What Are the Complications for Alzheimer's Disease?
Alzheimer's disease is most commonly associated with short-term memory problems, but the disease also causes a range of debilitating physical symptoms which become apparent in its later stages. If Alzheimer's disease causes a person's death, the death is usually caused by physical symptoms rather than cognitive decline.
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Reisberg Functional Assessment Staging
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In 1988, Dr. Barry Reisberg, Professor of Psychiatry at New York University, developed the Functional Assessment Staging (FAST) scale for assessing disease severity in progressive dementia. The FAST scale has been proven reliable in staging Alzheimer's dementia. According to the FAST scale, a normal adult with no functional decline is classified in Stage 1, while a normal older adult with awareness of some functional decline (misplacing objects and occasionally forgetting names) is classified in Stage 2. Stages 3 through 7 represent various stages of Alzheimer's disease, with Stage 7 representing severe disease. Physical symptoms begin to manifest in moderately severe Alzheimer's disease, which is Stage 6.
Early to Mild Alzheimer's Disease
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In early Alzheimer's disease, Stage 3, a person exhibits noticeable deficits in employment situations and gets lost when in unfamiliar places. He may retain little knowledge after reading written material, may have difficulty remembering names of new people and may lose or misplace items. In mild Alzheimer's disease, Stage 4, she requires assistance with handling finances and planning events, has difficulty with current events and may have deficits in serial subtraction.
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Moderate Alzheimer's Disease
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In moderate Alzheimer's disease, Stage 5, the person typically requires assistance in order to survive. He cannot choose proper attire, cannot recall a major life event or the name of an important family member and is frequently disoriented with regards to time.
Moderately Severe Alzheimer's Disease
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The debilitating physical symptoms associated with Alzheimer's disease begin to show in the moderately severe stage, which is Stage 6. A person typically requires assistance dressing, bathing and toileting and also develops urinary and bowel incontinence. He will have little to no short-term memory but may recall past events. He may not remember the name of a close family member and may be unaware of the year, season and surroundings. He almost always recalls his own name. Personality changes may occur, including delusions, paranoia, obsessive behavior and repeating activities, anxiety, agitation and inability to carry a thought long enough to carry out an activity.
Severe Alzheimer's Disease
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When the disease progresses to severe Alzheimer's disease, Stage 7, speech ability is limited to six intelligible words or less. Communication may be limited to grunting, or the person may become completely unresponsive. She loses the ability to walk, sit up, hold her head up, speak, smile and even swallow. Difficulty swallowing, called dysphagia, causes aspiration risks, and a family may choose to place a feeding tube for the person's survival.
Terminal Diagnosis
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When an individual reaches Stage 7, he is typically considered to be terminal with a life expectancy of six months or less, and is offered hospice services. Hospice care is designed not to treat the terminal disease but instead to make the person's final days pain-free. Hospice workers have specific expertise in managing symptoms of severe Alzheimer's disease, such as problems with skin, eating, incontinence, restlessness and sleep.
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