Alzheimer’s disease has a slow or insidious onset, and patients and their families often cannot say when the disease started. It is most common in people over the age of 70. A few patients have rapid onset of symptoms after physical illness, fractures or mental stimulation. There are more women than men. The main manifestations are cognitive decline, psychiatric symptoms and behavioral disturbances, and gradual decline in the ability to perform daily activities.
There are three periods according to the degree of deterioration of cognitive ability and physical function.
Stage 1 (1-3 years): Mild dementia stage
Manifestations are.
1. diminished memory, with prominent forgetfulness of recent events.
2. decreased judgment, where the patient is unable to analyze, think and judge events and has difficulty in dealing with complex problems
3. inattentive to work or household tasks, unable to carry out shopping, financial affairs, etc. independently, social difficulties.
4, although still able to do some already familiar daily tasks, but shows bewilderment and difficulty in understanding new things, emotional indifference, occasional irritation, often paranoid.
5. the emergence of temporal orientation disorders, the ability to orient to places and people, difficulties in orienting to geographical locations, and poor visuospatial abilities in complex structures.
6. little verbal vocabulary and difficulty in naming.
Stage 2 (2-10 years): moderate dementia stage
Manifestations are.
1. severe impairment of distant and near memory, decreased visuospatial ability of simple structures, and impaired orientation to time and place.
2. severe impairment in processing problems and identifying similarities and differences in things.
3. inability to perform outdoor activities independently, needing assistance in dressing, personal hygiene, and maintaining personal appearance; inability to perform calculations.
4. the appearance of various neurological symptoms, visible as aphasia, dysfunction and loss of recognition
5.Emotional change from indifference to impatience, often walking non-stop, visible urinary incontinence.
Stage 3 (8-12 years): Severe dementia stage
1. The patient has become completely dependent on the caregiver, with severe memory loss and only fragmented memory remaining.
2. The patient is unable to take care of himself/herself in daily life, incontinent, showing muteness, limb rigidity, positive cone bundle sign visible on examination, and primitive reflexes such as strong grip, groping and sucking.
Eventually comatose, usually dying from complications such as infection.