Alzheimer’s Disease: Symptoms, Diagnosis, Treatment and Reducing Your Risk

Alzheimer’s Disease: Symptoms, Diagnosis, Treatment and Reducing Your Risk

As I continue my blog series on Alzheimer’s disease, I am continually struck by just how complicated dementia is—and how complicated each type of dementia can be.

As I mentioned in my previous blog, I am very aware of what a devastating disease Alzheimer’s can be. It can be incredibly difficult not only for the person living with the disease but also for their family, caregivers, and friends. Sometimes those of us standing alongside someone with dementia can feel somewhat helpless. We may want to help but simply aren't sure what to do or how to respond to the changes we are seeing.

In my first blog, I explored Alzheimer’s disease, some of the risk factors, and the early symptoms to watch for. In this second blog, I want to continue that conversation by looking more closely at the progression of Alzheimer’s, diagnosis, treatment, and some of the things we can do to reduce our risk.

Recognizing the Symptoms of Alzheimer’s Disease

When we look at Alzheimer’s disease, the most common form of dementia, one of the challenges is that the early symptoms can sometimes be overlooked. They may initially appear to be a normal part of getting older.

The important question is not simply, “Are they forgetting things?” Most of us forget things from time to time.

The bigger question is: How much are these changes beginning to interfere with everyday life?

Some of the early signs of Alzheimer’s disease may include:

• Increasing memory loss that affects daily activities
• Difficulty solving problems or completing familiar tasks
• Trouble preparing a meal, shopping, or managing finances
• Increasing difficulty finding the right words
• Problems understanding conversations or written information
• Changes in reading and writing abilities
• Becoming confused about dates, times, or appointments
• Missing appointments or important commitments
• Difficulty finding familiar places or becoming disoriented
• Changes in mood, personality, or behaviour

For example, someone who has always been comfortable preparing meals may suddenly find even simple recipes confusing. Someone who has always been outgoing and socially engaged may begin withdrawing from friends and activities.

Personality changes can also be particularly difficult for families to understand. An individual who has always been mild-mannered and gentle may become irritable, angry, or agitated. Someone who has always been trusting may become suspicious or paranoid.

These changes can be incredibly difficult for the individual experiencing them. In some cases, they may be aware that something is changing but not understand why. At the same time, the changes can place enormous emotional and practical strain on caregivers, family members, and friends.

These are only some of the symptoms associated with Alzheimer’s disease. Not everyone will experience them in the same way or at the same pace.

The Three Stages of Alzheimer’s Disease

Alzheimer’s disease is often described in three general stages: mild, moderate, and severe. These stages are useful for understanding the progression of the disease, although every person's experience will be different.

Mild Alzheimer’s Disease

During the mild or early stage, family and friends may begin to notice that something isn't quite right.

There may be increasing memory loss, difficulty finding words, or subtle changes in the way someone manages their everyday life. Sometimes these changes are present for quite some time before a diagnosis is made.

Many people in the mild stage can continue to live relatively independently. They may still drive, prepare meals, manage their household, and participate in activities they enjoy, although some additional support may gradually become necessary.

For family members, this stage can be particularly confusing. You may find yourself wondering, “Is this just normal aging, or is something else happening?”

That uncertainty is one reason seeking professional advice when concerns arise can be so important.

Moderate Alzheimer’s Disease

As Alzheimer’s progresses, more areas of the brain become affected and the individual generally requires increased supervision and support.

Everyday tasks can become much more difficult. Someone may struggle with getting dressed, preparing food, managing medications, or completing other familiar activities.

You may also notice:

• Increasing confusion
• Repetitive questions or conversations
• Difficulty recognizing familiar people or places
• Wandering or becoming lost
• Further decline in language and communication
• Changes in sleep patterns
• Increased anxiety, agitation, or suspicion
• In some cases, hallucinations or paranoid thoughts

One example that families often describe is asking the same question repeatedly, even after receiving an answer only moments earlier.

It can be frustrating for the person asking and exhausting for the person providing the answer. Understanding that this repetition is a symptom of the disease—not something the person is deliberately doing—can sometimes help families respond with greater patience and compassion.

Severe Alzheimer’s Disease

In the severe or late stage of Alzheimer’s disease, a person generally requires extensive assistance with everyday activities and personal care.

Communication can become extremely limited. The individual may have difficulty recognizing loved ones or communicating their needs.

As the disease progresses, physical abilities can also decline. Difficulties with movement, eating and swallowing, and controlling bladder or bowel function may occur.

Problems with swallowing can be particularly serious because they can increase the risk of choking, malnutrition, dehydration, and infections.

This stage can be incredibly difficult for families to witness. It is also another example of the anticipatory grief that can accompany Alzheimer’s disease. The person we love is still physically present, yet so much of who they were and how we connected with them may have changed.

Getting a Diagnosis

As difficult as receiving an Alzheimer’s diagnosis can be, early assessment and diagnosis are important.

There are treatments and supports that may be most helpful earlier in the disease, and knowing what you are dealing with can allow individuals and families to plan for the future.

