Author: Petra Boh

Stages of Alzheimer’s Disease: 7 Stages & What to Expect

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7 stages of Alzheimer's disease from early to late stage

Stages of Alzheimer’s can help families understand how the disease may change over time and what type of support a person might need as symptoms progress.

However, Alzheimer’s disease does not follow exactly the same path in every person. Symptoms can overlap between stages, and one person may remain relatively independent in one area while needing considerable help in another.

The Alzheimer’s Association commonly describes Alzheimer’s disease in three broad stages: early or mild, middle or moderate, and late or severe.

Another widely referenced system is the seven-stage Global Deterioration Scale developed by Dr. Barry Reisberg and colleagues. This article explains those seven stages while also showing how they relate to the simpler early, middle and late-stage model.

What Are the 7 Stages of Alzheimer’s Disease?

The seven-stage model describes a gradual progression from no noticeable cognitive decline through severe Alzheimer’s disease.

The original Global Deterioration Scale was developed as a clinical framework for describing increasing cognitive and functional impairment.

The seven stages are:

  1. No noticeable cognitive decline
  2. Very mild cognitive decline
  3. Mild cognitive decline
  4. Moderate cognitive decline
  5. Moderately severe cognitive decline
  6. Severe cognitive decline
  7. Very severe cognitive decline

It is important not to think of these as seven sharply separated boxes. A person can show characteristics from more than one stage at the same time.

Stages 1-3: Preclinical and Early Changes

early stages of Alzheimer's disease before significant dementia symptoms develop

Changes associated with Alzheimer’s disease can begin in the brain many years before obvious memory or thinking problems develop.

The National Institute on Aging describes this period as preclinical Alzheimer’s disease. Importantly, having biological changes associated with Alzheimer’s does not necessarily mean that a person will develop dementia.

Stage 1: No Noticeable Cognitive Decline

At stage 1, there are no noticeable problems with memory, thinking or everyday function.

A person generally:

  • Functions independently
  • Has no obvious memory impairment
  • Completes normal daily activities
  • Shows no clear cognitive symptoms to family or friends

This stage cannot be identified simply by observing someone’s behavior. Modern research can detect certain Alzheimer’s-related biomarkers before symptoms appear, but these tests are interpreted by medical professionals and are not used to diagnose Alzheimer’s based on symptoms alone.

Stage 2: Very Mild Cognitive Decline

At this point, a person may notice occasional memory lapses.

They might:

  • Forget a familiar name
  • Misplace keys, glasses or a phone
  • Have occasional difficulty recalling a word
  • Take slightly longer to remember information

These experiences can also occur during normal aging. Stage 2 by itself does not establish that someone has Alzheimer’s disease.

Stage 3: Mild Cognitive Decline

Changes may become more noticeable to family members, friends or coworkers.

Possible signs include:

  • Increasing difficulty finding the right words
  • Frequently losing possessions
  • Difficulty learning new information
  • Reduced concentration
  • Problems organizing or planning
  • Difficulty handling complex work responsibilities
  • Getting lost in unfamiliar places

Some people at this level may be diagnosed with mild cognitive impairment (MCI). MCI can have several causes and does not always progress to Alzheimer’s dementia.

If memory or thinking problems are affecting everyday life, a medical assessment is important. Doctors may use medical history, neurological examination, laboratory testing, brain imaging and cognitive tests to investigate the cause.

Stage 4: Early-Stage Alzheimer’s Disease

early stage Alzheimer's disease showing mild changes in memory and independence

Stage 4 of the seven-stage model broadly corresponds with mild or early-stage Alzheimer’s disease.

This should not be confused with early-onset Alzheimer’s. Early-onset refers to Alzheimer’s disease that develops before age 65; early-stage describes the severity of the disease.

Many people in the early stages of Alzheimer’s can still live relatively independently. They may continue working, socializing and participating in familiar activities.

However, increasingly noticeable difficulties can include:

  • Forgetting recent conversations or events
  • Repeating questions
  • Difficulty managing money and paying bills
  • Problems planning meals or completing complicated tasks
  • Losing track of dates
  • Difficulty organizing appointments
  • Reduced ability to make sound decisions
  • Changes in mood, confidence or initiative

Driving ability should also be reviewed as Alzheimer’s progresses. Our article on driving and dementia explains some of the warning signs families can watch for.

Treatment During the Early Stages of Alzheimer’s

Early diagnosis has become increasingly important because treatment options have changed considerably in recent years.

According to the National Institute on Aging, medications are available to help manage Alzheimer’s symptoms.

In addition, the disease-modifying treatments lecanemab and donanemab are FDA-approved for certain people with mild cognitive impairment or mild dementia caused by Alzheimer’s disease.

These treatments are not suitable for everyone and have potentially serious risks, so eligibility needs to be assessed by an Alzheimer’s specialist.

This makes it especially important to consult an experienced doctor rather than waiting until symptoms become advanced. Depending on the situation, a care team may include neurologists, geriatricians and other dementia specialists.

Stages 5-6: Middle-Stage Alzheimer’s Disease

middle stages of Alzheimer's disease when increasing daily care may be needed

The middle or moderate stage is often when Alzheimer’s begins to have a much greater effect on everyday independence.

The Alzheimer’s Association notes that the middle stage can be the longest stage for many people and that care needs generally increase substantially during this period.

Stage 5: Moderately Severe Cognitive Decline

A person may still remember important details about themselves and recognize close family members, but everyday activities become increasingly difficult.

Common difficulties can include:

  • Forgetting their address or phone number
  • Becoming confused about where they are
  • Difficulty remembering the date or time
  • Needing help choosing appropriate clothing
  • Difficulty preparing meals
  • Needing reminders about medications
  • Problems managing personal hygiene

Assistance may be required with activities such as eating, shopping, transportation and dressing.

Families should balance safety with independence. Allowing a person to continue doing tasks they can still safely manage can help maintain confidence and quality of life.

Stage 6: Severe Cognitive Decline

Stage 6 generally involves much greater dependence on caregivers.

Memory problems become more severe, and a person may have difficulty recalling recent experiences or important details from their past.

They may also:

  • Confuse the names or identities of family members
  • Require considerable help getting dressed
  • Need assistance with bathing and grooming
  • Experience bladder or bowel incontinence
  • Have disrupted sleep patterns
  • Wander or become lost
  • Experience anxiety, agitation or restlessness
  • Develop hallucinations, delusions or paranoia

Behavioral and psychological symptoms can be particularly challenging for families. They may include anxiety, delusions, paranoia or changes in sleep and activity.

Sudden changes in behavior should not automatically be blamed on Alzheimer’s. Pain, infection, medication side effects, dehydration and other medical problems can cause rapid changes and should be discussed with a healthcare professional.

Stage 7: Late-Stage Alzheimer’s Disease

late stage Alzheimer's disease requiring extensive daily care and support

Stage 7 corresponds broadly with severe or late-stage Alzheimer’s disease.

At this stage, a person generally requires extensive assistance and supervision.

According to the Alzheimer’s Association, late-stage Alzheimer’s can involve major changes in mobility, communication, eating and personal care.

Common Changes in Stage 7

A person may:

  • Have very limited speech or lose the ability to communicate verbally
  • Need full assistance with bathing, dressing and toileting
  • Have difficulty walking and eventually become unable to walk
  • Need help sitting or changing position
  • Experience difficulty eating or swallowing
  • Lose weight
  • Become increasingly vulnerable to infections
  • Need around-the-clock care

Although verbal communication may decline dramatically, this does not mean that meaningful interaction has ended.

A familiar voice, gentle touch, favorite music and a calm environment may still provide comfort and connection. Our guide to dementia and communication discusses ways to maintain that connection as communication becomes more difficult.

How Long Does Each Stage of Alzheimer’s Last?

There is no reliable timetable for how long a person will remain in each of the stages of Alzheimer’s.

Progression varies considerably depending on factors such as:

  • Age at diagnosis
  • Overall physical health
  • Other medical conditions
  • The particular pattern of Alzheimer’s disease
  • Complications such as infections or falls
  • The person’s individual biology

The Alzheimer’s Association reports that people live an average of approximately four to eight years after an Alzheimer’s diagnosis, although some live for considerably longer.

For this reason, families should view stage descriptions as a general guide rather than a countdown.

Why Knowing the Stages of Alzheimer’s Matters

Understanding the likely progression of Alzheimer’s can help families plan before a crisis develops.

