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Symptoms

Symptoms of Alzheimer’s disease are divided into two categories

: cognitive, or intellectual, and

psychiatric.

Differentiating them is important so that behavioral problems that are caused by loss of cognitive

functioning are not treated with anti-psychotic or anti-anxiety medications.

The clinical symptoms of Alzheimer’s disease vary

, depending on the type of disease causing it, and

the location and number of damaged brain cells. With Alzheimer’s disease, manifestation of all of these

symptoms is quite probable; with other types of Alzheimer’s disease, it is possible to have some or all of these

symptoms.

Cognitive, or intellectual, symptoms are amnesia, aphasia, apraxia and agnosia.

Amnesia

is defined as loss of memory, or the inability to remember facts or events. We have two types of

memories: the short term (recent, new) and long term (old) memories. Short termmemory is programmed

in a part of the brain called the temporal lobe, while long termmemory is stored throughout extensive nerve

cell networks in the temporal and parietal lobes.

In Alzheimer’s disease,

short termmemory storage is damaged first. Aphasia is the inability to communicate

effectively. The loss of ability to speak and write is called expressive aphasia. An individual may forget words

he has learned, and will have increasing difficulty with communication. With receptive aphasia, an individual

may be unable to understand spoken or written words or may read and not understand a word of what

is read. Sometimes an individual pretends to understand and even nods in agreement; this is to cover up

aphasia. Although individuals may not understand words and grammar, they may still understand nonverbal

behavior, i.e., smiling. Apraxia is the inability to do preprogrammed motor tasks, or to perform activities of

daily living such as brushing teeth and dressing. An individual may forget all motor skills learned during

development. Sophisticated motor skills that require extensive learning, such as job related skills, are the first

functions impaired by Alzheimer’s disease. More instinctive functions like chewing, swallowing and walking

are lost in the last stages of the disease. Agnosia is an individual’s inability to correctly interpret signals

from their five senses. Individuals with Alzheimer’s disease may not recognize familiar people and objects.

A common yet often unrecognized agnosia is the inability to appropriately perceive visceral, or internal,

information such as a full bladder or chest pain

Major psychiatric symptoms include:

Personality changes, depression, and hallucinations & delusions.

Personality changes

can become evident in the early stages of Alzheimer’s disease. Signs include irritability,

apathy, withdrawal and isolation. Individuals with Alzheimer’s disease may show symptoms of depression at

any stage of the disease. Depression is treatable, even in the latter stages of Alzheimer’s disease.

Psychotic symptoms

include hallucinations & delusions, which usually occur in the middle stage of

Alzheimer’s disease. Hallucinations occur in about 25 percent of Alzheimer’s disease cases and are typically

auditory and/or visual. Sensory impairments, such as hearing loss or poor eyesight, tend to increase

hallucinations in the elderly with Alzheimer’s disease. Delusions affect about 40 percent of individuals with

Alzheimer’s disease.

Hallucinations & delusions

can be very upsetting to the person with Alzheimer’s disease. Common

reactions are feelings of fear, anxiety and paranoia, as well as agitation, aggression and verbal outbursts.

Individuals with psychiatric symptoms

tend to exhibit more behavioral problems than those without these

symptoms. It is important to recognize these symptoms so that appropriate medications can be prescribed

and safety precautions can be taken.

Psychotic symptoms

can often be reduced through the carefully supervised use of medications. Talk to your

primary care doctor, neurologist or geriatric psychiatrist about these symptoms because they are treatable.

Dementia Defined

Dementia is a general term that describes a

group of symptoms such as loss of memory,

judgment, language, complex motor skills,

and other intellectual function caused by

the permanent damage or death of the

brain’s nerve cells, or neurons.

One or more of several diseases, including

Alzheimer’s disease, can cause dementia.

Alzheimer’s disease is the most common

cause of dementia in persons over the age

of 65.

It represents about 60 percent of all

dementias. The other most common causes

of dementia are vascular dementia, caused

by stroke or blockage of blood supply,

and dementia with Lewy bodies. Other

types include alcohol dementia, caused by

sustained use of alcohol; trauma dementia,

caused by head injury; and a rare form of

dementia, frontotemporal dementia.

The clinical symptoms and the progression

of dementia vary, depending on the type

of disease causing it, and the location

and number of damaged brain cells.

Some types progress slowly over years,

while others may result in sudden loss of

intellectual function.

Each type of dementia is characterized by

different pathologic, or structural, changes

in the brain, such as an accumulation of

abnormal plaques & tangles in individuals

with Alzheimer’s disease, and abnormal tau

protein in individuals with frontotemporal

dementia.