Alzheimer’s Disease | Pantai Hospitals

What Is Alzheimer’s Disease?

Alzheimer’s disease is the most common form of dementia among older adults over the age of 65. Dementia refers to a decline in cognitive function that affects an individual’s ability to carry out his or her daily routine. Dementia is not a specific disease but rather a group of symptoms caused by an underlying condition, such as Alzheimer’s disease.

Alzheimer’s disease is a neurodegenerative disorder that progressively affects language, memory, comprehension, attention, judgement, and reasoning.

According to the Alzheimer’s Disease Foundation Malaysia (ADFM), approximately 204,000 to 264,00 elderly Malaysians (8.5 % to 11 % of the total population) are living with Alzheimer’s in 2020. This figure is estimated to increase to 637,500 to 825,00 people by 2050, a projected increase of 312 %.

What Are the Stages of Progression of Alzheimer’s Disease?

The stages of Alzheimer’s disease are:

Pre-clinical Alzheimer’s disease
Mild cognitive impairment
Mild dementia
Moderate dementia
Severe dementia

Some organisations stage Alzheimer’s disease as mild/early, moderate/middle, and severe/late.

What Are the Symptoms of Alzheimer’s Disease?

Symptoms of Alzheimer’s disease generally involve the gradual decline of memory, language, behaviour, reasoning, and the ability to handle complex tasks.

Alzheimer’s disease

Pre-clinical Alzheimer’s disease can last for several years or more. Individuals with pre-clinical Alzheimer’s disease have no obvious functional impairment or clinical signs of Alzheimer’s disease despite the early pathological changes that are already occurring in the parts of the brain.

Mild cognitive impairment due to Alzheimer’s disease

Mild cognitive impairment occurs when memory-related issues become noticeable due to a slight decline in brain function compared to peers of the same age. It is considered to be the stage between normal ageing and early-stage dementia. However, these changes are not significant enough affect daily routine.

Mild dementia due to Alzheimer’s disease

Individuals with mild dementia experience symptoms such as loss of concentration and/or memory, disorientation of time and place, and mood changes. The most common symptom is forgetting new information, such as recent events, names, or places. Other common symptoms include:

Having difficulty with finding the right words to express thoughts
Misplacing objects more than usual
Having difficulty with organising or making plans
Having difficulty with problem-solving
Taking longer to complete routine tasks

Moderate dementia due to Alzheimer’s disease

This stage involves the worsening of memory loss, loss of impulse control, besides difficulty in reading, writing, and speaking. It is usually the longest stage and can last for years. They may experience:

Difficulty recognising family and friends
Worsening confusion with time and space
Poor short-term memory
Forgetting own mobile number
Tendency to repeat stories
Difficulty with simple math
Personality changes (e.g., increased agitation, depressed, anxious, withdrawn)
Sleep disturbance

Individuals with moderate dementia tend to require care and assistance, especially with grooming and using the bathroom.

Severe dementia due to Alzheimer’s disease

Individuals in this stage require extensive care. The disease affects the entire cerebral cortex, leading to:

Almost total memory loss
Unable to recognise family members
Loss of awareness of surroundings
Needing help with basic daily activities (e.g., eating, sitting, walking)
Difficulty with eating, drinking, and swallowing
Urinary or faecal incontinence
Loss of ability to communicate as speech becomes limited to a few words or phrases
Susceptibility to infections, especially lung, urine and skin infections
Bedbound / wheelchair bound

What are the Risk Factors of Developing Alzheimer’s Disease?

Alzheimer’s disease occurs due to the abnormal accumulation of proteins in the brain, causing brain cells to die. It is suspected to be a result of genetic, environmental, and lifestyle factors.

Risk factors of developing Alzheimer’s disease include:

Older age
Gender (Alzheimer’s disease is seen more in women)
Family history of Alzheimer’s disease
Cardiovascular disease
High blood pressure
High cholesterol
Diabetes
Obesity
Sedentary lifestyle
Smoking
Excessive alcohol consumption
Head injury
Depression / Anxiety

Early-onset Alzheimer’s disease can develop at a relatively young age (45 years old on average) in certain individuals who have inherited specific gene mutations. Individuals with Alzheimer’s disease over 65 years of age typically pass away four to eight years after diagnosis.

However, some may live up to 20 years after showing early signs of Alzheimer’s disease. Common causes of mortality include infections (especially lung infections), malnutrition, and dehydration.

How Is Alzheimer’s Disease Diagnosed?

Your physician will try to get a better understanding of your daily routine, general health and changes in mood or behaviour from you and people close to you.

Your physician will conduct a thorough physical and neurological examination. A mental status examination is also needed to assess memory, problem-solving, language, attention, and basic math. Laboratory tests such as blood and urine tests are also done to rule out other possible causes of the symptoms.

Brain imaging such as computerised tomography (CT) scans and magnetic resonance imaging (MRI) scans can help support the diagnosis of Alzheimer’s disease and help rule out other possible conditions.

How Is Alzheimer’s Disease Treated?

There is no known cure for Alzheimer’s disease. However, there are medications and interventions to delay the progression of dementia and help with behavioural symptoms. These include:

Cholinesterase inhibitors to improve memory and reduce behavioural symptoms.
NMDA inhibitors to keep certain brain cells healthier.

Managing behavioural symptoms is vital for individuals with Alzheimer’s disease. Maintain a familiar and neat environment for them. Try to avoid confrontation and redirect their attention if they are feeling agitated. The use of clearly written instructions or reminders for daily tasks can be put in the living space to help patients remind themselves of what they need to do.

How to Prevent Alzheimer’s Disease?

A healthy lifestyle helps guard the brain from cognitive decline. Staying physically, mentally, and socially active can help reduce the chances of developing Alzheimer’s disease. Eating healthy, not smoking, and avoiding excess alcohol consumption also reduces the risk of Alzheimer’s disease.

How to Care for Someone with Alzheimer’s Disease?

Caring for someone with Alzheimer’s disease can affect caregivers mentally, physically, and financially. There are several things that can be done to help improve the quality of life for both individuals with Alzheimer’s disease and their caregivers. Understanding Alzheimer's disease is necessary to help caregivers navigate through the course of the disease. Learning about various stages of the condition and methods to cope with behavioural changes can be helpful.

Learning to manage stress and participating in activities that provide stress relief is especially important. Do not forget to take a break and indulge in your favourite activities every now and then. Staying physically active can provide both physical and mental benefits. A support group can be a huge source of support and strength. Caregivers and family members can share experiences, ideas, and provide emotional support for one another.

Dementia patients are usually elderly people with co-morbidities. It is advisable to seek medical advice from a geriatrician / geriatric specialist consultant.

Book an Appointment at Pantai Hospitals

Alzheimer’s disease can be overwhelming for affected individuals and their loved ones. Seeking help early can help reduce the burden of the disease and improve patients’ prognosis.

A dedicated and expert team of geriatricians at Pantai Hospitals is available for consultation to provide the best care and assistance to patients through health screening, diagnosis, and treatment. Get in touch with us to book an appointment with a geriatrician today.

Pantai Hospital Malaysia is accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.

‌This article has been medically reviewed by Consultant in Geriatric & Internal Medicine, Dr Tay Hui Sian.

Alzheimer’s Disease: Symptoms, Diagnosis, Treatment