In the earlier stages, this may involve:

  • Discussing future wishes
  • Reviewing legal and financial arrangements
  • Evaluating driving
  • Organizing medication management
  • Making the home safer

As Alzheimer’s progresses, planning may shift toward:

  • Help with meals and personal care
  • Supervision to prevent wandering
  • Mobility equipment
  • Respite care
  • Home care
  • Assisted living or memory care
  • Palliative or hospice care when appropriate

Planning ahead allows the person with Alzheimer’s to participate in decisions for as long as possible.

Stages of Alzheimer’s: Closing Thoughts

The stages of Alzheimer’s provide a useful framework for understanding how memory, thinking, communication and physical abilities may change as the disease progresses.

The seven-stage system gives families a detailed picture of progression, while today’s major U.S. Alzheimer’s organizations often use the simpler categories of mild, moderate and severe Alzheimer’s disease.

Neither system can predict exactly what will happen to an individual person or when it will happen.

Instead, use the stages as a guide for recognizing changing needs, asking the right questions and planning appropriate care.

If someone’s memory or thinking has changed noticeably, especially if it is interfering with everyday activities, speak with a healthcare professional rather than trying to determine an Alzheimer’s stage on your own.

Corticobasal Syndrome (CBS) – Symptoms, Causes & Treatment

Petra Boh Blog, Types ,
corticobasal syndrome CBS

A rare progressive neurological disorder, corticobasal syndrome (CBS) is a condition that causes changes in language skills, movement, or both.

What is Corticobasal Syndrome?

It is one of the illnesses that has caught the attention of behavioral neurologists and movement disorder specialists.

Also known as CBD (corticobasal degeneration) it may start with issues such as stiff muscles on one side of the body involving a leg, arm, or both.

Such motor abnormalities include apraxia which is the inability to perform voluntary or purposeful movements and muscle rigidity.

Persons with this condition often complain about having trouble controlling their arms or legs.

Historically, CBD was recognized as a neurological condition that was mostly associated with movement disorders.

However, in recent years, research has revealed that behavioral and cognitive abnormalities occur more often than what was believed.

In some cases, dementia warning signs may precede the development of motor symptoms.

The initial cognitive symptoms may include impairments in executive function, progressive aphasia, and loss of intellectual abilities.

CBS was first described in 1968 by Rebeiz and colleagues. Most people will this condition will start showcasing symptoms around the age of 60 but some will have the warning signs earlier.

What Causes Corticobasal Syndrome

what causes CBS
Scientists are yet to identify the exact cause of CBS.

Experts, however, know that in some individuals with the condition, there is usually a large build-up of tau.

This is a type of protein that usually occurs in the brain, but it is not clear why it at times builds-up in large amounts.

The function of tau within the nerve cells is quite complex and experts do not fully understand it.

It is, however, thought that tau is essential for the normal functioning of brain cells.

The abnormal tau levels in various brain cells result in their deterioration. The specific role that tau plays in the development of corticobasal syndrome is not yet clear.

Tau abnormalities are observed in numerous neurodegenerative brain disorders like Pick’s disease, Alzheimer’s disease, frontotemporal dementia with parkinsonism linked to chromosome 17 (FTDP-17), Niemann-Pick disease type C, and progressive supranuclear palsy.

Collectively, these disorders are known as “tauopathies.”

Large build-up of amyloid plaques

Some people with CBS also have a large build-up of amyloid plaques which are similar to those present in individuals who have Alzheimer’s disease (AD).

The excessive accumulation of these proteins in the nerve cells is quite dangerous because it results in brain cells losing their ability to function normally, and they die off eventually.

As a result, the affected sections of the brain will start to shrink.

Researchers believe that several factors contribute to the development of CBD.

These include a combination of multiple environmental, genetic, and factors that relate to aging.

A person develops corticobasal degeneration symptoms due to the progressive deterioration of tissue in various areas of the brain.

The loss of nerve cells happens in specific areas resulting in shrinkage or atrophy in specific brain lobes.

The type and severity of symptoms that a person will get will depend on the section of the brain that has been affected by the condition.

Moreover, the 2 areas of the brain that are mostly affected include basal ganglia and cerebral cortex, but some other areas may also be affected.

The cerebral cortex is mostly involved with higher functions of the brain including learning, memory, voluntary movement, and sensory information coordination.

The basal ganglia can be described as a cluster of nerve cells that is responsible for learning and motor functions.

Symptoms of Corticobasal Syndrome

symptoms of corticobasal syndrome
Trouble with movement is normally the first warning sign of CBS.

It may include poor coordination or trouble accomplishing simple goal-oriented activities like buttoning a shirt, gesturing with hands, or combing hair amongst others.

This symptom may start with one leg, arm, or hand. The limbs might shake and feel stiff.

Persons with this condition may experience movement that is slower than usual, go through changes in the feelings of the limbs or have a hard time making their limbs move.

As time goes by, moving around becomes harder.

In most cases, the symptoms will start on one side of the body and slowly move to the other side.

Other symptoms

Additional symptoms might include a slight tremor when a person is in a particular position or while performing a certain task.

Limb dystonia may also occur sometimes.

Dystonia describes a group of neurological conditions that are characterized by involuntary muscle contractions.

These put certain parts of the body into abnormal and sometimes painful positions and movements.

Affected persons may also experience contractures which is a condition where a joint becomes permanently fixed in an extended or bent position.

This can partially or completely restrict the movement of the joint that has been affected.

Alien limb phenomenon is also common in persons with CBS where a limb will carry out actions or assume certain positions without the awareness of the affected person.

Some individuals will also go through jerky or lightning-like movements.

Communication can become difficult

Language problems may also start to develop as the disease progresses.

Individuals may have challenges naming people and objects, finding the right words to speak, or just getting the words out mostly because of the problems with the muscles that help with speech.

After some time, people with malady may not be in a position to communicate effectively. Reading skills may start to diminish while writing can become harder especially if the movement symptoms have affected the hands.

Some people with CBD may also suffer problems with swallowing, uncoordinated walk, or inability to control eyelid blinking.

Others with CBS may also experience visuospatial difficulties or challenges seeing things and understanding their right place in space.

Persons with these challenges will have a difficult time locating things in space, grasping complex visual arrays like a cupboard, and judging distances while driving.

Individuals with the condition may also have a hard time with number knowledge and calculations.

It is also common for persons with CBS to develop memory problems where they keep repeating questions or misplace objects.

Later in the course of the illness, persons may experience personality changes.

This is where persons may exhibit disinhibition, reduced attention span, irritability, apathy, and obsessive-compulsive behaviors.

Some even get into the habit of saying inappropriate things. Others will experience difficulties when trying to move or open their eyes.

Eventually, persons with CBS might become bed-ridden and they may be susceptible to life-threatening complications like bacterial infections, pneumonia, blood infections, or blockage of one or more main arteries to the lungs primarily because of blood clots.

Keep in mind that the progression, severity, presentation, and symptoms of this disease vary greatly from one person to another.

Diagnosis

diagnosis of cbs
A positive diagnosis for corticobasal degeneration is suspected when characteristic neurologic warning signs occur progressively in the absence of a structural lesion like a tumor or stroke.

It is normally challenging to distinguish corticobasal degeneration from other related neurodegenerative disorders.

Currently, there are no tests for CBS.

A clinical diagnosis is done based on the pattern of symptoms and extensive neurological exam involving multiple specialized tests and these include:

An EEG (electroencephalogram)

This is a test that measures the brain’s electrical activity.

Imaging Techniques

CT (computerized tomography) and MRI ( magnetic resonance imaging) are helpful when it comes to ruling out other medical conditions. They also come in handy when the doctor wants to view brain tissue degeneration within the basal ganglia and cerebral cortex.

DaTscan

This technique measure the amount of dopamine which is a chemical that the brain makes.

Neuropsychological testing

It is where professionals conduct various memory tests with pictures and words. These are exclusive to evaluate the extent of a person’s symptoms and the impact they have on mental abilities.

The tests look into multiple abilities like concentration, numbers, counting, memory, understanding language, and how a person processes vital details such as words and pictures.

Diagnosis is also done to rule out other medical conditions that can cause similar symptoms like Alzheimer’s disease, motor neuron disease, and Parkinson’s disease.

It is important that a consultant with expertise in corticobasal degeneration confirms the diagnosis.

Most of the time, this will be a neurologist who is an expert in conditions that affect the nerves and brain.

In the majority of cases, the confirmation of the diagnosis is only possible once professionals conduct autopsy examinations of the brain.

This shows “ballooned” protein, neurons aggregations, and other characteristic abnormalities that are as a result of an abnormal build-up of tau protein.

