What are the 4 A’s of Alzheimer’s Symptoms?

In honor of World Alzheimer’s Day last month here in the United States, we want to shed light on the 4 A’s of Alzheimer’s symptoms, and provide a guide to help families determine the best possible care for their loved ones. 

Alzheimer’s disease was the fifth most common cause of death in seniors over the age of 65 in 2021, and nearly 7 million Americans are currently living with the disease. That number is expected to almost double by 2030. Alzheimer’s damages brain cells, eventually leading to brain shrinkage and eventually, significantly decreased quality of life and death. Combatting this disease, then, is of the utmost importance for so many American families. 

​Understanding the disease and what you can do to prevent and/or slow this disease can have a significant impact on your quality of life, as well as the quality of life for your family. Alzheimer’s doesn’t just affect your loved one, it affects your entire family. 

Causes of Alzheimer’s Disease

Copious amounts of research have been put into understanding Alzheimer’s and other dementias, and there has been significant progress made in understanding this disease. This is the first step toward treating it. Healthcare providers are armed with more knowledge and options than ever, but we’re just getting started. 

That being said, doctors and scientists don’t actually fully know what causes Alzheimer’s disease in a majority of patients. Research suggests; however, that the causes likely include a range of factors, including age-related changes in the brain, genetic factors, environmental, and lifestyle factors. It is unknown whether one or more factors have a more significant influence than others when it comes to increasing or decreasing risk, and it’s believed that this is individual to each person.

Symptoms of Alzheimer’s Disease

Understanding the symptoms of Alzheimer’s disease starts with, most obviously, memory problems. Referring to the 4 A’s of Alzheimer’s symptoms can help readers easily understand how Alzheimer’s disease affects those who are afflicted. 

Symptoms of the disease include those four A’s: Amnesia, Aphasia, Apraxia, and Agnosia. Let’s take a closer look at each of these: 

Amnesia is the most common sign or symptom of Alzheimer’s, and is the one many family members notice first. Amnesia is, put simply, a loss of memory. This can be short-term memory loss or long-term memory loss. It can be as simple as forgetting where someone put the car keys or the names of people, or as profound as forgetting important memories.

Aphasia refers to a loss of the ability to understand speech or use speech to express oneself. Aphasia has two forms: Expressive and receptive. Someone with expressive aphasia may struggle to find the right word, or may say words incorrectly. Receptive aphasia refers to the inability to understand or interpret language. 

Apraxia is when the body struggles to function due to a loss in voluntary motor skills. This will eventually lead to the body essentially ceasing to function. 

Agnosia references how Alzheimer’s impacts the brain’s ability to receive or process information gathered through the five senses: sight, taste, smell, hearing, and touch. 

Diagnosing Alzheimer’s Disease 

Early diagnosis is essential to help ensure treatment as soon as possible (including, possibly, clinical trials) to slow the progression of the disease. Oftentimes, families recognize the early signs of Alzheimer’s disease in their loved ones, and either bring it to their loved one’s attention, or perhaps their loved one’s doctor for medical advice. Once notified, a doctor will likely order tests to rule out any other health problems or causes for those early signs and symptoms that your family may be recognizing. 

The testing done for Alzheimer’s disease typically includes a physical exam and neurological exam in the doctor’s office. This is often followed by laboratory tests and brain imaging, such as an MRI. From there, doctors will likely order more tests that assess cognitive ability, the person’s ability to function, and to more precisely identify which areas of the brain may be affected. Other tests may also be added that help determine mental status and neuropsychological testing to more accurately measure memory and thinking skills. 

Those physical and neurological exams will include testing the ability to get up and walk around a room, balance and coordination, muscle tone and strength, reflexes, plus vision and hearing. Blood tests can help rule out vitamin deficiencies or other health conditions that can mimic the symptoms of Alzheimer’s disease. And brain imaging, including an MRI, CAT scan (or CT), and PET scan, can help visualize the brain to see if cognitive symptoms were caused by stroke, brain trauma, tumors, or specific dementia evaluation.

Stages of Alzheimer’s Disease

Understanding the stages and disease process of Alzheimer’s disease can help prepare families for what their loved one is going through and how it may change life for not only their loved one, but their entire family.

The preclinical stage includes brain changes that often begin many years before someone shows signs of the disease. It can last for many years before any symptoms of Alzheimer’s begin (including the early stages of Alzheimer).

Mild/Early Stage

The mild, or early stage of Alzheimer’s are when people experience changes that include mild forgetfulness. This is often mistaken for a simple sign of aging, but it may also be accompanied by slight behavior changes or problems concentrating. 

This is when warning signs are becoming more visible to families, although seniors may try to hide those symptoms out of fear of what they mean. Patients may still be able to live independently at this stage, but may benefit from assistance from a home care provider, since elderly people in this stage may have difficulty with remembering names, recalling events, remembering to take medication or where they put things, making plans and paying bills, other organization tasks.  

Moderate/Middle Stage

The moderate, or middle stage​ of Alzheimer’s is typically the longest stage of the disease. It lasts many years, and includes advanced symptoms like more trouble recalling events, names, and places, difficulty learning new things, difficulty planning and preparing meals, difficulty remembering their own name, but perhaps not other details like phone numbers or addresses, difficulty reading, writing, and even simple math. 

​The disease progress through this stage will result in advanced difficulties like recognizing people, but not knowing their names (even a spouse or child). Other symptoms include losing track of time or location, needing assistance with daily tasks and daily activities, needing assistance with personal grooming and personal care, personality changes, paranoia, or delusions, plus increased restlessness or anxiety. 

Wandering away is a common fear at this stage, and many families sadly choose to put loved ones in nursing homes as this phase progresses. 

Final

The final stage of Alzheimer’s includes severe Alzheimer symptoms that impair not just mental function but the ability to function at all without significant help. Patients may lose most physical abilities (including walking, sitting, eating), can’t have conversations or hold in their bowel or bladder, are unaware of their surroundings, and are at an increased risk of infections and other illnesses.

How to prevent or slow down Alzheimer’s Disease

While there are medications and treatments for Alzheimer’s, there is sadly no cure. In addition to medications, doctors recommend these lifestyle changes to slow down Alzheimer’s progression in its earliest stage, and to prevent Alzheimer’s as well:

Exercise improves brain health and cognitive abilities overall, while reducing the risk of health impairments like diabetes, high blood pressure, heart disease, and stroke. Walking, yoga, tai chi, and other activities are especially recommended for older adults. Starting small and gradually adding more is a great way to avoid overdoing it. Talk to a doctor before starting any sort of exercise program. 

Mental stimulation​ keeps your mind engaged through activities like reading, playing cards or board games, playing video games, learning new things, taking up new hobbies, volunteering, and meeting new people.  

Eating healthy foods like greens, fruits and berries, vegetables, and lean protein can help improve brain health and overall health over time. Avoiding excessive alcohol and losing weight also show promise in preventing Alzheimer’s and assisting with early disease control.

We provide support and home care for Alzheimer’s patients in OKC.

70% of family members say that coordinating care of loved ones with Alzheimer’s is stressful. Here at LiveBetter at Home, we recognize how important it is for those with Alzheimer’s to stay happy, safe, and healthy at home as long as possible. Our home care services help older adults stay independent and safe while improving quality of life through in-home care, respite care, and virtual care. To learn more about how we can help provide peace of mind for your family, contact us on our website, or call us at (405) 461-6175.