What are the 7 stages of Alzheimer's?

This article by Angela Stringfellow provides some great content on the seven stages of Alzheimer's disease broken down. Ms. String fellow has several great articles on her blog  https://blog.caregiverhomes.com She has legal advice, support group information for South Dakota, Pennsylvania, end of life planning, nursing home costs and discussions of companionship. You can read more of her content on the link provided above. I shared this article, because I felt that it was a critical first step in understanding the stages of Alzheimer's when a family has had a loved one diagnosed. This can help break the disease down into stages. It will in now way prepare a family for all that is about to happen, but it can provide a guideline of sorts.

Alzheimer's disease can be broken down into seven stages. 

1. Prior to Diagnosis: No Dementia.  
2. Stage One: No Impairment.  
3. Stage Two: Very Mild Cognitive Decline.  
4. Stage Three: Mild Cognitive Decline. 
5. Early-Stage Dementia. 
6. Stage Four: Moderate Cognitive Decline. 
7. Mid-Stage Dementia.

"Alzheimer’s disease is a progressive disease that gradually worsens over a period of four to 20 years. On average, however, most people live between four and eight years following diagnosis.(Stringfellow, 2019)"

The 7 Stages of Alzheimer’s Disease: What to Expect from Preclinical Alzheimer’s Disease to End-Stage Alzheimer’s
https://blog.caregiverhomes.com/the-7-stages-of-alzheimers
By: Angela Stringfellow

Alzheimer’s disease is a progressive disease, developing slowly and gradually worsening, typically over a period of several years. It impacts memory, thinking, language, problem-solving, and even personality and movement as the disease progresses. While not everyone will experience the same symptoms, and the disease may progress at a different rate for each individual, there is a similar trajectory that most people follow as the disease progresses. The typical progression of Alzheimer’s disease may be broken down into three, five, or seven stages. 

Prior to Diagnosis: No Dementia

In the first three stages of the seven-stage model, an individual is not considered to have dementia, as the symptoms are commonly associated with typical aging and are not typically noticeable by healthcare providers or family members. This is also known as Preclinical Alzheimer’s Disease.

Stage One: No Impairment

In the first stage, a person with Alzheimer’s disease has no memory impairment with no evident symptoms of dementia. At this stage, Alzheimer’s disease is undetectable. This stage is also sometimes called No Cognitive Decline.

Stage Two: Very Mild Cognitive Decline

In this stage, a person with Alzheimer’s disease begins to experience the typical forgetfulness associated with aging. They may forget where they left their car keys or their purse. These symptoms are typically not noticed by the individual’s family members or physician.

Stage Three: Mild Cognitive Decline

Individuals in this stage experience increased forgetfulness as well as slight difficulty with focus or concentration. These symptoms may result in decreased work performance for those in the workforce, or for those who do not hold outside employment, they may experience decreased performance in ordinary household tasks such as cleaning or paying bills. They may get lost or begin to struggle to find the right words in communication.

In stage three, increased forgetfulness and decreased performance are likely to be noticed by the person’s family members. The average duration of stage three is approximately seven years prior to the onset of dementia.

Early-Stage Dementia

In the first three stages above, an individual is not considered to have dementia. At stage four, however, that changes, and a person is considered to have early-stage dementia. Note that early-stage dementia differs from early-onset dementia or early-onset Alzheimer’s disease, which refers to the onset of clinical symptoms prior to age 65.

Stage Four: Moderate Cognitive Decline

Stage four comprises what is clinically described as early-stage dementia. A person with early-stage dementia (in stage four of the seven-stage model) will experience increased forgetfulness, often forgetting recent events, as well as difficulty concentrating, difficulty with problem-solving, and difficulty managing finances. They may have challenges when traveling to unfamiliar areas alone, and they may have difficulty performing complex tasks or organizing and expressing thoughts.

People in stage four may also be in denial about their forgetfulness and other symptoms, and as socialization becomes increasingly difficult, they may begin to withdraw from family and friends. In stage four, a healthcare provider can easily identify cognitive decline in an examination and interview with the patient. The average duration of stage four is approximately two years.

Mid-Stage Dementia

Stage five marks the beginning of mid-stage dementia, which continues through stage six.

Stage Five: Moderately Severe Cognitive Decline

Major memory deficiencies are present beginning in stage five, and people in this stage of the disease may require assistance with activities of daily living, such as bathing, dressing, and preparing meals. Memory deficits in this stage are severe, with individuals often forgetting prominent bits of information that affect their daily lives – such as their home address or phone number. They may not be able to identify where they are (orientation to place) or what time of day it is (orientation to time). Stage five lasts, on average, one and a half years.