Treatment Options

treatment options for cbs cbd
There is still no approved cure for the corticobasal syndrome. Nonetheless, there are several treatments that can benefit persons with the disease, and these include:

Medications

Doctors can prescribe medication that can help manage the symptoms. Examples of these drugs include cholinesterase inhibitors which are helpful if a person with CBS is having memory problems.

The most common medicines that persons take include rivastigmine, donepezil, and galantamine.

For the movement symptoms, an individual may be treated with drugs that are used for persons with Parkinson’s disease.

These include carbidopa or levodopa but the effects of the drugs are subject to research.

Physicians may also recommend drugs to help deal with other issues like incontinence and bladder problems, sleeping problems, anxiety, pain, and bone strength.

It is also important for physicians to treat any existing conditions that affect the brain.

These include high cholesterol, high blood pressure, and diabetes.

Eating Right and Working Out

Research indicates that getting physically active helps to improve brain health, general fitness, and mood.

Getting enough sleep, eating a balanced diet, and limiting alcohol intake also helps to promote good health.

Alternative Therapies

Several therapies can help people with CBS and these include:

Speech and Language Therapy

It can help enhance communication between people with the condition and others. The experts can also help manage swallowing problems.

Physical Therapy

This in addition to stretching exercises can help ease movement challenges by maintaining the range of motion and mobility of rigid stiffened joints as well as preventing the development of contractures.

Occupational Therapy

It may be useful in assessing the safety of an affected individual’s home as well as determining the adaptive medical equipment that may boost a person’s independence. That’s when occupational therapy comes into play. Affected people may need to use devices like a walker or a crane to assist in walking.

Cognitive Stimulation

This comes in handy for persons with CBS but is showcasing dementia symptoms. This type of therapy involves engaging in exercises and activities that aim to enhance language ability, problem-solving skills, and memory.

Palliative Care and Advanced Care Planning

Palliative care is normally offered to relieve pain as well as other distressing symptoms a person may be facing while offering spiritual, social, and psychological support.

This can be beneficial at any stage of CBD alongside other treatments. An individual can receive this type of care at home, in a hospital, or at a hospice.

Advanced care planning is where persons with the corticobasal syndrome will make plans for the future highlighting their wishes in regards to medical care and other important decisions.

Affected individuals share the plans with their family members and health professionals who are taking care of them.

Seeing that this is quite a rare condition, clinical trials may at times not be available for persons seeking them.

CBS Prognosis

CBS prognosis
Corticobasal degeneration is a condition that changes over time and is believed to affect females and males equally.

An individual with the disease can live for years after a positive diagnosis. Symptoms of the conditions tend to worsen over 3-8 years and often cause great disability.

Research suggests that a majority of affected individuals live for about 6-8 years on average although this varies from one person to the next.

Closing Thoughts

Even though currently there are no therapies or treatments that can reverse or slow down the progression of corticobasal syndrome, there is still hope.

Scientists reckon that the biology of CBS may be similar to that of other neurodegenerative diseases.

It is possible that therapies that are useful for these conditions can be helpful to persons with corticobasal degeneration.

Stroke-Related Dementia: What Is It?

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stroke-related dementia

When learning about the various types of dementia, it is important to talk about stroke-related dementia.

This is dementia that develops after the brain has been damaged by a stroke.

What is stroke-related dementia?

Strokes happen when there is an interruption of blood flow to the brain causing blood vessels to burst.

Worth noting is that not everyone who experiences a stroke will end up with dementia.

Strokes are normally associated with vascular dementia which is the second most common type of dementia.

In short, dementia is a general term describing problems with memory, planning, judgment, reasoning, and other thought processes.

Symptoms of Stroke-Related Dementia

symptoms of stroke-related dementia
The symptoms of this kind of dementia can appear suddenly, after a few days, weeks, or months in a gradual or stepwise manner.

The symptoms that a person will get depend on the kind of stroke they experienced as well as the section of the brain that has been damaged.

Cognitive decline normally happens within three months of a recognized stroke.

Examples of some warning signs of vascular dementia include:

  • Loss of memory especially with remembering recent events
  • Problems following instruction, inattention, and poor concentration
  • Poor judgment
  • Confusion
  • Getting lost in familiar places
  • Challenges with problem-solving, reasoning, and calculations
  • Depression
  • Mood and behavior changes
  • Crying or laughing inappropriately
  • Psychosis: loss of contact with reality, aggression, hallucinations, agitation, delusions, and inability to appropriately relate with other people and surroundings

The Diagnosis Process

the diagnosis process of stroke-related dementia
It is not easy for medics to diagnose stroke-related dementia.

This is because several medical conditions can cause an individual to experience dementia-like symptoms.

Doctors have to identify the cause of the symptoms to determine whether or not a person has dementia.

It is important because there are some causes of dementia that are reversible with treatment.

The diagnosis process is not an easy one.

Health care providers will gather details from different sources to come up with the proper diagnosis.

They usually start with a medical interview where the doctor will ask questions like:

  • When the symptoms appeared
  • Past and recent medical problems
  • Medications a person is taking or was taking in the past
  • Lifestyles and habits

Physicians also conduct physical examinations to look for physical disabilities as well as signs of underlying conditions like previous strokes, high blood pressure, or heart and blood vessel diseases.

Doctors will also include mental status examinations to check memory, orientation, language, and attention.

Some professional practitioners will as well conduct neuropsychological testing which is a detailed cognitive assessment that helps them pinpoint and document an individual’s cognitive strengths and problems.

A doctor may also recommend laboratory tests such as blood tests to rule out blood disorders, infections, hormonal disorders, chemical abnormalities, and kidney or liver problems.

The lab tests are also important for identifying other health issues like diabetes and various vascular disorders that might underlie dementia.

Imaging studies can also be done to help detect stroke and rule out other conditions that can cause dementia.

Treatment Options for Stroke-Related Dementia

treatment options for stroke related dementia
Sadly, treatments currently available cannot reverse brain damage that is caused by strokes if the injury has lasted for a few hours.

Treatment aims at enhancing vascular health in a bid to prevent the occurrence of new strokes and slow down the progression of cognitive decline and other related symptoms.

Treatment options include surgery, medication, and behavioral interventions.

High Blood Pressure and Alzheimer’s Risk

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blood pressure and alzheimer's

New research suggests there may be a link between hypertension or high blood pressure and Alzheimer’s disease (AD).

High blood pressure occurs when the force of blood pushing against blood vessels becomes too high.

This can cause harm because it stresses not only the blood vessels but the heart as well.

The blood vessels cease to function properly because they have to work harder than normal.

Over time, the arteries will become narrower which can result in problems such as stroke, kidney failure, or heart disease.

Damaged small blood vessels can also negatively affect the sections of the brain responsible for memory and thinking.

Blood Pressure and Alzheimer’s Risk

Persons with higher blood pressure are also more likely to have brain lesions. These are the areas of dead tissues that develop because of low blood supply.

AHA statistics report that about 46% of America’s adult population has blood pressure. Not to mention, 16% do not even know they have the condition.

Alzheimer’s disease is the most common cause of dementia.

Dementia is a general term for the progressive loss of memory and other cognitive abilities that can seriously interfere with a person’s day-to-day life.

High blood pressure can affect the brain

high blood pressure can affect the brain
Scientists believe that hypertension can also affect a person’s brain to the extent of developing some of the main markers for AD.

A study published in Neurology states that seniors who have higher average blood pressure compared to their age-mates are more likely to develop plaques and tangles in the brain which are both markers for Alzheimer’s.

The study had 1,288 participants who were 65 years and older. The researchers conducted annual cognitive testing and blood pressure checks on the subjects.

Moreover, experts also kept track of the medications the participants took and their medical histories. They also agreed to go through a brain autopsy after death to look for signs of brain aging like plaques and tangles.

Researchers discovered that persons who had higher than average blood pressure had more dead tissues resulting from strokes (blocked blood flow) as well as tangles and plaques.

Dr. Claudia Padilla, a neurologist, explained that plaques and tangles happen when proteins that the body produces break down into toxic forms which significantly affect neurons in the brain.

Director of global science initiatives at Alzheimer’s Association, James Hendrix, Ph.D. notes that damage that the toxic proteins cause is only part of the problem.

He said that lack of sufficient blood flow affects how the brain works around damaged tissue which can worsen symptoms of brain tissue damage.

Hypertension may not be the warning sign of AD

hypertension may not be the warning sign of AD
Padilla also stated that because this was an observational study on the relationship between blood pressure and Alzheimer’s disease, the results do not prove that hypertension causes warning signs of AD.

