Alzheimer’s: Signs & Symptoms


Alzheimer’s disease (AD) is the most common type of dementia seen in older adults. An estimated 5.4 million Americans of all ages had Alzheimer’s disease in 2012. Nearly half (45%) of people over the age of 85 have AD. By 2050, the number of individuals age 65 and over with Alzheimer’s could range from 11 million to 16 million unless science finds a way to prevent or effectively treat the disease. One in eight older adults has AD, and it is the sixth leading cause of death in the United States (Alzheimer’s Association, 2012). Those affected with AD may live from 3–20 years or more after diagnosis, making the life span with this disease highly variable.

Risk factors

Advanced age is the single most significant risk factor for AD (Alzheimer’s Association, 2012). More women than men have AD, but this is because women live longer than men, not because gender is a risk factor. Family history and heredity are also identified risk factors for AD, as are head trauma and poor cardiac health.

Warning Signs

Alzheimer’s disease is characterized by progressive memory loss. The person affected by AD is gradually less able to remember new information and memory lapses begin to affect daily function. It is a terminal disease that over its course will eventually leave a person completely dependent upon others for care.


Initially, the clinical progression of the disease is slow with mild decline; however, deterioration increases the longer the person lives, with an average life span of 8 years after diagnosis (Cotter, 2002; Fletcher, Rapp, & Reichman, 2007). The underlying pathology is not clear, but a growth of plaques and fibrillary tangles, loss of synapses, and neuronal cell loss are key hallmarks of AD that interfere with normal cell growth and the ability of the brain to function. Absolutely definitive diagnosis is still through autopsy, although clinical guidelines make diagnosis easier than decades ago when less was known about the disease. Primary care physicians generally make the diagnosis through a thorough history, physical exam, cognitive testing, and labs. New criteria for diagnosis include staging the disorder and biomarkers (beta amyloid and tau in the cerebrospinal fluid and blood) (Alzheimer’s Association, 2012b). An MRI of the brain may be ordered to rule out other causes of symptoms.

The clinical course of AD is divided into several stages, depending on the source consulted. In the early course of AD, the person may demonstrate a loss of short-term memory. This involves more than common memory loss, such as where the keys were put, and may involve safety concerns such as forgetting where one is going while driving. The inability to perform math calculations and to think abstractly may also be evident. In the middle or moderate phase, many bodily systems begin to decline. The person may become confused as to date, time, and place. Communication skills become impaired and personality changes may occur. As cognitive decline worsens, the person may forget the names of loved ones, even their spouse. Wandering behavior as well as emotional changes, screaming, delusions, hallucinations, suspiciousness, and depression are common. The person with AD is less able to care for her- or himself and personal hygiene suffers. In the most severe and final phase, the person becomes completely dependent upon others, experiences a severe decline in physical and functional health, loses communication skills, and is unable to control voluntary functions. Death eventually results from body systems shutting down and may be accompanied by an infectious process. Although there is no single test, and the diagnosis may be one of exclusion, early diagnosis is important to maximize function and quality of life for as long as possible. Persons experiencing recurring and progressing memory problems or difficulties with daily activities should seek professional assistance from their physician.


Treatment for AD is difficult. There are several medications (such as Aricept, Namenda, Razadyne, and Exelon) that may help symptoms (such as memory), but they do not slow the course of the disease. There is currently no cure; however, research continues to occur in pharmacology, nonpharmacology, and the use of stem cells to manage symptoms and perhaps one day eradicate the disease.

Treatment will focus on symptom management, particularly in the areas of behavior, safety, nutrition, and hygiene. Behavioral issues such as wandering and outbursts pose a constant challenge. Many long-term care facilities have special “memory care” units to care for Alzheimer’s patients from the early to late stages of the disease. These units provide great benefits such as consistent and educated caregivers with whom the patient or resident will be familiar, a safe and controlled environment, modified surroundings to accommodate wandering behaviors, and nursing care 24 hours a day. Additionally, nurses are present to manage medications and document outcomes of therapies. However, many family members wish to care for their loved ones at home for as long as possible.

Thus, another important aspect of care in AD is care for the caregivers. Howcroft (2004) suggested that “support from carers is a key factor in the community care of people with dementia, but the role of the caregiver can be detrimental to the physical, mental, and financial health of a carer” (p. 31). She goes on to say that the caregivers of persons with AD would benefit from training in how to cope with behaviors that arise in these patients and how to cope with practical and legal issues that may occur.

Research has shown that ongoing skills are needed by family caregivers to deal with the progressive decline caused by AD. In fact, “a 63% greater risk of mortality was found among unpaid caregivers who characterized themselves as being emotionally or mentally strained by their role versus noncaregivers” (National Conference of Gerontological Nursing Practitioners & National Gerontological Nursing Association, 2008b, p. 4). Adapting to stress, working on time management, maximizing resources, and managing changing behavior were all skills caregivers needed to develop in order to successfully manage home care of their loved ones. When interventions and resources were not used by caregivers in the early stages of the care recipient’s AD, the risk of a healthy patient being institutionalized due to caregiver burden was higher (Miller, Rosenheck & Schneider, 2012). Caregivers needed not only to acquire knowledge and skills, but also to make emotional adjustments themselves to the ever-changing situation.

