How the Alzheimer’s Disease Progresses

Mayo Clinic Staff wrote . . . . . . . .

Alzheimer’s disease can last more than a decade. See what types of behaviors are common in each of the stages as the disease progresses.

Alzheimer’s disease tends to develops slowly and gradually worsens over several years. Eventually, Alzheimer’s disease affects most areas of your brain. Memory, thinking, judgment, language, problem-solving, personality and movement can all be affected by the disease.

There are five stages associated with Alzheimer’s disease: preclinical Alzheimer’s disease, mild cognitive impairment due to Alzheimer’s disease, mild dementia due to Alzheimer’s, moderate dementia due to Alzheimer’s and severe dementia due to Alzheimer’s. Dementia is a term used to describe a group of symptoms that affect intellectual and social abilities severely enough to interfere with daily function.

The five Alzheimer’s stages can help you understand what might happen, but it’s important to know that these stages are only rough generalizations. The disease is a continuous process. Your experience with Alzheimer’s, its symptoms and when they appear may vary.

Preclinical Alzheimer’s disease

Alzheimer’s disease begins long before any symptoms become apparent. This stage is called preclinical Alzheimer’s disease. You won’t notice symptoms during this stage, nor will those around you.

This stage of Alzheimer’s can last for years, possibly even decades. Although you won’t notice any changes, new imaging technologies can now identify deposits of a protein called amyloid beta that is a hallmark of Alzheimer’s disease. The ability to identify these early deposits may be especially important in the future as new treatments are developed for Alzheimer’s disease.

Additional biomarkers — measures that can indicate an increased risk of disease — have been identified for Alzheimer’s disease. These biomarkers can be used to support the diagnosis of Alzheimer’s disease, typically, after symptoms are evident.

There are also genetic tests that can tell you if you have a higher risk of Alzheimer’s disease, particularly early-onset Alzheimer’s disease. As with newer imaging techniques, biomarkers and genetic tests will become more important as new treatments for Alzheimer’s disease are developed.

Mild cognitive impairment (MCI) due to Alzheimer’s disease

People with mild cognitive impairment have mild changes in their memory and thinking ability. These changes aren’t significant enough to affect work or relationships yet. People with MCI may have memory lapses when it comes to information that is usually easily remembered, such as conversations, recent events or appointments.

People with MCI may also have trouble judging the amount of time needed for a task, or they may have difficulty correctly judging the number or sequence of steps needed to complete a task. The ability to make sound decisions can become harder for people with MCI.

Not everyone with mild cognitive impairment has Alzheimer’s disease. The same procedures used to identify preclinical Alzheimer’s disease can help determine whether MCI is due to Alzheimer’s disease or something else.

Mild dementia due to Alzheimer’s disease

Alzheimer’s disease is often diagnosed in the mild dementia stage, when it becomes clear to family and doctors that a person is having significant trouble with memory and thinking that impacts daily functioning.

In the mild Alzheimer’s stage, people may experience:

  • Memory loss for recent events. Individuals may have an especially hard time remembering newly learned information and ask the same question over and over.
  • Difficulty with problem-solving, complex tasks and sound judgments. Planning a family event or balancing a checkbook may become overwhelming. Many people experience lapses in judgment, such as when making financial decisions.
  • Changes in personality. People may become subdued or withdrawn — especially in socially challenging situations — or show uncharacteristic irritability or anger. Reduced motivation to complete tasks also is common.
  • Difficulty organizing and expressing thoughts. Finding the right words to describe objects or clearly express ideas becomes increasingly challenging.
  • Getting lost or misplacing belongings. Individuals have increasing trouble finding their way around, even in familiar places. It’s also common to lose or misplace things, including valuable items.

Moderate dementia due to Alzheimer’s disease

During the moderate stage of Alzheimer’s disease, people grow more confused and forgetful and begin to need more help with daily activities and self-care.

People with moderate Alzheimer’s disease may:

  • Show increasingly poor judgment and deepening confusion. Individuals lose track of where they are, the day of the week or the season. They may confuse family members or close friends with one another, or mistake strangers for family.

    They may wander, possibly in search of surroundings that feel more familiar. These difficulties make it unsafe to leave those in the moderate Alzheimer’s stage on their own.

  • Experience even greater memory loss. People may forget details of their personal history, such as their address or phone number, or where they attended school. They repeat favorite stories or make up stories to fill gaps in memory.
  • Need help with some daily activities. Assistance may be required with choosing proper clothing for the occasion or the weather and with bathing, grooming, using the bathroom and other self-care. Some individuals occasionally lose control of their bladder or bowel movements.
  • Undergo significant changes in personality and behavior. It’s not unusual for people with moderate Alzheimer’s disease to develop unfounded suspicions — for example, to become convinced that friends, family or professional caregivers are stealing from them or that a spouse is having an affair. Others may see or hear things that aren’t really there.