The study did not determine how higher average late-life blood pressure ends up increasing plaques and tangles in the brain.

However, she added that the study found a clear association between higher blood pressure in late life and the presence of protein plaques and tangles which are symptoms of Alzheimer’s disease.

Based on the findings of the study, Padilla considers it important to control blood pressure as a strategy for preventing cognitive decline.

In another interesting study on the relationship between blood pressure and Alzheimer’s, a Johns Hopkins analysis of formerly gathered data revealed that individuals who took prescribed blood pressure medication were half as likely to develop AD than those who did not.

The report established earlier work from researchers at Johns Hopkins who found that using potassium-sparing diuretics reduced the risk of Alzheimer’s by about 75%.

The risk was reduced by a third for persons who used any kind of antihypertensive drugs. Director of Johns Hopkins Memory and Alzheimer’s Treatment Constantine Lyketsos, M.D said that they found that if a person did not have Alzheimer’s and they were taking blood pressure medication, they were less likely to develop dementia.

He continues to say that if a person developed dementia from AD and was taking certain antihypertensive, the illness was less likely to progress.

They were not sure if this connection arises from better management of blood pressure or there are specific drugs that end up interfering with processes that relate to AD. Lyketsos suspected that both play a role.

Controlling your levels of blood pressure is important

controlling your levels of blood pressure is important
An in-depth examination of long-term data from 4 countries by a team of global scientists also supported the idea that controlling high blood pressure can reduce the risk of Alzheimer’s.

The experts cross-referenced data from 6 large longitudinal studies. They observed the heath of more than 31,000 adults who were 55 years and above.

The scientists analyzed data from community-based comprehensive health studies conducted between 1987 and 2008 in France, United States, Netherlands, and Iceland.

They looked into 5 primary types of blood pressure drugs diuretics, ACE inhibitors, calcium channel blockers, beta-blockers, and angiotensin II receptor blockers.

The data was divided into 2 groups; 15, 553 people with normal blood pressure, and 15,537 people with high blood pressure.

In all, there were 1,741 Alzheimer’s disease diagnoses over time.

The results showed that treating hypertension reduced the risk of developing Alzheimer’s by 16% regardless of the type of antihypertensive medication a person was on.

In other words, it is important to take the link between lowering blood pressure and Alzheimer’s risk seriously.

High blood pressure medication can boost blood flow to the brain

high blood pressure medication can boost blood flow to the brain
A small clinical trial also revealed that using blood pressure medication for treatment can enhance blood flow to key brain regions in persons with Alzheimer’s disease.

The research was part of a larger trial that was looking into whether nilvadipine could improve thinking and memory skills with persons with Alzheimer’s.

It involved a trial of 44 participants who had mild to moderate AD. The average age of the participants was 77 years.

They were randomly assigned to either use blood pressure medication nilvadipine or inactive placebo pills for 6 months. At the end of the trial, specialized MRI scans showed the persons on the drugs recorded a 20% increase in blood flow to the hippocampus.

This is the structure of the brain that is involved in learning and memory.

These are the first areas that Alzheimer’s damages.

Persons on the real drug also indicated that their blood pressure dropped by eleven points when compared to the group that was on the placebo.

Experts, however, acknowledged that the size of the study was too small and short.

Unfortunately, it is impossible to conclusively indicate whether enhanced blood flow could have effects on the symptoms.

The lead author Dr. Jurgen Claassen hoped that future research could give a better answer to the query and it should mostly focus on persons with early Alzheimer’s.

He, however, explained that persons with early-stage AD showed benefits.

Closing Remarks

Even though several studies have linked high blood pressure to Alzheimer’s symptoms more research is still required.

The findings of the studies affirm that what’s good for the heart is also good for the brain.

We can reduce hypertension through various lifestyle changes like physical exercise, eating a healthy diet, and reducing sodium. Some medications can also help lower blood pressure.

Do Concussions Cause Alzheimer’s Disease?

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do concussions cause alzheimers

There has been a lot of concern as to whether concussions cause Alzheimer’s disease (AD) in the medical field.

This is mostly because the immediate effects of a head injury can include symptoms that are seen in the disease. These would be memory loss, confusion, and changes in speech, personality, and vision.

Can Concussions Increase Risk for Alzheimer’s

These symptoms can quickly vanish, last for some time, or become permanent depending on the severity of the injury.

Also, the symptoms that develop after an injury in most cases will not become worse over time something synonymous with AD.

This said some kinds of head injuries increase the risk of a person developing Alzheimer’s later in life.

Concussions can stimulate cognitive decline

concussions can stimulate cognitive decline
Research reveals that concussions can accelerate the development of cognitive decline and brain atrophy.

These relate to Alzheimer’s in people who are at the genetic risk of this progressive illness.

This is especially true for people who carry one form of the APOE (apolipoprotein) gene. This gene has the potential to increase the risk of AD.

These findings are documented in the journal Brain and they show promise of identifying the influence that concussions have on neurodegeneration.

One of the environmental risk factors of developing neurodegenerative illnesses such as late-onset Alzheimer’s is a moderate-to-severe traumatic brain injury.

It is still not yet clear whether concussion or mild traumatic brain injury also contribute to increasing the risk.

Several studies have been conducted to try and establish the link between Alzheimer’s disease and concussions. Check out details of a few of these studies below.

Researchers from BUSM (Boston University School of Medicine), observed 160 war veterans from Afghanistan and Iraq.

The group comprised some people who had never suffered a concussion and others who had suffered one or more concussions.

The researchers measured the thickness of the participant’s cerebral cortex using MRI imaging in 7 regions. These are usually the first to indicate atrophy in AD and 7 control regions.

The experts stated that they found that lower cortical thickness in some of the regions of the brain caused by a concussion was first to be affected in AD.

Assistant professor of psychiatry at BUSM and research psychologist at the National Centre for PTSD Jasmeet Hayes, Ph.D. and corresponding author of the study explained that the results suggested that concussions when combined with genetic factors may be associated with accelerated memory decline and cortical thickness in areas that are relevant to Alzheimer’s.

Concussions have an impact on the young brain, too

concussions have an impact on the young brain
The researchers noted that the brain abnormalities appeared in a relatively young group. The average age of the participants was 32 years.

The researchers translated this to imply that the influence of concussions on neurodegeneration can be detected early in a person’s lifetime.

They, therefore, advised that after suffering a concussion, it is important to document as much as possible.

But at least when it happened and the symptoms that a person showcased. This is because when concussions combine with other factors like genetics, they can cause long-term health consequences.

The experts were hopeful that other researchers will build on their findings to give a clear answer when asked if concussions cause Alzheimer’s disease.

Head injuries can cause AD twice as likely

head injuries can cause AD twice as likely
Another study revealed that young adults who suffer from moderate or severe head injury are two times likely to develop AD later in life.

This was after Dr. Brenda Plassman and her colleagues from Duke University Medical Centre in Durham, North Carolina conducted research trying to find the link between Alzheimer’s and head injury in over 7000 US marine and Navy veterans from World War II.

The subjects of the study included 548 veterans who had experienced a head injury and 1228 who did not have any head injuries.

The experts discovered that people with a history of head injury were more than double the risk of developing AD.

Moderate head injury was associated with a 2.3 times increase in risk.

In addition to that, severe head injury was associated with more than 4 times the risk.

Severe head injury, in this case, was one where a person remained unconscious and was admitted to a hospital.

Moderate injury referred to bouts of amnesia or loss of consciousness that lasts for less than 30 minutes after the injury.

Do genes have a role?

do genes have a role
The experts also went ahead to test for the presence of the apolipoprotein E gene. Participants who had this gene were 14 times more likely to develop Alzheimer’s.

Because there was no apparent relationship with a head injury and APOE gene, the researchers suggested that more work is necessary.

This will allow us to understand the effects of the gene and a head injury better. Potentially, more research will also give a better understanding of the causes of AD.

Yet another study reported that brain scans of elderly persons with a prior head injury and poor memory have more build-up of plaque associated with AD which supports that concussions may cause Alzheimer’s disease.

In this study associate professor of neurology and epidemiology at Mayo Clinic Rochester and her team evaluated 448 residents of Olmsted County who did not have any signs of memory problems.

They also studied 141 residents who had mild cognitive impairment (thinking and memory problems).

All the participants of this study were 70 years and above.

Before the study, they all reported whether they had experienced a brain injury that caused the loss of memory or consciousness.

The researchers conducted brain scans on all the subjects.

