The Stages of Alzheimer’s Disease starts at birth
Alzheimer’s disease is much more than the loss of memory. It is the loss of everything.
Back To Birth
The stages of Alzheimer’s disease mimic the stages of human development from birth to maturity, but in reverse order. The last abilities acquired in human development are the first that Alzheimer’s takes away, and the first functions that develop are the last that Alzheimer’s repeals. For example, memory, which is one of the brain’s later-acquired capacities, is among the first functions lost, while the ability to smile, which is learned very early, is among the last, although the lack of a smile can seem quite rational; there is very little for someone with Alzheimer’s to smile about.
In 1980, New York University neurologist Barry Reisberg, M. D., observed that there were precise inverse relationships between stages of Alzheimer’s disease and phases of child development in the areas of cognition, coordination, language, feeding, and behavior. He documented these developments in comparison charts. Placed side by side, the sequences of abilities gained and lost nearly perfectly mirror one another. Alzheimer’s unravels the brain almost exactly in the reverse order as it develops from birth. Reisberg called this unraveling “retrogenesis,” which means back to birth.
Retrogenesis is not a perfect reversal, but the deconstruction is remarkably similar to the construction. In this one aspect, at least, Alzheimer’s makes sense. It has its own logic. From this understanding, the observer can have a sense that something coherent is happening, rather than a random and unintelligible breakdown. It is human development in reverse. It is not surprising, therefore, to hear caregivers report that Alzheimer’s patients in the middle and later stages find tremendous comfort in children’s books and
music. They like stuffed animals and dolls. What the child craves – nurturing, safety, soft edges, colorful sights, simple words – is what the mid-stage Alzheimer’s patient craves.
Dr. Reisberg developed a system that outlines key symptoms characterizing seven stages of Alzheimer’s disease ranging from unimpaired function to very severe cognitive decline. What follows are the Seven Stages of Alzheimer’s disease, which roughly parallel the stages of human development from birth to maturity, in reverse. It is indeed second childhood.
The Seven Stages of Alzheimer’s
Stage 1: No cognitive impairment (normal function)
Individuals experience no memory problems and none are evident to a health care professional during a medical interview.
Stage 2: Very mild cognitive decline (normal age-related changes)
Forgetting familiar words or names; misplacing keys, eyeglasses or other everyday objects. This could be the beginning of Alzheimer’s or just normal “senior moments.
Stage 3: Mild cognitive decline
Early stage Alzheimer’s can be diagnosed in some, but not all, individuals with
these symptoms. Problems remembering names or finding the right word; inability to remember information that has been read just moments before; losing or misplacing valuable objects; and decline in ability to plan or organize.
Stage 4. Moderate cognitive decline
(Early-stage Alzheimer’s disease)
Decreased knowledge or awareness of recent occasions or current events; decreased capacity to perform complex tasks, such as making a shopping list and shopping, planning dinners, paying bills and managing finances; reduced memory of personal history; impaired ability to perform challenging mental arithmetic – for example, to count backward from 100 by 7s.
Stage 5: Moderately severe cognitive decline
(Mid-stage Alzheimer’s disease)
The middle stages bring the end of ambiguity. The subtle cues that something was not quite right are now impossible to avoid: inability to recall current address, telephone number or the name of the college or high school from which they graduated; becoming confused about where they are, about the date, day of the week, or season; confusion becomes worse at sundown: agitation, restlessness, anxiety, crying; inability to dress appropriately for the season or the occasion; and inability to count backward by twos from forty.
Stage 6: Severe cognitive decline
Having great difficulty remembering personal history; may forget name of spouse; must be assisted getting dressed; without supervision making mistakes such as putting shoes on wrong feet; needing help in using the bathroom; beginning to lose bowel and bladder control; experience disruption of normal sleep/waking cycle; experience significant personality and behavioral changes such as suspiciousness, delusions, hallucinations and compulsive, repetitive behaviors (hand wring, shredding tissues); and the tendency to wander and get lost.
Stage 7: Very severe cognitive decline
(Late-stage Alzheimer’s disease)
This is the severe and final stage of Alzheimer’s. It is the stage in which all
contact with the outside world is lost: inability to respond or speak coherently; needing help in eating and going to the bathroom; general incontinence of bowel and bladder; inability to walk; inability to sit without support; inability to smile; inability to hold head up; and swallowing is impaired.
How Does Alzheimer’s Cause Death?
People with Alzheimer’s live an average of eight years after diagnosis, but may survive anywhere from three to 20 years or more. Alzheimer’s is a fatal disease. Which brings us to the question: How do people with Alzheimer’s die? How can a bad memory kill you? As I said at the beginning of this article, Alzheimer’s is much more than the loss of memory. It is a complete unraveling of the mind. It is the destruction of cells in the brain that control all bodily functions. As this destruction progresses, patients lose the ability to coordinate basic motor skills such as walking, controlling bladder and bowel, and swallowing.
Once they can’t walk, they become bedridden and run the risk of developing blood clots and bed sores. Incontinence can result in bladder infections. Inability to swallow leads to malnutrition. It can also cause food to be inhaled into the lungs, which can result in pneumonia. It is possible that an Alzheimer’s patient could progress to the point that damage from the disease to the centers of the brain that control breathing could cause death, but patients rarely get that far without an infection setting in. The majority of Alzheimer’s patients die from pneumonia, blood clots to the lungs, complications from urinary tract infections, or infectious bed sores.. Although these may be the immediate cause of death, the underlying cause is the deterioration brought about by Alzheimer’s.
Is there any hope in all this horror? At this time, Alzheimer’s disease cannot be stopped and it cannot be reversed, but perhaps it can be prevented. It is in Stage 1, where there are no symptoms, that lifestyle changes in the form of good diet, exercise, and certain nutrients could mean the difference between health and the next six stages of Alzheimer’s disease.
Mary Lou Williams, M. Ed., is a lecturer and writer in the field of nutrition. She welcomes inquiries. She can be reached at 239 267-6480.