    Individuals often grow restless or agitated, especially late in the day. Some people may have outbursts of aggressive physical behavior.

Severe dementia due to Alzheimer’s disease

In the severe (late) stage of Alzheimer’s disease, mental function continues to decline, and the disease has a growing impact on movement and physical capabilities.

In severe Alzheimer’s disease, people generally:

  • Lose the ability to communicate coherently. An individual can no longer converse or speak coherently, although he or she may occasionally say words or phrases.
  • Require daily assistance with personal care. This includes total assistance with eating, dressing, using the bathroom and all other daily self-care tasks.
  • Experience a decline in physical abilities. A person may become unable to walk without assistance, then unable to sit or hold up his or her head without support. Muscles may become rigid and reflexes abnormal. Eventually, a person loses the ability to swallow and to control bladder and bowel functions.

Rate of progression through Alzheimer’s disease stages

The rate of progression for Alzheimer’s disease varies widely. On average, people with Alzheimer’s disease live eight to 10 years after diagnosis, but some survive 20 years or more.

Pneumonia is a common cause of death because impaired swallowing allows food or beverages to enter the lungs, where an infection can begin. Other common causes of death include dehydration, malnutrition and other infections.

Source: Mayo Clinic

Read also at The U.S. National Institute of Neurological Disorders and Stroke:

Alzheimer’s Disease Information Page . . . . .


Mexican-style Noodle Soup with Seafood


2 medium tomatoes, chopped
1 small onion, chopped
1 large jalapeno chili, seeded and chopped
2 garlic cloves, mashed
5 tablespoons olive oil
1/8 teaspoon turmeric
8 ounces spaghetti, broken into 2-inch pieces
1 (8-ounce) bottle clam juice
1/8 teaspoon saffron
1/2 teaspoon smoked paprika
4 ounces black cod, cut into 8 pieces
8 large shrimp, shelled and deveined
16 littleneck or other small clams, scrubbed
1/2 fennel bulb, thinly sliced
1/2 cup fresh or frozen peas
4 ounces fresh cooked crabmeat
2 cups thinly sliced kale strips


  1. Place the tomatoes, onion, jalapeno, and garlic in a blender and puree until smooth.
  2. In a skillet, heat 3 tablespoons of the olive oil over medium heat. Add turmeric, the pureed vegetables and cook for 5 minutes.
  3. In a large pot over medium heat, heat the remaining 2 tablespoons olive oil. Add the spaghetti and saute until golden.
  4. Add the clam juice, 6 cups water, saffron, and smoked paprika. Stir in the pureed vegetables. Cook until the spaghetti is al dente.
  5. Using a slotted spoon, transfer as much spaghetti as possible from the pot to warm bowls. Cover and keep warm.
  6. Add the black cod, shrimp, clams, fennel, and peas to the pot. Cover and cook over medium heat for 3 minutes.
  7. Add the crab and kale and heat through. Discard any clams that don’t open.
  8. Divide the seafood and broth over the pasta in the bowls and serve hot.

Makes 4 to 6 servings.

Source: True Food

In Pictures: Bento with Sausage Flowers

Smoked Foods Are Tastier, Less Harmful with A Tip from the Auto Industry

Infusing foods with smoke can impart delicious nuanced flavors, but could also come with an unwelcome side of carcinogens. To reduce the carcinogen content of smoked foods, researchers took a lesson from the automobile industry, running the smoke through a zeolite filter to remove harmful compounds. It worked, and with a happy bonus: superior smoke flavor.

The researchers will present their work today at the 255th National Meeting & Exposition of the American Chemical Society (ACS). ACS, the world’s largest scientific society, is holding the meeting here through Thursday. It features more than 13,000 presentations on a wide range of science topics.

“The smoking process can cause carcinogens to form in foods. Not all smoked foods are dangerous, but we do know most can contain low levels of these substances, so we should try to remove them. If we could produce a smoke with fewer carcinogens, but that still has the same great taste, that would be ideal,” says Jane K. Parker, Ph.D., leader of the study. “Zeolite filters, which are put in a tailpipe, have been used in the car industry to reduce environmental pollutants, but they haven’t been applied to food yet. We want to change that.”

As a first step, engineers from Besmoke, a company that specializes in natural smoking, teamed up with Parker, who is at the University of Reading (U.K.). They optimized filters made from zeolite, a porous aluminosilicate mineral, with the goal of maximizing the removal of carcinogenic polycyclic aromatic hydrocarbons (PAHs) from smoke. PAHs are a ubiquitous side product of fuel consumption, long known to increase the risk for a variety of cancers, as well as cardiovascular disease. The U.S. and European Union regulate environmental levels of PAHs.