The results revealed that persons who had cognitive impairment and concussion history had amyloid plaques levels that were 18% higher than those who did not have a history of head trauma but had cognitive impairment.

They concluded that the link between concussions and AD is quite complex. This is because the results showed an association but not a cause and effect link.

Risk Factors for Developing Alzheimer’s After a Concussion

risk factors for developing alzheimers after a concussion
Scientific research supports the idea that suffering concussions may increase the chances of a person developing AD.

Some factors also seem to affect the risk of concussions causing Alzheimer’s disease and these include:

Age

The age when a person suffers from a concussion may have an impact on whether they end up developing AD.

Several studies suggest that suffering concussions at a young age increases the risk of developing Alzheimer’s disease. This applies to when a person is older.

The severity of the Injury

The risk of concussions causing Alzheimer’s disease increases with the severity of the injury.

Repeated mild injuries may also increase an individual’s risk for future problems with reasoning and thinking.

Conclusion

Keep in mind, although concussions can increase the risk of developing AD, other factors also play a role.

Not everyone who suffers a severe head injury will end up developing the disease.

More research is still necessary to understand the link between Alzheimer’s disease and concussions.

Average Age for Alzheimer’s Disease: Key Facts

Petra Boh Blog, Signs , ,
Older woman with text reading “Average Age for Alzheimer's Disease”

What is the average age for Alzheimer’s disease? There is no single age at which Alzheimer’s begins, but the vast majority of people who develop the disease are 65 or older.

Age is the greatest known risk factor for Alzheimer’s disease. The likelihood of developing the condition increases substantially as people get older, although Alzheimer’s is not a normal part of aging.

A smaller number of people develop Alzheimer’s before age 65. This is known as younger-onset or early-onset Alzheimer’s disease.

What Is the Average Age for Alzheimer’s Disease?

Most cases of Alzheimer’s disease occur after age 65.

According to the National Institute on Aging, most people with Alzheimer’s develop the disease at age 65 or older, while fewer than 10% develop symptoms before age 65.

There are two broad age-related categories of Alzheimer’s disease: late-onset Alzheimer’s and younger-onset Alzheimer’s.

Late-Onset Alzheimer’s Disease

late-onset Alzheimer's disease in older adults

Late-onset Alzheimer’s is the most common form of the disease and generally refers to Alzheimer’s that develops at age 65 or older.

The risk increases considerably with age.

The 2026 Alzheimer’s Disease Facts and Figures report estimates that 7.4 million Americans aged 65 and older are living with Alzheimer’s dementia.

The percentage of people living with Alzheimer’s rises sharply across older age groups:

  • Ages 65–74: approximately 5.2%
  • Ages 75–84: approximately 13.8%
  • Age 85 and older: approximately 35.8%

About 74% of Americans aged 65 and older who are living with Alzheimer’s are at least 75 years old.

These figures help explain why there is no precise average age for Alzheimer’s disease. The likelihood of developing it continues to increase as people move through their 70s, 80s and beyond.

Importantly, growing older does not mean that someone will inevitably develop Alzheimer’s.

Many people live into their 80s and 90s without developing the disease.

Younger-Onset Alzheimer’s Disease

younger-onset Alzheimer's disease before age 65

Although Alzheimer’s is much more common among older adults, it can also develop before age 65.

This is called younger-onset Alzheimer’s disease, although the term early-onset Alzheimer’s is also widely used.

Many people diagnosed with younger-onset Alzheimer’s are in their 40s or 50s, although rare inherited forms of the disease can cause symptoms even earlier.

Most younger-onset cases are not caused by a single inherited genetic mutation.

However, researchers have identified three rare genes that can directly cause inherited Alzheimer’s disease: APP, PSEN1 and PSEN2.

The National Institute on Aging explains that these genetic variants account for only a small proportion of younger-onset Alzheimer’s cases.

Another gene, APOE, can affect a person’s risk of developing Alzheimer’s, particularly later in life. However, carrying an APOE risk variant does not mean that a person will definitely develop the disease.

How Does Alzheimer’s Risk Change With Age?

how Alzheimer's risk increases with age

When considering the average age for Alzheimer’s disease, it is important to understand that age itself does not directly cause Alzheimer’s.

Instead, aging is associated with biological changes that can make the brain more vulnerable.

Researchers are studying several age-related processes that may contribute to Alzheimer’s disease. These include inflammation, changes to blood vessels, reduced energy production within brain cells, oxidative damage and changes in the way proteins are processed and cleared from the brain.

Over many years, abnormal forms of proteins including beta-amyloid and tau can accumulate in the brain.

These changes may begin long before noticeable memory problems or other symptoms develop.

Other factors can also influence Alzheimer’s risk, including genetics, cardiovascular health, family history and certain lifestyle and environmental factors.

This is why two people of the same age can have very different levels of risk.

At What Age Is Alzheimer’s Usually Diagnosed?

There is no standard age of diagnosis.

Some people are diagnosed soon after symptoms first appear, while others may experience changes in memory and thinking for several years before receiving a diagnosis.

Because late-onset Alzheimer’s occurs after 65 and becomes increasingly common with advancing age, many diagnoses occur during a person’s 70s and 80s.

A diagnosis may involve medical history, physical and neurological examinations, blood tests, brain imaging and assessments of memory and thinking.

You can read more about the types of cognitive tests used when evaluating dementia.

Anyone experiencing persistent changes in memory, thinking, judgment or everyday functioning should discuss them with a qualified healthcare professional rather than assuming they are simply part of getting older.

What Is the Average Age of Death for Alzheimer’s Patients?

There is no single average age of death for people with Alzheimer’s because the disease can be diagnosed at very different ages.

A more useful measure is how long people typically live following a diagnosis.

According to the Alzheimer’s Association, people aged 65 and older live an average of approximately four to eight years after an Alzheimer’s diagnosis, although some people live for as long as 20 years.

Survival varies considerably from one person to another.

Factors such as age at diagnosis, the stage of the disease, general health and other medical conditions can influence life expectancy.

You can read more about average dementia survival and life expectancy.

Average Age for Alzheimer’s Disease: Closing Thoughts

There is no exact average age at which everyone develops Alzheimer’s disease.

The clearest dividing point is age 65. Alzheimer’s developing at or after age 65 is considered late-onset disease, while Alzheimer’s affecting someone younger than 65 is usually described as younger-onset or early-onset Alzheimer’s.

Most people with Alzheimer’s are older adults, and the prevalence rises significantly with age. Current U.S. data shows that approximately 5% of people aged 65–74 have Alzheimer’s dementia compared with more than one-third of those aged 85 and older.

Age is therefore an important risk factor, but Alzheimer’s should never be regarded as an inevitable consequence of growing older.

Understanding the relationship between age and Alzheimer’s can help people recognize when symptoms deserve further investigation and encourage timely medical assessment.

Obesity and Alzheimer’s Disease – Risk?

Petra Boh Blog, Causes ,
obesity and alzheimer's disease

When looking into the risk factors of Alzheimer’s disease (AD), researchers have been paying close attention to the relationship between obesity and Alzheimer’s.

Alzheimer’s Association reports that over 5 million people in the US are living with AD. Unfortunately, we expect this number to rise to almost 14 million by 2050.

Does Obesity Increase Alzheimer’s Risk?

Alzheimer’s is a progressive brain disorder that results in loss of memory, cognitive skills, and also causes changes in behavior.

The increasing rate of this progressive illness means that it is important to identify the biomarkers that tell when a person is at high risk of developing AD.

Early diagnosis can lead to the development of treatment and prevention strategies with a positive impact.

What is obesity?

We can describe obesity as a complex condition that involves too much body fat according to Mayo Clinic.

This increases the risk of a person suffering other health problems like diabetes, heart diseases, certain cancers, and high blood pressure.

Experts also state that obesity is one of the risk factors for developing AD.

This is because obesity often leads to insulin resistance. Data suggests that in middle age, insulin resistance can increase the risk of Alzheimer’s disease through numerous pathways.

These include dysfunctional brain insulin and decreased brain glucose metabolism which can result in increased amyloid deposition as well as reduced brain volume.

Results from human and animal studies show that subjects with AD have increased brain insulin resistance.

Worth noting is that excessive insulin in a person’s bloodstream ends up interfering with the energy supply in the brain. This is primarily because it lowers the amount of glucose or fuel that reaches the brain.

Obesity can contribute to Alzheimer’s

obesity can contribute to alzheimer's
Over the years, research has revealed that obesity and related comorbidities as potential contributors to Alzheimer’s disease pathophysiology.

