Alzheimer’s disease

Overview

Alzheimer's disease is the leading cause of dementia. It is a biological process that starts with the accumulation of proteins, forming amyloid plaques and neurofibrillary tangles in the brain. Over time, this leads to the death of brain cells and a gradual shrinkage of the brain. 

Early signs of Alzheimer's disease involve forgetting recent events or conversations. As the disease progresses, it leads to significant memory loss and impairs a person's ability to perform daily activities.

There is currently no cure for Alzheimer's disease. In its later stages, the decline in brain function can lead to issues such as dehydration, malnutrition, or infections, which can ultimately be fatal¹.

Symptoms of Alzheimer's

Alzheimer's disease is divided into 3 stages²:

Early Stage Symptoms

• Forgetting Recent Conversations or Events: As Alzheimer's disease advances, individuals may find it increasingly challenging to recall recent conversations or events. This memory loss can lead to misunderstandings and frustration, both for the individual and their loved ones. 
• Misplacing Items Frequently: Frequent misplacement of items becomes a common occurrence during the early stages of Alzheimer's. This can lead to heightened frustration and confusion, as individuals may spend significant time searching for misplaced objects, such as keys, glasses, or even important documents. The inability to locate familiar items can evoke anxiety, and in some cases, may result in accusations directed toward others or even the belief that items have been stolen. 
• Struggling to Remember Names and Places: A common symptom of Alzheimer's is the difficulty in recalling the names of familiar places and objects, which can have a profound impact on social interactions. This struggle may cause individuals to feel embarrassed or self-conscious, leading them to withdraw from social situations. For instance, forgetting the name of a close friend or a favourite restaurant can create barriers to maintaining relationships.
• Difficulty Finding the Right Words: Communication becomes increasingly difficult for those in the early stages of Alzheimer's, as they may struggle to find the right words during conversations. This can result in pauses, incomplete sentences, or frustration when trying to express thoughts and feelings.
• Repeatedly Asking the Same Questions: Short-term memory loss often manifests in the repeated asking of the same questions. This behaviour is not only indicative of cognitive decline but can also create a cycle of frustration for both the individual and their caregivers. For example, a person with Alzheimer's might ask the same question multiple times within a short period, often forgetting that they have already received an answer. This can be emotionally taxing for loved ones, who may feel overwhelmed or exhausted by the need to provide constant reassurance. Understanding that this repetition is a symptom of the disease can help reduce feelings of frustration and foster more compassionate interactions.
• Poor Judgment and Decision-Making Challenges: Individuals with Alzheimer's may display poor judgment or face significant challenges in decision-making, which can affect their daily choices. This may manifest in various ways, such as dressing inappropriately for the weather, neglecting personal hygiene, or making uncharacteristic financial decisions. These lapses can create serious consequences, such as health risks or financial exploitation. 
• Becoming Less Adaptable to Change: A noticeable reluctance to embrace change can be observed in those experiencing middle-stage Alzheimer's. Individuals may become less adaptable and hesitant to try new activities or routines, preferring the comfort of familiar patterns. This can manifest in resistance to changes in living situations, daily schedules, or even modifications in caregiving approaches. 

Additionally, early signs may also include mood alterations, such as heightened anxiety, agitation, or moments of confusion.

Middle Stage Symptoms

As Alzheimer's disease progresses into its middle stage, individuals often experience a significant decline in their memory capabilities. At this point, recalling the names of familiar people can become increasingly challenging, and many may find themselves unable to recognize family members and friends they once knew well.

In addition to worsening memory issues, a range of other symptoms may emerge:

• Confusion and Disorientation: Individuals may experience heightened confusion, leading to situations where they become lost, even in familiar environments. They might wander without understanding where they are or have difficulty grasping the time of day.

• Repetitive and Impulsive Behaviors: There can be an increase in behaviours that seem obsessive or repetitive, as well as impulsive actions that are out of character.

• Delusions and Paranoia: Some may develop false beliefs, such as delusions, or feel paranoid, leading them to mistrust caregivers or family members, which can strain relationships.

• Language Difficulties: Problems with communication may arise, making it hard for individuals to find the right words or follow conversations.

• Sleep Disturbances: Sleep patterns can be significantly disrupted, leading to insomnia or other sleep-related issues, which further impact daily functioning.

• Mood Changes: Emotional fluctuations can become more pronounced, with individuals experiencing rapid mood swings. They may also feel increased levels of anxiety, frustration, or depression as they navigate their changing reality.

• Hallucinations: Some may experience hallucinations, perceiving sights or sounds that aren’t present, which can be distressing and confusing.

Late Stage Symptoms

People in the later stages may also exhibit changes in behaviour that can be alarming. They may become aggressive, demanding, or suspicious of those around them, including loved ones and caregivers. This shift can create a challenging environment for caregivers, who may find themselves navigating volatile situations that were once uncommon.

In addition to these behavioural changes, a range of physical symptoms may emerge as Alzheimer's progresses:

• Difficulty Eating and Swallowing: Known as dysphagia, this symptom can complicate mealtimes and may lead to choking hazards. Caregivers often need to modify food textures or provide assistance to ensure that the individual receives adequate nutrition.

• Challenges with Mobility: Individuals may experience significant difficulty in changing positions or moving independently. This can increase the risk of falls and may necessitate the use of mobility aids or assistance from caregivers.

• Weight Loss: Severe weight loss can occur as a result of difficulties with eating or a general decline in appetite. This can exacerbate health issues and lead to further complications, making proper nutrition a crucial focus for caregivers.

• Incontinence Issues: Many individuals may experience urinary incontinence or bowel incontinence as the disease progresses. These challenges can lead to embarrassment and discomfort, requiring caregivers to provide compassionate support and frequent assistance.

• Gradual Loss of Speech: As Alzheimer's disease advances, individuals may experience a gradual decline in their ability to communicate verbally. This can be frustrating for both the individual and their loved ones, as it may hinder meaningful interactions and expression of needs or emotions.

Alzheimer's and TCIH Approaches

• Breathwork: A recent study identified a method for reducing amyloid beta levels in adults of all ages: breathing exercises that lower the levels of these peptides in the blood, which are linked to Alzheimer's disease³. Certain breathing techniques can promote relaxation and reduce stress, which in turn might help regulate the production or clearance of amyloid beta. By incorporating breathwork into daily routines, individuals may potentially support brain health and lower the risk of cognitive decline.
• Art Therapy: Art therapy offers a valuable outlet for individuals with dementia and Alzheimer’s, providing a new way to express themselves when verbal communication becomes challenging. This form of expression helps reduce frustration, promote emotional well-being, and foster a sense of accomplishment⁴. 
• Laughter Yoga: Numerous studies have shown that Laughter Yoga offers significant benefits for individuals with dementia and Alzheimer's disease. In this practice, laughter is intentionally induced through exercise, without requiring any specific reason or understanding⁵. The act of laughing, even when simulated, has been found to reduce stress, improve mood, and stimulate brain activity.