The best filter they developed removed as much as 93 percent of benzo[a]pyrene, a known carcinogen. “There have been a couple of attempts to reduce carcinogens in smoke using other technologies, but they aren’t as effective as our approach,” Parker says. But the question remained about how food flavored with the filtered smoke compared to that produced by unfiltered smoke.

To address this question, the researchers smoked tomato flakes, coconut oil and water using either filtered or unfiltered smoke. Then, they added the smoked tomato flakes to cream cheese and used the water to brine some chicken. A panel of expert tasters trained to describe differences in flavor profiles with standard terminology tried the cream cheese, coconut oil and chicken. “To the tasters, the chicken made with filtered smoke had a bit of a ‘Christmas ham’ aroma and a more rounded balanced flavor,” Parker says. Foods made with the unfiltered smoke, by contrast, tended to score higher in the categories of “ash tray” and “acrid smoke.”

Parker’s team attempted to figure out why the filtered smoke tasted better by taking a closer look at how the filtering affected the chemical content. They used mass spectrometry to analyze the compounds in the two types of smoke. “The profiles showed that it was largely the higher molecular weight components that were being removed by the filter,” Parker says. “These chemicals may be the ones giving the foods a harsher flavor and aroma profile.”

The researchers’ next steps are to understand why the filter selectively removes these compounds. “We think there is interesting science at work,” Parker says. “If we can figure out how the higher molecular weight compounds are sticking to the filter, we can manipulate the zeolite to improve the removal efficiency.”

Source: American Chemical Society

New Treatment for Arthritic Knee Pain

Dennis Thompson wrote . . . . . . .

Tiny pellets could treat arthritic knee pain, delaying the need for knee replacement surgery, a small study has found.

Microparticles inserted into small blood vessels around the knee helped reduce the pain and improve function in eight arthritis sufferers, according to clinical trial results. The results were presented Monday at the Society of Interventional Radiology’s annual meeting, in Los Angeles.

“Patients overall were able to improve their physical function in the knee after the procedure, and there were no adverse events related to this treatment,” said lead researcher Dr. Sandeep Bagla.

Bagla is director of interventional radiology at the Vascular Institute of Virginia in Woodbridge. Boston Scientific, maker of the microparticles, funded the study.

Much of the pain that comes from knee arthritis actually stems from inflammation in the lining of the knee joint, also called the synovium, Bagla said. In fact, small blood vessels created by degenerative arthritis feed this inflammation by increasing blood flow to the lining.

To treat this, Bagla and his colleagues decided to try blocking those tiny blood vessels using microparticles — spheres about a tenth of a millimeter in size made from a synthetic gel-like material.

The microparticles are inserted using a catheter run through a pinhole-sized incision, in a procedure that lasts between 45 and 90 minutes, Bagla said.

“It’s an outpatient procedure, and no physical therapy is required before or after this procedure,” he said.

The small pilot study — the first U.S. clinical trial of this procedure — involved 20 patients with moderate to severe arthritis pain. Only 13 had undergone the procedure by the time of Monday’s annual meeting, and only eight had made it to the one-month follow-up, Bagla said.

Those eight patients averaged a 58-point decrease in pain, as measured on a 100-point visual scale used to estimate pain, Bagla said. They started with an average baseline of 72, which means their pain was brought down to manageable levels, he said.

Physical function of their knee also improved, based on an index used to judge the effects of osteoarthritis, Bagla added.

Overall, the two scales represented an 80 percent improvement in function, the researchers concluded.

Bagla said no side effects are expected because the procedure only blocks additional blood flow to the knee, rather than cutting it off altogether.

“You don’t normally have this degree of increased blood supply to this lining. We’re not blocking normal blood vessels to the knee or leg or bone or cartilage,” he said.

Final results from this clinical trial are expected to be released this summer. Researchers are already kicking off a second, larger trial to better understand how the procedure works and which patients it might benefit, Bagla said.

They think it will be most appropriate for people between ages 40 and 70 who aren’t ready to go through knee replacement, or people who are on chronic pain medication for their knee arthritis, Bagla said.

“Perhaps we can demonstrate and prove patients do not need to be on these medications and can alternatively go through a minimally invasive procedure like this to reduce their knee pain,” Bagla said.

Dr. Suresh Vedantham, president of the Society of Interventional Radiology, called the new procedure “very promising,” given that it focuses on the inflamed knee lining that causes the pain.

“This therapy is very well-targeted to that particular mechanism, and certainly it should be investigated further,” said Vedantham, who wasn’t involved with the study. He’s a professor of radiology and surgery at the Mallinckrodt Institute of Radiology at Washington University in St. Louis.

Research presented at medical meetings is typically considered preliminary until it is published in a peer-reviewed journal.

Source: HealthDay

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