This suggests that conditions like poor-quality diet, diabetes, and a sedentary lifestyle may be part of AD’s modifiable risk factors.

A study published in Obesity Reviews examined possible mechanisms in the relationship between AD and obesity.

This also included recommended treatment strategies that may play a role in the development as well as the progression of Alzheimer’s.

Reports from numerous animal and human studies suggest that there is a link between obesity and Alzheimer’s.

Obesity and higher body mass index (BMI) have been linked to reduced white matter, brain atrophy, cognitive decline, the integrity of the blood-brain barrier, and an increased risk for late-onset Alzheimer’s.

The calculated effect size of obesity for the neurodegenerative disease was 1.54 according to various results from longitudinal epidemiological studies.

Strong evidence points to midlife obesity as a risk factor for Alzheimer’s.

A cross-sectional study that was published in Obesity revealed that there is an inverse relationship between cognitive function and BMI among healthy middle-aged adults.

Several observational studies have also reported that obesity in mid-life increases the risk of dementia later in life.

Weight loss can occur later in life due to the disease

weight loss can occur later in life due to the disease
Even though there seems to be a connection between obesity and Alzheimer’s, this association tends to shift later in life.

According to the statistics about 20%-45% of patients with Alzheimer’s tend to experience weight loss as the illness progresses.

There may be a possibility that a decline in BMI that goes before AD diagnosis may be related to the neurodegeneration sections of the brain that are responsible for homeostatic weight regulation.

Several factors can contribute to weight loss including decreased motivation for self-care, https://readementia.com/why-do-dementia-patients-stop-eating/, paying less attention to mealtime, social withdrawal, and altered metabolism amongst others.

At times, genetic factors might also come into play.

For instance, there have been reports on a connection between increased weight loss in AD and the presence of the APOE gene.

Inappropriate diet has a degenerating impact on the body and mind

inappropriate diet has a degenerating impact on the body and mind
Another study on the association between obesity and Alzheimer’s suggests that when HFS (high-sugar and high-fat) diet linked to obesity is paired with normal aging, it can lead to the development of AD.

You can find the details of this study in Physiological Reports. The study was conducted by researchers from Brock University in Ontario, Canada.

They chose to look at the effects of an obesity-inducing diet on insulin signaling which is the process that lets the body know how to use sugar as well as markers of cellular stress, and inflammation.

These are some of the factors that play a role in the progression of Alzheimer’s during the aging process in mice.

There were two groups of mice one on a normal diet and the other on HSF.

The researchers measured the animals’ stress and inflammation levels in the prefrontal cortex and hippocampus areas of the brain after 13 weeks of the allocated diets.

The prefrontal cortex oversees complex cognitive, behavioral, and emotional functions. The hippocampus deals with long-term memory.

Obesity affects aging and brain functioning

obesity affects aging and brain function
After comparing the two groups of mice, the experts found that the HFS had higher markers for insulin resistance, inflammation, and cellular stress in the hippocampus region.

This is thought to play a role in the progression of Alzheimer’s disease. Their prefrontal cortex region also showed more signs of insulin resistance.

On the other hand, there were no alterations in cellular stress and inflammation markers.

The researchers concluded that the region-specific differences between the hippocampus and prefrontal cortex in regards to aging with an HFS diet shows that the pathology of the disease is not uniform in all section of the brain.

When compared to baseline readings, the control group also recorded an increase in inflammation levels.

The results according to this study indicate that although age plays a role in the progression of AD, obesity also worsens the effects of aging on the function of the brain.

The research team acknowledged that their study offers fresh details to the mechanistic link between obesity and Alzheimer’s.

This is regarding the pathways that lead to the early progression of AD and the negative effects that the HFS diet has on the hippocampal and prefrontal cortex regions of the brain.

Obesity and Alzheimer’s Conclusion

After talking about the link between obesity and Alzheimer’s, it is important for people to manage their weight well especially during mid-life or better yet earlier to reap the benefits later in life.

A healthy diet and proper exercise are key to reducing the risk of a myriad of health problems including Alzheimer’s disease.

Multi-Infarct Dementia: What Is It?

Petra Boh Blog, Types , , ,
multi-infarct dementia

A kind of dementia, multi-Infarct dementia (MID) is a type of vascular dementia that is caused by multiple strokes.

It is also considered to be the second-most common cause of dementia after Alzheimer’s disease.

The strokes interrupt blood flow to the brain, which ends up affecting how the organ functions.

A brain infarct or stroke happens due to the block or interruption of blood flow to any part of the brain.

Everything You Need To Know About Multi-Infarct Dementia

Blood transports oxygen and other essential nutrients to the brain. When the brain lacks oxygen, it causes the death of brain tissues.

Multi-Infract imply that multiple areas in the brain have been injured because of lack of blood from a series of small strokes.

There are times when blockages of the brain cause an infarction (stroke) without any stroke symptoms.

These are known as “silent” strokes which are known to increase an individual’s risk of getting vascular dementia.

If someone experiences a series of small strokes over time, they may end up developing infarct dementia.

Symptoms of Multi-Infarct Dementia

symptoms of multi-infarct dementia
The type of symptoms a person gets often depends on the area of the brain that the stroke has damaged.

At times the symptoms appear suddenly after a stroke or they may appear slowly over time.

We can categorize MID warning signs into two major sections as seen below.

Early Dementia Symptoms

  • Loss of executive function
  • Getting lost in familiar places or wandering
  • Short-term memory loss or confusion
  • Losing bowel or bladder control
  • Walking with shuffling rapid steps
  • Crying or laughing inappropriately
  • Challenges performing routine tasks like paying bills
  • Personality changes
  • Losing interest in activities or things that were previously enjoyed

Late-Stage Symptoms

As the disease progresses, a person may also experience other symptoms such as:

Some individuals may go through periods where they seem to improve and then decline after experiencing small strokes.

MID Risk Factors

MID risk factors of multi Infarct dementia
Some of the risk factors that increase a person’s risk of getting this disease include:

Medical Conditions

Diabetes, heart failure, previous strokes, atrial fibrillation, high blood pressure, cognitive decline prior to the stroke, and hardening of the arteries are some of the medical conditions that increase the risk of MID.

Age

Increasing age is a common risk factor for all types of dementia including MID.

The disease mostly affects persons who are between the ages of 60-75. In some rare cases, some people get the illness before they celebrate their 60th birthday.

Research also shows that men are slightly more likely to develop the disease than women.

Lifestyle Risk Factors

These include alcohol consumption, smoking, little to no physical activity, poor diet, and low level of education.

Diagnosing Multi-Infarct Dementia

diagnosing multi infarct dementia
There is no single test that can determine whether a person has MID or not. Worth noting is that each MID case is not the same.

One person may experience severe memory impairment while another individual may only experience mild memory loss.

Diagnosis can also be difficult because it is possible for a person to have both Alzheimer’s disease and MID making it challenging for a doctor to diagnose either of the diseases.

Medics base diagnosis on a number of factors such as:

  • History of stepwise mental decline
  • Blood pressure reading
  • Neurological exam
  • Blood tests
  • Physical Exams: this is where the doctor will ask questions pertaining to diet, sleep patterns, medications, past strokes, personal habits, stressful events, recent illness, and other medical issues.
  • Ruling out other causes of dementia like depression, diabetes, anemia, high cholesterol, brain tumors, carotid stenosis, chronic infections, thyroid disease, drug intoxication, vitamin deficiency, and high blood pressure.
  • Radiological imaging tests such as X-rays, CT & MRI scans that detail tiny areas of tissue that died from lack of adequate blood supply, electroencephalograms that measure the electrical activity of the brain, and transcranial doppler that is used to measure the velocity of blood flow through the blood vessels in the brain

MID Treatment Options

MID treatment options
Currently, there is no treatment for multi-infarct dementia.

Experts have not yet discovered how to reverse brain damage that occurs after a stroke. Treatment options mainly focus on preventing strokes from reoccurring in the future.

This is done by putting in place measures to avoid or control the medical conditions and diseases that put individuals at risk of experiencing strokes.

Stroke risk factors include diabetes, high blood pressure, cardiovascular disease, and high cholesterol.

