Moderate Dementia Due to Alzheimer’s Disease: Middle Stage Symptoms

Moderate Alzheimer’s disease (AD) is characterized by a more pronounced decline in the abilities of patients with the disease. Tasks that were easy before can become frustratingly difficult and independence can be lost quickly. There are some medications and therapies that may help.

Alzheimer’s disease is a disease marked by 3 distinct phases. The first stage is the early stage of AD and is marked by mild cognitive impairment. This is a term that is quite nonspecific and makes it difficult to diagnose. As the disease worsens, the next stage of concern would be the moderate form of AD.

Symptoms of moderate Alzheimer’s disease

As AD transitions from mild cognitive impairment seen in Phase 1 of the disease to Phase 2, a new trigger term for the disease emerges. This term is referred to as “moderate dementia.”

In medicine, dementia is described as any decrease in a patient’s mental abilities that can lead to some kind of difficulty in carrying out his daily life. With a condition like moderate dementia, a patient must expect a substantial change in her life, as he is unable to carry out some of the basic skills of daily living that they once mastered without difficulty.

This can get quite frustrating and symptoms can manifest very quickly in some cases. The most noticeable symptoms that you would notice at first would be problems with urination. The medical term for this is called incontinence. This means that a patient will get wet before they can get to the bathroom. As you can imagine, this can be quite embarrassing and frustrating for patients at the onset of the disease.

As moderate dementia progresses, the next symptoms to start to appear would be problems with speech. Patients will find themselves struggling to find the correct words or phrases in a sentence. Moderate forgetfulness and memory loss are also seen with this period.
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The explanation for why this happens is due to the accumulation of plaque (the misfolded protein) that is synonymous with AD. In the early stages of AD, only the neurons that send signals between different parts of the brain are damaged. This leads to delays and slight decreases in normal functioning, but since we have many different neural connections in the brain, the symptoms are quite minor at first. These neurons will continue to be damaged until, ultimately, regions of the brain are affected. This can lead to more general changes, such as changes in personality, memories, or behavior.

The moderate stage of Alzheimer’s disease is usually the longest stage of the disease and the decline depends almost exclusively on a case-by-case basis.
As the deterioration worsens, it can even be difficult for patients to recognize family and friends. At this stage, patients will eventually also lose the natural impulse control ability that our brains control every day. As a result, patients can start doing seemingly strange things like undressing in public or making vulgar statements. Complex tasks that require several steps, such as getting dressed, are almost impossible to perform alone at this stage, so the help of a spouse or child will be of the utmost importance during this stage.

What treatments are available?

As you already know, there is no treatment option available that can cure Alzheimer’s disease. A gradual decline will occur regardless of the interventions performed, but patients can greatly benefit from some currently available therapies to slow this decline. This can give you and your family valuable time so that you can still spend quality time together.

Medications for Alzheimer’s disease

There is a combination of medications and therapy that can be done to benefit patients. Before this stage of Alzheimer’s disease. What will ultimately be chosen depends on age, general health, past medical history, and severity of limitations at the time of initial therapy. These medications are called donepezil, rivastigmine, and galantamine. They all work by stopping the breakdown of acetylcholine (ACh), the main chemical signal responsible for sending messages between different neurons in the brain. The effects of these drugs, on average, last about 6 to 12 months, which is a substantial amount of time considering the course of the disease without therapy.

In addition to the medications listed above, memantine and a combination of memantine and donepezil are FDA approved for the treatment of moderate to severe Alzheimer’s. Memantine is prescribed to improve memory, attention, reason, language, and the ability to perform simple tasks, and can be used alone or with other treatments for Alzheimer’s disease.

Therapies for Alzheimer’s disease

In addition to medications, there are other strategies that can also be beneficial for patients with AD. This may include behavioral therapy not only for the patient but for her family as well.
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This is a great way for families to learn together about what kinds of symptoms to expect and how to react to possible new situations that they have never had to experience before. This is also a good way to structure additional assistance in case it becomes too burdensome for a loved one to care for the patient alone. Often times, knowing what to expect can help alleviate some of the anxiety and fears not only for the patient, but also for the friends and family who will help provide care. This can keep everyone calm when outbreaks of AD symptoms suddenly appear.

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