Stage Six: Severe Cognitive Decline

Also known as Middle Dementia, stage six marks a period in which a person requires substantial assistance to carry out day-to-day activities. They may have little memory of recent events and forget the names of close friends or family members. Many people in stage six have limited memory of their earlier lives and will also have difficulty completing tasks or successfully exhibiting cognitive skills such as counting backwards from 10.

People in stage six may also begin to experience incontinence of bowel or bladder, and speech ability is often diminished. Significant personality changes may also be noticeable at this stage, as individuals may suffer from delusions, anxiety, or agitation. This stage lasts an average of about two and a half years.

Late-Stage Dementia

The seventh and final stage comprises the final stage in the three-stage model: late-stage dementia.

Stage Seven: Very Severe Cognitive Decline

Also known as Late Dementia, stage seven is the final stage in the progression of Alzheimer’s disease. At this stage, most people will have lost their ability to speak or communicate. They often require assistance with most of their activities, including toileting, eating, dressing, bathing, and other daily activities, around the clock. Because people in stage seven often lose psychomotor capabilities, they may be unable to walk or require significant assistance with ambulation. This stage lasts an average of two and a half years.

Alzheimer’s disease is a progressive disease that gradually worsens over a period of four to 20 years. On average, however, most people live between four and eight years following diagnosis. The progression of the disease may be different for each individual, but family members and caregivers should familiarize themselves with the typical stages that occur throughout progression. It’s a challenging road to travel for both the person with Alzheimer’s disease and those who love them, but knowing what to expect can help to ease some stress and uncertainty.

Nevada joins other states in Healthy Brain Initiative Planning Lab

by News 4-Fox 11 Digital Team Reno, Nevada July 18, 2019

RENO, Nev. (News 4-Fox 11) — The Nevada Department of Health and Human Services participating in the Healthy Brain Initiative Planning Lab along with eight other states, according to the Association of State and Territorial Health Officials.

Health officials say the planning lab is designed to assist states as they develop strategies to address Alzheimer’s disease and other dementia as chronic conditions.

DHHS will be able to collaborate with other states and build a coordinated public health program that can integrate with existing programs in Nevada.

“The inclusion of Nevada in this planning lab will be a great benefit as we work to develop a statewide public health response to the Alzheimer’s epidemic. It is a chance to build partnerships with providers and those living with this disease,” said Richard Whitley, director of the Department of Health and Human Services. “I am proud of the team at DHHS for their work on this public health concern, and I offer my thanks to the Association for including Nevada in this opportunity.”

The Healthy Brain Initiative Planning Lab is a collaboration between the Association of State and Territorial Health Officials and the Alzheimer’s Association with support from the Centers for Disease Control and Prevention.

Got My Tickets for Hilarity for Charity, 2019!

Hilarity for Charity, 2014. 

Scott Kelley, Seth Rogen & Brooke Westlake-Kelley 

It's official! Hilarity for Charity  
(a nonprofit movement, lead by Seth Rogen and his lovely wife Lauren Miller Rogen) are hosting their 2019 amazing fundraisers to raise awareness, inspire change, and help accelerate the progress of Alzheimer's care, research and support through the engagement of millennials. (And the rest of us young folks) who have been affected by this awful disease that is now the newest healthcare disease epidemic.

Hilarity for Charity, 2016. 

Brooke M. Westlake-Kelley & Lauren Miller-Rogen

Want to join me and the rest of the people who will be going? Below is the link to get tickets. They are on sale now! Come on! Join the fun! You know you want to! And you know you want to go to this amazing comedy/ party because your are also going to be helping kick Alzheimer's in the %#$@!!!!…

Click here to get tickets:  https://aesbid.co/ELP/HFCCF19

Hilarity for Charity, 2016. 

Nikki & Ken Dodson with 

Brooke M. Westlake-Kelley

Date:  Saturday September 14th, 2019
Location: ROW DTLA, Los Angeles, California.
Theme: HFC County Fair
Time: 7pm to 11pm

Now, onward with planning my trip to L.A. I am super excited!!! 

Hilarity for Charity, 2015.

Miley Cryrus, performing live on stage. 

