzheimer's disease.'
Mild cognitive impairment
The criteria for dementia are conservative meaning that a patient must have had considerable decline in the ability to think before a diagnosis of dementia is appropriate. The progression of Alzheimer's disease is so insidious and slow that patients go through a period of decline where their memory is clearly worse than its baseline, yet they still do not meet criteria for dementia. This transitional syndrome is called Mild Cognitive Impairment (MCI). Individuals affected with MCI have cognitive impairment that is demonstrated on formal neuropsychological testing but are still able to function well. Formal neuropsychological testing usually means that the patient is administered a battery of standardized tests of memory and thinking. Some of these tests are something like the IQ tests we may have taken in school. When these tests were developed they were administered to hundreds or thousands of people so that statistics are available to say how a person's score compares to a sample of healthy persons of the same age. If a person scores in the top 50%, it means that he or she did better than at least 50% of other normal people who took the test. Persons with lower scores - often in the bottom 7% - are considered to have MCI.
There are several forms of MCI. Perhaps the most common is associated with impairment in memory but not in the ability to plan and reason. Persons with this type called "amnestic MCI" (amnestic comes from "amnesia" and means no memory) have a high risk of developing Alzheimer's disease over the next few years. Persons with preserved memory but impaired reasoning or impaired judgment (call non-amnestic MCI) have a lower risk of developing Alzheimer's disease.
As treatments are developed that decrease the risk of developing Alzheimer's disease or slow its rate of progression (as of June 2007, no such medication has been approved by the FDA), recognition of amnestic MCI will be increasingly important. It is hoped that medications will be developed that will slow the rate of progression of MCI to Alzheimer's disease or completely prevent the development of Alzheimer's disease.
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