Such findings suggest that nurses should focus a good deal of time on educating caregivers of persons with AD to cope with, as Nancy Reagan put it, “the long good-bye.” Scientists continue to explore the causes of AD and hope in the near future to be able to isolate the gene that causes it. In the meantime, results from a fascinating longitudinal study (called the Nun study) on aging and AD, which used a group of nuns who donated their brains to be examined and autopsied after death, has suggested that there is a connection between early “idea density” and the emergence of AD in later life. That is, essays the nuns wrote upon entry to the convent were analyzed and correlated with those who developed AD. It was found that those with lower idea density (verbal and linguistic skills) in early life had a significantly greater chance of developing AD (Grossi, Buscema, Snowdon, & Antuono, 2007; Snowdon, 2004). The nun study has allowed researchers to examine hundreds of brains so far in nuns who died between 75 and 107 years of age and discover other important facts such as a relationship between stroke and the development of AD in certain individuals, and the role of folic acid in protecting against development of AD (Snowdon, 2004). Scientists from a number of fields continue to research the causes and possible treatments for AD and the Nun study project is continuing at the University of Minnesota. Snowdon’s research suggests that early education, particularly in verbal and cognitive skills, may protect persons from AD in later life.

For more information on Alzheimer’s disease, visit the Alzheimer’s Association website at:

Adapted from Mauk, K. L., Hanson, P., & Hain, D. (2014). Review of the management of common illnesses, diseases, or health conditions. In K. L.
Mauk’s (Ed.) Gerontological Nursing: Competencies for Care. Sudbury, MA: Jones and Bartlett Publishers. Used with permission.



By |2023-08-25T18:57:07-05:00August 11th, 2023|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Alzheimer’s: Signs & Symptoms

Guest Blog: Tips on Caring for Loved Ones with Dementia

Dementia is a chronic or progressive syndrome that affects a person’s thinking, memory, comprehension, orientation, language, learning capacity, judgment, and calculation. People with dementia slowly lose their cognitive abilities, which leads to a decline in their social behavior and emotional control. Dementia develops when the brain is injured or damaged, such as what happens to individuals with Alzheimer’s disease.

According to the Alzheimer’s Association, over five million Americans are currently dealing with Alzheimer’s dementia. An estimated 80% are seniors aged 75 and up. If proper care, attention, and medication are not prioritized, the total can balloon to 13 million by 2050. Medical and health facilities are doing every means possible to address the situation.

If your senior family member has dementia and living at home or is under assisted living care, your best contribution is to care for your loved one properly. Here are tips to help you out.

 Ask simple questions.

Someone with dementia will find open-ended questions confusing and intimidating. Instead of asking “what” questions, try to rephrase them to “yes-no” questions. For example, instead of asking, “What time would you like to take a bath today?” try asking, “Would you like to take a bath at 4 pm?”

Keep your words simple and clear.

 Allow your loved one to help with daily tasks.

When dementia progresses, your loved one may find it difficult to remember and focus on tasks. You can help him or her maintain daily activities and skills and stay active. Allow him or her to assist you with simple activities such as setting the table, making the bed, and gardening. Help your loved one remember tasks and things by placing memory aids, such as signs and labels, all over the house.

 Take your loved one to lunch.

Keeping senior loved ones with dementia socially active is essential. Have lunch together at his or her favorite restaurant. Go to a place where he or she used to frequent when communication wasn’t yet a problem. Make your loved one feel special and important.

 Hold and touch your loved one.

Your touch is very powerful and reassuring. Hold your loved one’s hand or stroke his or her face now and then. Let him or her feel your love and support.

Most important of all, ask for help. Talk to a caregiver or get in touch with an assisted living care facility.

About the Author

 Melissa Andrews is the Content Marketing Strategist for Paradise Living Centers, an assisted living center for seniors with locations in Paradise Valley and Phoenix, Arizona. In her spare time, she enjoys cooking and going on hiking trips with her siblings and cousins.

By |2023-03-01T15:57:36-05:00March 4th, 2023|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog: Tips on Caring for Loved Ones with Dementia

Guest Blog: Cognitive Issues in Seniors: Everything You Need To Know

In essence, mild cognitive impairment (MCI) is a condition in which an individual experiences a slight decline in mental abilities. While minor, the decline can be easily noticed by the person concerned or the people they interact with. The changes, however, are not severe enough to interfere with their routine activities and daily life.

Decline Due to Normal Aging vs. Mild Cognitive Impairment: What the Difference?

Gradual cognitive decline is sometimes evident with healthy aging. For instance, the mental processing slows down, the ability to learn new information is reduced, and the likelihood of getting distracted increases.

However, decline brought about by normal aging will not affect overall functioning or the ability to perform routine activities. Normal aging will also not affect intelligence, recognition, or long-term memory.

In normal aging, older people may forget names (and words) and misplace things occasionally. However, with mild cognitive impairment, the person forgets information and conversations one would usually remember, such as planned events and other appointments.

Does MCI Always Lead to Dementia?

Dementia is the general term used to describe the severe decline in mental function that interferes with daily living. There are instances, where a treatable disease or illness causes MCI.

However, researchers also discovered that for most patients with MCI, it is considered the point along the pathway to dementia. MCI can be secondary to various illnesses, including Parkinson’s and Alzheimer’s disease, vascular dementia, and frontotemporal dementia.

Is MCI Common?

According to the American Academy of Neurology, MCI is present in about 8 percent of people aged 65 to 69, in 15 percent of people aged 75 to 79, in 25 percent of those aged 80 to 84, and in about 37 percent of people aged 85 years or older.


If you suspect you have MCI, it is recommended that you see your doctor right away. While there is no specific test that can confirm a diagnosis, your doctor can tell if you have MCI based on the symptoms that manifest and the information you will provide.

About the Author

Melissa Andrews is the Content Marketing Strategist for Paradise Living Centers, an assisted living center for seniors with locations in Paradise Valley and Phoenix, Arizona. In her spare time, she enjoys cooking and going on hiking trips with her siblings and cousins.

By |2023-01-30T17:06:25-05:00February 17th, 2023|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog: Cognitive Issues in Seniors: Everything You Need To Know