Treatment is also tailored to a person’s individual and most of them will include:

Medications

Doctors may prescribe certain medications to help improve symptoms such as:

  • Folic acid
  • Memantine
  • Hydergine
  • Nimodipine
  • Angiotensin: these help to lower blood pressure by converting enzyme inhibitors
  • Calcium channel blockers that help with short-term cognitive function
  • Some serotonin reuptake inhibitors that are antidepressants which may help neurons grow in a bid to re-establish connections in the brain

Healthy Lifestyle Habits

Practicing healthy habits is also key when it comes to MID treatment and some of them include:

Alternative Therapies

Herbal supplements are also common when it comes to treating MID. However, more studies are still necessary to prove their efficiency.

Some of the herbal supplements that are being studied for use in MID treatment are:

  • Lemon Balm: A great alternative to restore memory
  • Wormwood: It enhances cognitive function
  • Water Hyssop: Used to improve intellectual function and memory

It is important to consult a doctor before taking any supplements to be on the safe side.

Other treatment options include rehabilitation therapy for mobility problems and cognitive training to help regain mental function.

Caregiver Support

Relatives and friends of persons with MID can help them cope with their physical and mental problems.

This can be done by encouraging regular physical and social activities as well as daily routines to help reinforce mental abilities.

Alarm clocks, calendars, and lists are useful when it comes to reminding the affected persons of important events and times.

MID Prognosis

MID prognosis
The prognosis for persons with multi-infarct dementia is not clear.

This is mostly because the symptoms of the disease can appear all over sudden after each small stroke mostly in a step-wise pattern.

Some individuals with the disorder can appear to improve after some time and then decline after experiencing silent strokes.

The disease will spiral downwards with intermittent periods of fast deterioration. Some people may die after a MID diagnosis while others will survive many years.

Death may also occur from heart disease, stroke, pneumonia, or other infections.

Normal Pressure Hydrocephalus: Is It Reversible?

Petra Boh Blog, Prevention, Signs , ,
Doctor reviewing a brain scan for normal pressure hydrocephalus

Normal pressure hydrocephalus (NPH) is an important condition to recognise because some of its symptoms can look very similar to dementia, yet they may improve with treatment.

So, is normal pressure hydrocephalus reversible?

The answer is: sometimes, to a significant degree. Treatment can improve walking, thinking and bladder-control problems in some people with NPH. However, improvement varies from person to person, and a complete recovery cannot be guaranteed.

This makes early recognition particularly important. Unlike many progressive causes of dementia, normal pressure hydrocephalus may be treatable when the right patients are identified.

What Is Normal Pressure Hydrocephalus?

The brain contains interconnected spaces called ventricles. These ventricles contain cerebrospinal fluid (CSF), which surrounds and cushions the brain and spinal cord.

Normally, CSF circulates through the brain and is continuously produced and absorbed.

With normal pressure hydrocephalus, too much CSF accumulates within the ventricles. As the ventricles enlarge, they can affect nearby brain tissue and interfere with areas involved in walking, thinking and bladder control.

Despite the name, the pressure of the cerebrospinal fluid may not always be continuously elevated. The condition is called “normal pressure” hydrocephalus because CSF pressure can sometimes appear within a normal range when measured.

NPH occurs most often in adults over the age of 60. Its symptoms can resemble those seen with Alzheimer’s disease, Parkinson’s disease and other neurological conditions, which is one reason diagnosis can be difficult.

The Johns Hopkins Medicine notes that specialised assessment can help distinguish NPH from other disorders with similar symptoms.

What Causes Normal Pressure Hydrocephalus?

possible causes of normal pressure hydrocephalus

In many people, the exact cause of NPH is unknown. This is often referred to as idiopathic normal pressure hydrocephalus.

In other cases, problems with CSF circulation can develop following another condition or event.

Possible causes or associated factors include:

  • Previous bleeding around the brain, including subarachnoid haemorrhage
  • Head injury
  • Brain infection such as meningitis
  • Brain surgery
  • Brain tumours or other structural abnormalities
  • Other conditions that interfere with the normal circulation or absorption of cerebrospinal fluid

A history of one of these conditions does not necessarily mean that someone will develop NPH, and many cases occur without an obvious underlying cause.

What Are the Symptoms of Normal Pressure Hydrocephalus?

symptoms of normal pressure hydrocephalus including walking cognitive and bladder problems

Normal pressure hydrocephalus is classically associated with three main groups of symptoms:

  • Difficulty walking or changes in gait
  • Cognitive or thinking problems
  • Urinary urgency or loss of bladder control

This combination is sometimes referred to as the classic NPH triad.

However, a person does not need to have all three symptoms at the same time. Symptoms may develop gradually, and one may be much more noticeable than the others.

Walking and Balance Problems

Walking difficulty is often one of the earliest and most prominent signs of NPH.

A person may:

  • Walk with shorter steps
  • Have difficulty starting to walk
  • Feel as though their feet are stuck to the floor
  • Shuffle their feet
  • Have difficulty turning
  • Become unsteady
  • Fall more frequently

Because these changes commonly occur in older adults for many other reasons, they can initially be attributed to aging, arthritis or another neurological condition.

Memory and Thinking Changes

NPH can also affect cognition.

Possible changes include:

  • Forgetfulness
  • Slower thinking
  • Difficulty concentrating
  • Trouble planning or organising tasks
  • Difficulty responding to questions
  • Apathy or reduced motivation
  • Confusion
  • Mood changes

These symptoms can resemble Alzheimer’s disease or another form of dementia.

However, the pattern can differ. NPH often produces slowing of thinking, reduced attention and problems with planning and organisation rather than memory loss alone.

Bladder Problems

Changes in bladder control are another common feature.

A person may initially experience a sudden or frequent need to urinate. As the condition progresses, some people develop urinary incontinence.

Bladder problems in an older adult can have many causes, so they should not be assumed to indicate NPH on their own.

Why Is Normal Pressure Hydrocephalus Sometimes Mistaken for Dementia?

NPH can be difficult to diagnose because the people most commonly affected are older adults — the same population in which Alzheimer’s disease, Parkinson’s disease, vascular disease and other causes of cognitive impairment become more common.

The Hydrocephalus Association explains that NPH symptoms can overlap with Alzheimer’s disease, vascular dementia, Parkinson’s disease and several other conditions.

It is also possible for a person to have NPH and another neurological condition at the same time.

For this reason, doctors do not diagnose normal pressure hydrocephalus from symptoms alone.

How Is Normal Pressure Hydrocephalus Diagnosed?

diagnosing NPH using neurological assessment brain imaging and cerebrospinal fluid testing

Diagnosing NPH usually involves several steps rather than one single test.

A neurologist or neurosurgeon may assess:

  • The person’s symptoms and medical history
  • Walking and balance
  • Cognitive function
  • Bladder symptoms
  • Brain imaging
  • The response to temporary removal of cerebrospinal fluid

Brain Imaging

An MRI or CT scan can show whether the brain’s ventricles are enlarged.

Doctors also look at the pattern of enlargement and other features of the brain to determine whether the changes are consistent with NPH or may have another explanation.

Imaging is important, but enlarged ventricles alone are not enough to confirm that NPH is responsible for a person’s symptoms.

Lumbar Puncture or Spinal Tap

A lumbar puncture can be especially useful when assessing whether someone may respond to treatment.

Doctors remove a quantity of cerebrospinal fluid and then reassess symptoms — particularly walking ability.

If walking or another symptom temporarily improves following removal of CSF, this can provide evidence that the person may respond to a permanent shunt.

However, failure to improve after a single lumbar puncture does not always rule out the possibility of benefiting from surgery.

External Lumbar Drainage

In some cases, doctors may use a temporary lumbar drain to remove cerebrospinal fluid over a longer period.

The healthcare team can then repeatedly assess walking, cognition and other symptoms.

Johns Hopkins lists physical assessment, gait evaluation, MRI or CT imaging, spinal tap and temporary CSF drainage among the tests that may be used when diagnosing NPH and assessing possible response to treatment.

Is Normal Pressure Hydrocephalus Reversible?

This is where NPH differs from many other conditions that can cause dementia-like symptoms.

Normal pressure hydrocephalus can be treatable, and some of its symptoms may be partially or substantially reversed.

However, it would be inaccurate to say that every person with NPH will fully recover.

The degree of improvement depends on factors such as:

  • Whether NPH is actually responsible for the symptoms
  • How long the symptoms have been present
  • The severity of the condition
  • Other neurological or medical conditions
  • How the person responds to temporary CSF drainage
  • Whether complications develop following treatment

Johns Hopkins states that complete recovery is possible but is not often seen. Many patients may instead experience meaningful improvement in one or more symptoms following successful treatment.

How Is Normal Pressure Hydrocephalus Treated?

shunt surgery used to treat normal pressure hydrocephalus

The most commonly used treatment for normal pressure hydrocephalus is surgery to implant a shunt.

