progression of Alzheimer's disease in the elderly

Written by Zhang Hui
Neurology
Updated on March 16, 2025
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The progression of dementia in the elderly mainly includes the following aspects. The first is the pre-stage of mild cognitive impairment, during which patients show no clinical symptoms. Some may only report slight memory impairment, with a possible slight decline in learning ability and a mild decrease in the capability to learn new things. As the disease progresses to the second stage, the period of mild cognitive impairment occurs, where patients will experience impaired memory, but it is not particularly obvious, and daily life is not affected at all. Then, entering the third stage, some periods of dementia occur, during which patients' memory, executive abilities, computational skills, and judgment are significantly impaired. Patients might even get lost or possibly forget their own names. As the disease further progresses into the later stages of dementia, the elderly may exhibit some psychiatric symptoms. They become delirious, talk to themselves, and may see things that do not exist. Eventually, the elderly may end up bedridden, with complications such as pulmonary infections and bedsores.

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Written by Zhang Hui
Neurology
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Late-stage symptoms of dementia

In the later stages of dementia, symptoms become very severe. Patients experience significant impairment in memory function, forgetting not only recent events but also events from the past. Additionally, patients show obvious impairments in visuospatial abilities, having trouble locating the bathroom in their own home, and often getting lost when they go out. There is also a noticeable change in behavior, with patients exhibiting aggression, cursing, and inappropriate actions like urinating or defecating in random places. Some patients may experience recurrent visual and auditory hallucinations. As the disease progresses, elderly patients may eventually become bedridden for life, not interacting with anyone, remaining silent, and refusing to eat. They ultimately may die from complications such as lung infections, urinary tract infections, malnutrition, and bedsores. Therefore, the symptoms of dementia in its later stages are quite severe, with cognitive impairments, abnormal mental and behavioral symptoms, and various infections all posing serious threats to the health of the elderly.

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Written by Zhang Hui
Neurology
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Symptoms of dementia in the elderly

Dementia in the elderly is medically known as Alzheimer's disease, which is categorized into mild, moderate, and severe stages. The clinical manifestations vary with the severity of the disease. Mild dementia primarily presents as memory impairment, starting with a decline in short-term memory, where patients often forget daily activities. For instance, they might forget the way home when they go out, forget to add salt when cooking, or forget to turn off the stove. Patients may also exhibit personality disorders, such as neglecting personal hygiene or not wanting to bathe. As the disease progresses to moderate dementia, besides worsening memory impairment, the patient's ability to work, learn new knowledge, and communicate with others significantly diminishes. There is a notable decline in previously acquired knowledge and skills, such as judgment and calculation abilities. They may also experience aphasia, apraxia, agnosia, and some patients may exhibit significant behavioral and psychological abnormalities. With further progression to severe dementia, patients may become emotionally detached, exhibit unpredictable crying or laughing, fail to recognize family members, lose verbal abilities, and even become unable to perform simple tasks such as dressing or eating. They may spend their days in bed, not speaking, and gradually lose contact with the outside world, ultimately leading to death.

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Written by Zhang Hui
Neurology
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How is Alzheimer's treated?

The treatment of Alzheimer's disease mainly includes the following aspects. First, enhance care to prevent accidents. Patients with Alzheimer's may get lost, forget to turn off fires or gas, etc., so it is essential to strengthen care to prevent accidents. Second, encourage the elderly to read more books and newspapers and enhance learning, which can effectively slow down the progression. Third, have the elderly interact more with others and exercise more. This can strengthen their physical health and, to some extent, delay the development of Alzheimer's disease. Another aspect is drug treatment, which mainly includes acetylcholinesterase inhibitors and some NMDA receptor antagonists. These can improve the symptoms to some extent and enhance the quality of life. Additionally, in the later stages of Alzheimer's, some psychiatric symptoms such as visual hallucinations and aggressive behavior like hitting or yelling may occur. Appropriate atypical antipsychotic drugs can be administered for treatment.

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Written by Tang Bo
Neurology
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Mild manifestations of senile dementia

Mild dementia, especially in its early stages, often goes unnoticed by family members. The initial symptoms generally include being particularly forgetful. This particularly affects short-term memory; for example, a person might repeat what was just said or be repeatedly clumsy in daily tasks, sometimes losing keys or forgetting to turn off the stove while cooking. This might seem like a lack of concentration, but in reality, it is due to forgetfulness. Emotionally, individuals who were once lively might become indifferent or detached, sometimes showing signs of excitement or agitation. Behaviorally, there can be changes, such as previously generous individuals becoming stingy. Interests and hobbies that were once loved may no longer hold appeal, and individuals may become lethargic and less concerned with cleanliness and personal appearance.

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Written by Zhang Hui
Neurology
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Is senile dementia hereditary?

Dementia primarily refers to Alzheimer's disease, which mainly has two types: The first type is sporadic Alzheimer's disease, which does not have a clear familial history. It is caused by the degeneration and death of neurons due to various reasons, leading to certain clinical symptoms. This type of sporadic dementia does not have a genetic predisposition. The other type of dementia has a clear family history, where patients typically exhibit mutations in the APP gene, leading to increased secretion, which in turn causes the death of neurons and results in the symptoms of dementia. This familial type of dementia has a genetic predisposition. Dementia is a common condition in neurology and is the most common neurodegenerative disease. Currently, there are no effective treatments available. Family members must pay attention to caregiving, and patients can take cholinesterase inhibitors, which can improve symptoms to a certain extent.