Evidence-Based Practice! Through genetic testing, research, and clinical tests scientists are working to develop predictive models from various perspectives. Designing pharmacological protocols that are individualized and designed to give people with AD the opportunity to maintain functional autonomy and participate in care planning is a priority (Nicholas et al., 2021).
Self-Assessment Quiz Question #5 What is true about clinical research trials for AD? a. Only patients with late-onset AD should participate. b. There are no clinical research trials in this arena. c. While genetic testing may not be appropriate for all AD patients, clinical research trials need all types of people. d. Clinical research trials are specifically for children of early-onset AD patients.
STAGES OF ALZHEIMER’S DISEASE
Seven clinical stages of Alzheimer’s disease The Reisberg Alzheimer’s Scale is the clinical standard used to determine patient disease stage (Alzheimer’s Association, 2019). Also known as the Global Deterioration Scale (GDS), it is used by clinicians and in residential care settings, and it offers expectations for caregivers. The scale divides the
disease into seven stages, with two categories. Category 1 includes Stages 1–3 and is considered predementia. Category 2 covers Stages 4–7, the dementia stages. See Table 2.
Table 2. Stages of AD Stage
Description
Clinical Presentation
Stage 1
No evident dementia
• No identifiable dementia • Person is mentally healthy
Stage 2
Subjective memory loss and age-related forgetfulness
• Can last 15 years in healthy people • May have difficulty remembering where they have placed things • May not be able to recall names as they have in the past • Subjective cognitive decline • Memory issues may be noticed by loved ones or coworkers • May repeat statements • Job performance may be impaired • Concentration may be impacted • High levels of anxiety • Patient should visit a physician to understand root cause of MCI • Lifestyle changes can be made to reduce stress, improve diet, and increase physical exercise • Diagnosis by a trained professional can be made with great accuracy • May sense a loss of independence • May become forgetful with finances, bill paying, organizing the home • Poor time management • May inadvertently engage in unsafe behavior (e.g., leave door unlocked or forget to shut off oven) • May be aware but lack understanding • Evident decline in activities of daily living • May start to wear the same clothing, be resistant to changing • Needs daily assistance with life management, including finances • Cannot recall daily occurrences, cannot comprehend concepts such as the weather or their current address • Memory is erratic from moment to moment • May exhibit a lack of control, agitation, and aggression • May be in denial or embarrassed • May isolate and avoid socialization
Stage 3
Mild cognitive impairment (MCI)
Stage 4
Moderate cognitive decline; mild dementia
Stage 5
Moderately severe cognitive decline; moderate dementia
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Book Code: SWUS1525
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