_______________________________ Alzheimer Disease and Dementias: Early Detection and Care Planning
dementia, accounting for 60% to 70% of cases [1]. The disease is marked by amyloid plaques and tau tangles in the brain, disrupting neuronal communication and causing cell death. Early symptoms include memory loss, difficulty in planning and problem-solving, and challenges with language and spatial awareness. As it progresses, individuals may experience severe memory impairment, confusion, mood changes, and difficulty with basic activities [12]. The exact cause of Alzheimer disease is not fully understood but is believed to involve genetic, environmental, and lifestyle factors. Major risk factors include age (primarily affecting those older than 65 years of age) and gender (more common in women). Other risks include family history, genetic muta- tions, and conditions like cardiovascular disease and diabetes. There is no cure, but treatments can temporarily slow symptom progression and improve quality of life. Ongoing research aims to uncover the disease’s mechanisms and develop more effective therapies [4; 10]. THE LONG PRECLINICAL PHASE OF ALZHEIMER DISEASE Research indicates that Alzheimer disease can begin 20 years or more before clinical symptoms appear [12; 13]. During this preclinical phase, amyloid-beta plaques and tau tangles accumulate in the brain, disrupting neuronal function and leading to gradual brain cell death. This period is marked by subtle brain changes that are not yet noticeable. Advanced imaging techniques and biomark- ers, like cerebrospinal fluid analysis, can detect these early changes, offering insights into disease progression [2]. Identi- fying individuals in this stage is crucial for early intervention and developing treatments to slow or halt the disease before significant cognitive impairment occurs. Recognizing that Alzheimer disease starts decades before symp- toms manifest highlights the importance of early detection and monitoring. It also emphasizes the need for ongoing research to develop preventive strategies and treatments targeting the disease’s earliest stages. By focusing on the preclinical phase, healthcare providers can better manage the eventual onset of symptoms, improving outcomes for patients and their families. STAGES OF ALZHEIMER DISEASE Alzheimer disease progresses through stages marked by increas- ing cognitive and functional decline. The Reisberg Scale, or Global Deterioration Scale (GDS), divides this progression into seven stages, grouped into early, middle, and late stages: • Early stages (1–3): Mild cognitive changes that may not be immediately recognized as Alzheimer disease • Middle stages (4–5): More pronounced cognitive decline and increased dependency on caregivers • Late stages (6–7): Severe cognitive and physical impair- ment, requiring comprehensive care and support
Recognizing these stages aids in planning appropriate inter- ventions and support for individuals with Alzheimer disease and their caregivers.
Early Stage (Stages 1–3) Stage 1: No Cognitive Decline
Description: No noticeable symptoms of cognitive impairment. The individual functions normally, with no memory problems or other signs of dementia. Fit into early stage: This stage represents normal cognitive function without any detectable signs of Alzheimer disease. Stage 2: Very Mild Cognitive Decline Description: Minor memory lapses, such as forgetting familiar words or the location of everyday objects. These lapses are not evident to friends, family, or medical professionals. Fit into early stage: This stage is often considered normal age-related memory decline and may not be recognized as Alzheimer disease. Stage 3: Mild Cognitive Decline Description: Noticeable difficulties in memory and concen- tration. Common symptoms include losing valuable objects, trouble remembering names, and difficulty performing tasks in social or work settings. Friends and family may notice these changes. Fit into early stage: This stage marks the beginning of notice- able cognitive impairment, often referred to as mild cognitive impairment. It is a critical period for early diagnosis and intervention. Middle Stage (Stages 4–5) Stage 4: Moderate Cognitive Decline (Mild or Early- Stage Alzheimer Disease) Description: Clear-cut symptoms of Alzheimer disease become apparent. Individuals may have difficulty with complex tasks such as managing finances, planning events, and remembering recent events. They may also become moody or withdrawn, especially in socially or mentally challenging situations. Fit into middle stage: This stage is characterized by a decline in cognitive abilities that affects daily life. It is often when a formal diagnosis of Alzheimer disease is made. Stage 5: Moderately Severe Cognitive Decline (Moderate or Mid-Stage Alzheimer Disease) Description: Significant gaps in memory and cognitive func- tion. Individuals may need help with daily activities such as dressing and grooming. They may forget important details like their address or phone number and may become confused about the date or time.
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MDRI2026
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