Signs of Alzheimer’s disease at the start (and after)

There Alzheimer’s disease is a neurodegenerative pathology who would touch between 800,000 and a million people In France. It is mainly characterized by progressive loss of memory and of certain intellectual and cognitive functionsleading to serious consequences in daily life. Reminder of characteristic symptoms of this disease with Dr. Maï Panchal, scientific director of the Vaincre Alzheimer Foundation.

At first: memory loss, disorientation

The main warning sign of Alzheimer’s disease is memory loss. But not just any : “Those are recent memory problems, explains Dr Maï Panchal, scientific director of the Overcoming Alzheimer’s Foundation, which means the person really has difficulty remembering recent facts. She is too unable to acquire new information.”

“THE repetitive questions should really alertregardless of age because it suggests that the person is unable to register new information. Entry into the disease can also occur with disorientation problems : “These are people who manage to compensate on memory but who are not not able to read a map or navigate the street or car” specifies the researcher.

What are the particularities of memory loss in Alzheimer’s?

Alzheimer’s disease causes memory disorders that must be distinguished from memory loss linked to natural cognitive aging: “We all have cognitive complaints especially from the age of 50, it is very common and it can happen because we thought of something else, because the attention was changed so we forgot, for example where we put our keys, it doesn’t matter” explains Dr Panchal.

In Alzheimer’s disease, the person forgets what he forgets.

In Alzheimer’s disease, most often, the person forgets what they forget: “The person who, for example, comes to a consultation with a detailed written list of all their forgetfulness does not necessarily have the profile of an Alzheimer’s patient. The Alzheimer’s patient will not do this since they forget their own forgetfulness and is unaware of its difficulties. For him, his forgetfulness is age-related and it doesn’t matter..” This explains why often in the case of Alzheimer’s disease it is the family who is at the origin of the consultation, rarely the patient himself.

Neurological symptoms: language disorders, difficult daily tasks

Alzheimer’s disease is a “neuro-progressive” disease. It first has neurological repercussions on the memory And orientation in space then at a more advanced stage “the person may have language disordersof the difficulty scheduling an appointment, of the difficulty accomplishing everyday tasks like doing your shopping or tying a tie.” lists our interlocutor.

Physical symptoms: “It’s not like Parkinson’s”

Physical symptoms appear later in the disease but are not directly linked to Alzheimer’s disease: “It’s not not like Parkinson’s disease, explains Dr. Panchal. There is no no motor problems and direct physical problems. It’s more about the consequences of Alzheimer’s disease.” Concretely, the person suffering from Alzheimer’s moves less over time, walks less, which promotes imbalances and the falls And “this is what should absolutely be avoided”. “It is important to prevent the disease from getting worse, physical activity must be implemented to maintain body balance and agility of movements” insists our interlocutor.

Some patients are aggressive

The aggression that can manifest in an Alzheimer’s patient is not an early disorder. She appears “rather at advanced stages” specifies our interlocutor. And not in all patients : “There are aggressive patients, others not at all and who are totally apathetic and still others who will mainly need to walk, without any specific goal. Not all patients develop the disease in the same way.

Loss of memory, energy… At the start of Alzheimer’s disease, the signs do not always alert loved ones and can be attributed to old age. Even more so because this disease mainly affects people over 65 years old. So when to worry? “It’s really when problems registering new information become bothersome to the point of starting to need others”, repeats Dr. Panchal.

What is the difference between Alzheimer’s and Lewy body disease?

Lewy body disease represents 20% of neuroprogressive diseases and is sometimes confused with Alzheimer’s disease because it also causes memory problems. “But there are symptoms that we only see in Lewy body disease: cognitive fluctuations and the hallucinations.” L’Condition of patient with Lewy body disease can change within a day or even within the hour: “He goes from a completely normal and lucid state to a very disoriented state“. Hallucinations can occur in the advanced stages of Alzheimer’s disease, but in Lewy body disease, it is an early symptom. “The patient can see or feel things that are not there : he sees people, animals…”. Another difference: there is lots of sleep problems like the nightmares from the start of the illness whereas in the case of Alzheimer’s it is rather at the end. “Patients are often misdiagnosed and referred to psychiatry thinking that it is depression when normally a first depressive event after the age of 50 in someone who has no history and no reason to have depression must alert on something else”. The problem is that a bad diagnosis leads to poor care.

What are the signs at the end of life?

Alzheimer’s disease progresses in three stages : beginner (approximately 2 to 5 years depending on the diagnosis), moderate (this is the longest, around ten years) and severe (around 3 years). “The severe stage is when all the symptoms of the disease intensify and the person is dependent, even for the simplest actions and it ends with complications” explains Dr. Panchal. It is these complications that can lead to death, not the disease itself. Among them :

• malnutrition and dehydration : the person no longer wants to eat, they no longer feel the sensation of hunger and thirst.
• the wrong paths : the person has difficulty eating, “forget even how we chew and how we swallow”,
• weight loss linked to malnutrition: “This is a very bad sign, often weight loss occurs at the same time as memory deterioration.”
• infections : “In the severe stage, the person no longer walks, speaks very little, stays in bed or in a chair and is therefore at greater risk of developing infections. At the light stage, she will complain in the event of an infection. (urinary for example, editor’s note)at the severe stage she will no longer be able to say it.”

30% of patients with Alzheimer’s-like symptoms do not have Alzheimer’s

When to consult?

Alzheimer’s disease develops in the brain 10 to 15 years before the first symptoms appear. When memory problems start to interfere with daily life, when you are worried about a parent who keeps asking the same questions, you need to go see someone. First the general practitioner and after the neurologist city. “We can also make a memory consultation to the hospital but waiting times are often very long” warns Dr. Panchal. This consultation is often a source of stress and of worry but “you have to go calmly because it’s not necessarily Alzheimer’s”. “30% of patients with Alzheimer’s-like symptoms do not have Alzheimer’s“ continues the researcher. It may be a depressiontaking medications that aggravate memory problems, biological problems (vitamin B deficiency, etc.), problems of thyroid... If the Alzheimer’s diagnosis is confirmed, it’s necessary to stay positive and say to yourself that it’s a good thing that it was asked early: “With the early diagnosis, we are able to have appropriate care as soon as possible and live as best we can with the disease.” The care is multidisciplinary: speech therapy “from the start to maintain language and communication” advises our interlocutor, physiotherapyof the psychomotor skills… and one medical treatment. All of this contributes to the “secondary” prevention that is to say to prevent the disease from getting worse since today we do not know how to cure it.

Thanks to Dr Maï Panchal, scientific director of the Fondation Vaincre Alzheimer.