A diagnosis may involve several steps. A healthcare professional will generally ask about medical history, symptoms, and changes that have been noticed. Family members or close friends may also be asked for their observations because they may have noticed changes that the individual hasn't recognized.

Cognitive testing may be used to assess areas such as:

• Memory
• Attention
• Problem-solving
• Language
• Reasoning
• Orientation

Blood tests may also be completed to help rule out other conditions that could be contributing to changes in thinking or memory.

Depending on the situation, further investigations may include brain imaging such as a CT scan, MRI, or PET scan.

It is important to remember that memory problems do not automatically mean someone has Alzheimer’s disease. There are other medical, neurological, and mental health conditions that can cause similar symptoms. That is why a thorough assessment is so important.

If you or someone you love is experiencing noticeable changes in memory, thinking, behaviour, or everyday functioning, it is worth talking with your doctor rather than simply assuming it is part of getting older.

Treatment for Alzheimer’s Disease

Sadly, there is currently no cure for Alzheimer’s disease. Treatment focuses on managing symptoms, supporting quality of life, and, for some people, slowing the progression of the disease.

There are medications that may help manage certain symptoms, and newer treatments are also being studied and developed. Medication can be helpful for some people, but it does not work the same way for everyone, and its benefits may change as the disease progresses.

This is an important conversation to have with your healthcare provider, as medications need to be considered alongside an individual's overall health, other medications, and stage of Alzheimer’s disease.

Treatment isn't only about medication, however.

There are also a number of non-medication approaches that can support individuals living with Alzheimer’s and their caregivers. Depending on the person's interests and abilities, these may include:

• Regular physical activity
• Music and reminiscence activities
• Cognitive and memory-based activities
• Social programs and support groups
• Counselling and emotional support
• Meaningful daily routines
• Caregiver education and support

It is also important to explore what resources are available in your own community.

Here in Grande Prairie, for example, the local Alzheimer’s Society and other organizations supporting  dementia  care can provide information, education, support, and connections to community resources. Sometimes simply knowing that you are not alone can make a tremendous difference.

Can Alzheimer’s Disease Be Prevented?

Perhaps one of the hardest facts to accept is that there is no guaranteed way to prevent Alzheimer’s disease.

However, there are things we can do that may help reduce our risk of cognitive decline and support overall brain health.

One of the most important areas is heart health. Managing conditions such as high blood pressure, high cholesterol, diabetes, and cardiovascular disease is important for our overall health and may also help protect brain health.

A healthy lifestyle can make a difference too.

Keep Moving

Regular physical activity is important at any age. You don't necessarily need to join a gym or become a marathon runner. Something as simple as getting outside for a walk each day can be a good place to start.

Exercise supports cardiovascular health, mood, sleep, and overall well-being.

Eat for Heart and Brain Health

We have heard it many times, but eating a healthy, balanced diet really does matter. Foods that support heart health can also support brain health.

Don't Smoke

If you smoke, quitting can reduce a number of health risks, including those associated with cardiovascular and brain health.

Be Mindful of Alcohol

Heavy alcohol consumption can negatively affect brain health and is associated with an increased risk of dementia. Being mindful of how much alcohol you consume is another way of supporting your overall health.

Stay Socially Connected

This is one area I don't think we talk about enough.

As we get older, our social circles can sometimes become smaller. Retirement, moving, health concerns, and the loss of friends or family members can all change our social connections.

But staying connected matters.

Having meaningful relationships and opportunities to talk, laugh, participate, and share our lives with others can support our emotional well-being and help us remain engaged with the world around us.

For some older adults, staying socially connected takes a little more effort than it once did. Joining a group, volunteering, participating in an activity, or simply arranging a regular coffee with a friend can make a difference.

Looking After Our Health and Each Other

Writing these blogs about Alzheimer’s disease can feel somewhat depressing—and at times, even a little hopeless.

There is still so much we don't know.

But I also think there is an important message here: we don't have to wait until something is wrong to start taking care of our brain health.

Regular medical checkups, managing our health conditions, staying active, eating well, maintaining social connections, and paying attention to changes in ourselves or our loved ones are all worthwhile.

If you notice something that doesn't seem right, don't ignore it. Talk with your doctor. Early assessment can provide answers, open the door to treatment and support, and give families an opportunity to plan for what lies ahead.

And perhaps most importantly, remember that Alzheimer's disease affects more than the person who receives the diagnosis. It affects spouses, children, grandchildren, friends, and caregivers. The grief, frustration, exhaustion, uncertainty, and love that can exist alongside caregiving are very real.

You don't have to navigate those feelings alone.

Research into Alzheimer’s disease and other forms of dementia continues around the world. Scientists and healthcare professionals are learning more about the causes, risk factors, diagnosis, and treatment of these diseases every day. There is still much work to be done, but progress is being made.

Perhaps one day we will be able to prevent or cure this devastating disease. Until then, our best approach is to stay informed, look after our health, seek help when we have concerns, and support one another along the way.