Alzheimer Disease, or AD, is the most known type of dementia. This is because most people think that when someone is demented, it will sure be Alzheimer Disease. It is true that 70% or so of all Dementia syndromes is AD. But that means that another 30% is not. I will state again that this is a syndrome. Being a syndrome means that every person who has AD can show their disease in different ways. So what are the main symptoms of AD?

In the beginning it is very hart to see if someone is demented. When you get older it is normal to start forgetting some things or events. This is called normal aging and like the name says, it is normal. It is start to get pathological when people can not function properly anymore without help. They start forgetting things that people normally don't forget. It's starting to get pathological when the behaviour is constant and not when it is one or two times that you forget where your wallet is.

Amnesia is the first and main symptom of Alzheimer disease. At first you won't notice it much but when time goes on, people start to forget names of people who are close to them. They will forget appointments they made with other people. This is first directed at the short term memory. Short term memory is all new information you receive and collect. If i will ask you to remember a list 0f 10 words and ask you to repat them immediatly or after a minut or so, that is short term memory. Here it will strike the hardest, demented people will stop remembering things you told them 5 minutes ago. they will ask you repeatedly the same question what can be annoying if you don't know why they do that. When i test people for Dementia, one test would be to remember 3 words. I ask them to repat the words immediatly and after one minute. When they are demented they will only remember one word maybe two and sometimes none.

When the process is ongoing, people will also start forgetting events that happened some time ago. This is called impairment in long term memory. The rule here is what was remembered first will go out last. It is like going back in time. This is the main reason why many people can't name the correct date, they think it is 10 or 15 years past in time. You can compare this to a bookshell with hundreds of books. Each book represent some event in time. But now the books are falling lime domino stones and each fallen book is something that is forgotten. Sometimes a book that is way back in the shell will also drop.

When this happens, they can only remember fragments of how things happened. Soetimes people will start telling honoust lies to make up for the holes in their memory. This is called Confabulating and is also seen in Korsakov's Disease.

The process of losing memory will go on in time until people don't know anything anymore. They will just sit on a chair and do nothing. This is almost the end stage of dementia and death is not far away.

This is something i hear often and also another symptom of AD. What happens is that people make weird mistakes when they are doing things like clothing themselves, making coffee or operating a televison. This is called Apraxia. When i am making coffe (which i do very often), my mind has a set of things i have to do to make it work. I have to collect water, get some coffee, put the machine on, get some cups etcetera, etcetera. What happens with demented people is that they mix it up. Maybe they will collect water but forget to put the coffee in, or put the coffee in but forget about the water. To summarise, people start forgetting how to operate things. When the disease is ongoing they even start to forget where the remote control is for. They could use it for something else like a microwave.

Apraxia of speech is when people mix up words or make up words by themselves. They will forget the meaning of certain objects and make totally different words of it. A fridge can be called a food cooler, or a car can become a person on wheels. There are many different types of apraxia of speech and i will not explain them all to you. The two most important are Broca apraxia (of speech) and Wernicke apraxia. Both named to the persons who first saw these symptoms.

When someone has Broca apraxia, people will forget words and will make use of the exaples i just wrote down (food cooler).Eventually they can not speak anymore and become mute in the end. What many people forget is that when people have Broca, they do not only forget how to speak words, they will also lose the ability to identify the meaning of many words. When you speak to them they will not understand what you are talking about.

When people have Wernicke apraxia, they will make use of words that don't exist. In their mind these words represent normal objects and they can speak them fluently as if nothing is wrong (what they believe). When people use these words i normally ask if they can explain it to me. I will not tell them that the words do not exist cause in their mind they do exist. To remain trust with the person you should not point them everytime on the mistakes they are making.

I am not going to explain Science Fiction related things. What i mean by orientation is how someone is aware or where he is and who he is and who you are. In the beginning of AD people start forgetting what time it is and can't tell you the date and year. They will also have problems of moving around in places. They will manage themselves in their own house cause that is save. But when they go to town for some shopping they will get lost. It is like they are in a giant new city with no map. The subconsious mind will somehow notice this and that is why most people don't want to leave the house. They stay home where it is save.

Impairment in orientation is something you see very early in the onset of Dementia. it start mostly with impairment of orientation in time and space. In the ongoing of the disease it will also hit the orientation in person. At that point they will start forgetting names of relatives and at the end they will even not remember who that person is. This is very confronting for the caregiver relatives as the person they love can't remember them anymore.

The symptoms i just mentioned are the ones that are related to intelectual performance. Most people can cope with this behaviour but have more problems with the behavioural problems that exist in Alzheimer disease.

People with AD can become violant and agressive. The boundaries and values normal people like you and me have is lost in their behaviour. They can become angry at silly reasons and even try to hit you. This is very hard to deal with and the most difficult to accept for relatives. the person they love and taking care off is not showing gratitude and is even being agressive. keep in mind that you should blame the disease and not the person. The person you love and knew, is changing into a different person. You should always remember the person who he was and not what he has become.

Next to agressive behaviour many people will show sexual tainted behaviour. They will make sexual remarks to persons they do or do not know and can be sexual obsessed. For relatives this is very hard to accept and they will often be ashamed when the one they care for is showing this inpropriate behaviour. As i mentioned before, behavioural problems are the hardest to accept and mostly the reasons why people will go to a nursery home.

These are the most important symptomes of people with Alzheimer disease. There are much more symptoms but if i explain them all to you than i could rather write a book. If you have some questions after this article you could aks me a question in the comments.

I would like to end with saying that understanding Alzheimer disease is the best way to handle people with this disease. When i am talking to my patients i always try to project how they feel and why they do what they do. This will not always work but will certain gain trust and understanding. Understanding is the first stage in accepting the disease.