A shunt is a thin flexible tube that allows excess cerebrospinal fluid to drain away from the brain.

Most commonly, one end of the shunt is placed in a ventricle within the brain. The tubing runs underneath the skin to another part of the body — usually the abdomen — where the excess fluid can be absorbed.

A valve helps regulate the amount of cerebrospinal fluid that drains.

The shunt generally remains in place long term.

Which NPH Symptoms Improve Most After a Shunt?

Improvement varies, but walking and gait problems are often among the symptoms most likely to respond.

Some people also experience improvements in thinking, memory, bladder control or independence with everyday activities.

Cognitive symptoms may be less likely to fully resolve when they have been present for a long time or when another neurological condition, such as Alzheimer’s disease, is also present.

This is another reason why identifying NPH early can be valuable.

Does Shunt Surgery Work for Everyone?

No.

Although many appropriately selected patients improve after shunt surgery, not everyone benefits.

Doctors therefore try to determine who is most likely to respond before recommending an operation.

Improvement after a lumbar puncture or temporary CSF drainage can help predict a favourable response, although no test can predict the outcome with complete certainty.

Shunt surgery also has potential complications.

These can include:

  • Shunt blockage or malfunction
  • Infection
  • Over-drainage or under-drainage of cerebrospinal fluid
  • Bleeding or subdural haematoma
  • The need for adjustment, repair or replacement of the shunt

For this reason, people with a shunt require ongoing medical follow-up.

Why Early Diagnosis Matters

Symptoms of normal pressure hydrocephalus can progress if the condition remains untreated.

Because the disorder can mimic more common causes of cognitive decline, families may initially assume that changes in walking or thinking are simply due to aging or dementia.

A combination of:

  • New or worsening walking difficulty
  • Cognitive changes
  • Urinary urgency or incontinence

should therefore prompt medical assessment, particularly in an older adult.

Recognising NPH is important because it is one of the neurological conditions in which treatment may produce meaningful improvement.

Normal Pressure Hydrocephalus: The Bottom Line

Normal pressure hydrocephalus is potentially treatable, but describing it as completely reversible for everyone would be misleading.

Some people experience substantial improvements following shunt surgery, particularly in walking and mobility. Cognitive and bladder symptoms may also improve, although the response varies considerably.

A complete recovery is possible in some cases but is not guaranteed.

What makes NPH especially important is that its symptoms can resemble dementia, Parkinson’s disease or normal aging. Identifying the condition correctly may therefore give some patients an opportunity for treatment that would otherwise be missed.

If an older person develops a combination of difficulty walking, worsening thinking or memory problems and changes in bladder control, a healthcare professional can assess whether normal pressure hydrocephalus or another condition may be responsible.

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Alzheimer’s Disease

Behavioral Variant Frontotemporal Dementia

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behavioral variant frontotemporal dementia

Behavioral variant frontotemporal dementia (BvFTD) is one of the most common types of dementia that is called FTD (frontotemporal dementia).

It accounts for around half of the cases of this disease.

What is BvFTD

Brain condition called FTLD (frontotemporal lobar degeneration) causes FTD. BvFTD is a kind of frontotemporal dementia because it affects the temporal and frontal lobes of the brain.

Another name for the disease is also Pick’s disease. Some doctors also use terms frontotemporal disorder or frontal lobe disorder.

The brain’s frontal lobe controls essential facets of daily life such as emotional control, judgment, behavior, planning, multitasking, inhibition, and executive function.

The temporal lobe, on the other hand, primarily affects language, behavior, and emotional response.

Symptoms of Behavioral Variant Frontotemporal Dementia

symptoms of behavioral variant frontotemporal dementia
The symptoms of BvFTD start mildly and progressively become worse over time.

The rate of progression, however, varies from one person to another. A person may experience various emotional and behavioral issues like:

  • Withdrawal from social interaction
  • Poor personal hygiene
  • Abrupt mood changes
  • Difficulty keeping a job
  • Disinterest in previously enjoyable activities
  • Inappropriate or compulsive behavior
  • Apathy
  • Hoarding
  • Repetitiveness

An individual with BvFTD may also experience neurological and language changes such as:

The symptoms of this type of dementia usually start showing for people who are between 40-60 years.

In some cases, they can be seen in persons who are as young as 20 years.

Most people with frontotemporal dementia are between ages 45-64.

Persons with Pick’s disease rarely recognize when they change their behaviors or the effect this has on others around them.

Causes of BvFTD

causes of bvFTD
Frontotemporal dementia is normally caused by abnormal amounts of tau which is a kind of nerve cell protein.

These proteins exist in all nerve cells.

If a person has Pick’s disease, the proteins will accumulate into clumps in the brain’s temporal and frontal lobe which can result in the death of cells.

After the cells die, the brain tissue will start to shrink which will result in dementia symptoms.

It is not yet clear what causes the formation of these abnormal proteins in the nerve cells.

Some studies indicate that genetics play a role in the development of this kind of dementia.

This is because about 40% of people with behavioral variant frontotemporal dementia usually have a family history of at least one relative who has been diagnosed with a neurodegenerative disease.

For the rest of the people, the development of this type of dementia is known to be sporadic. It does not relate to genetics, as none of their relatives has FTD.

Stages of Behavioral Variant Frontotemporal Dementia

stages of behavioral variant frontotemporal dementia
BvFTD usually occurs in three main stages as explained below.

Early Stage BvFTD

The early stages of FTD usually have some unique features. At this stage, memory loss is usually not prevalent.

A person may, however, experience changes in social and personal behavior. Most individuals will start to disregard social boundaries or start engaging in activities that may be deemed inappropriate.

They can end up behaving carelessly, impulsively, and in some cases criminally.

The ability to handle money may deteriorate and the concern for other peoples’ feelings may start to diminish.

Misdiagnosis also occurs often during this initial stage. This is because a specialist can easily misdiagnose or overlook it as a psychiatric condition.

Middle Stage BvFTD

In the middle stage, the symptoms of BvFTD become more similar to those of frontotemporal dementia.

They may even resemble those of other types of dementia such as Alzheimer’s disease.

At this point, people with progressive disease may require some assistance with day to day activities like bathing, dressing, and grooming.

Disturbances of behavior became more consistent.

Most people will also start developing language problems.

Late-Stage BvFTD

The final stage of the illness is usually the most challenging. Language and behavior problems become worse and memory deterioration also happens fast.

For most people, it may be necessary to have round-the-clock care to ensure adequate safety and care.

BvFTD Diagnosis

bvFTD diagnosis
Diagnosis for Pick’s disease (or BvFTD) is usually not an easy task, especially in the early stages.

Many times, medics can misdiagnose it for other conditions like depression, Alzheimer’s disease, Parkinson’s disease, vascular dementia, drug or alcohol dependence, or other psychiatric disorders.

The symptoms a person showcases and the results of neurological examinations are key to behavioral variant frontotemporal dementia diagnosis.

Glucose positron emission scans and brain scans like MRIs (magnetic resonance imaging) are also helpful in the diagnosis process.

These must, nonetheless, be interpreted in the context of an individual’s neurological exam and medical history.

Treatment Options

treatment options for bvftd
Currently, the FDA has not approved any medication that can be used to treat BvFTD.

In a majority of the cases, it may not be possible to slow down the progression of symptoms.

Environmental and behavioral interventions are considered some of the most effective options for managing symptoms.

Experts advocate for the use of distracting and reassuring tactics instead of challenging disruptive behaviors that can lead to more agitation.

Some doctors can also recommend pharmacological measures to help relieve distressing symptoms. The role of medication in frontotemporal dementia intervention is still not clear.

Selective SSRIs (serotonin reuptake inhibitors) are used to treat challenging behaviors.

Antipsychotics like olanzapine have been used on individuals suffering from prominent psychosis and agitation.

Studies are, however, on-going to try and introduce an effective treatment option for BvFTD.

Behavioral Variant Frontotemporal Dementia Prognosis

behavioral variant frontotemporal dementia prognosis
Years after positive BvFTD diagnosis, affected persons usually start to showcase problems with coordination and muscle weakness.

This can leave a person bedbound or needing a wheelchair.

The problems can result in difficulties with chewing, swallowing – eating in general – controlling bladder/bowels, and moving.

In the long run, persons with frontotemporal degenerations die because of physical changes that cause lung, skin, or urinary tract infections.

From the onset of symptoms, the average life expectancy is approximately 8-9 years. Some people may live up to 20 years or more with this progressive disease.