(Yes, I took a selfie. You are welcome :)

#ENDALZ 
#HFC
#GRANDAMABEV #REMEMBERMYPHOTO #FORGRANDMA #ALZHEIMERS 
#ALZHEIMERSAWARENESS #PURPLE #PURPLEDIGNITY #BEVERLYJEAN #KICKALZINTHEBALLS #ALZHEIMERSASSOCIATION #ENDALZHEIMERS #WIPEOUTALZHEIMERS #WIPEOUTALZ #FORHER 

Follow me on Instagram, Facebook & Twitter!

Instagram: https://www.instagram.com/bmwphotography/
Facebook:https://www.facebook.com/bmwestlake
Twitter: https://twitter.com/PhotographyBMW

First National Study for Alzheimers and Brain Imaging

Alzheimer’s Diagnosis, Management Improved by Brain Scans

A first-of-its-kind national study has found that a form of brain imaging that detects Alzheimer’s-related “plaques” significantly influenced clinical management of patients with mild cognitive impairment and dementia.

The study revealed that providing clinicians with the results of positron emission tomography (PET) scans that identify amyloid plaques in the brain changed medical management – including the use of medications and counseling – in nearly two-thirds of cases, more than double what researchers predicted in advance of the study. The technique, known as “amyloid PET imaging,” also altered the diagnosis of the cause of cognitive impairment in more than one in three study participants.

The multicenter study of more than 11,000 Medicare beneficiaries, published April 2, 2019, in the Journal of the American Medical Association (JAMA), was managed by the American College of Radiology and led by scientists at the Alzheimer’s Association, UC San Francisco, Brown University School of Public Health, Virginia Commonwealth University School of Public Health, Washington University School of Medicine in St. Louis, UC Davis School of Medicine, and the Kaiser Permanente Division of Research.

Gil Rabinovici, MD, lead author and principal investigator.

“We are impressed by the magnitude of these results, which make it clear that amyloid PET imaging can have a major impact on how we diagnose and care for patients with Alzheimer’s disease and other forms of cognitive decline,” said study lead author and principal investigator Gil Rabinovici, MD, Distinguished Professor of Neurology at the UCSF Memory and Aging Center and member of the UCSF Weill Institute for Neurosciences.

“These results present highly credible, large-scale evidence that amyloid PET imaging can be a powerful tool to improve the accuracy of Alzheimer’s diagnosis and lead to better medical management, especially in difficult-to-diagnose cases,” added Maria C. Carrillo, PhD, Alzheimer’s Association chief science officer and a co-author of the study. “It is important that amyloid PET imaging be more broadly accessible to those who need it.”

Alzheimer’s disease is characterized by the accumulation of both amyloid protein plaques and tau protein “tangles” in the brain, the presence of which are required for a definitive diagnosis. Until recently, amyloid plaques could only be detected by postmortem analysis of autopsied brain tissue. With the advent of amyloid PET – which involves injecting patients with “tracer” molecules that stick to amyloid plaques and can be used to visualize their location in the brain – it became possible to detect plaques with a brain scan and therefore more accurately diagnose people living with the disease.

Though there is no cure for Alzheimer’s disease, early diagnoses enable physicians to prescribe appropriate symptom-management therapies, counsel families on important safety and care-planning issues and direct people to clinical trials for promising new drugs. It also allows people with the disease and their families to plan for the future, including legal and financial issues, and accessing resources and support programs. PET imaging results that reveal no signs of amyloid buildup in the brain rule out Alzheimer’s disease as the cause of memory loss, which can prompt an evaluation for alternative and sometimes reversible causes, such as medication side effects, sleep or mood disorders and other medical conditions.

However, despite FDA approval of amyloid PET tracers, use of amyloid PET imaging to assist with the accurate diagnosis of the cause of someone’s dementia is currently not covered by Medicare or health insurance plans, making it unavailable to most people.

Launched in 2016, the four-year Imaging Dementia – Evidence for Amyloid Scanning (IDEAS) study was developed by a team of scientists convened by the Alzheimer’s Association to determine whether learning the results amyloid PET imaging would change medical management and health outcomes of people with memory loss and cognitive decline. IDEAS recruited nearly 1,000 dementia specialists at 595 sites in the U.S. and enrolled more than 16,000 Medicare beneficiaries with mild cognitive impairment or dementia of uncertain cause. Under their Coverage with Evidence Development policy, the Centers for Medicare & Medicaid Services (CMS) reimbursed amyloid PET scans conducted at 343 facilities and interpreted by more than 700 imaging specialists as part of this clinical study.

“This was a uniquely real-world study that looked at the impact of amyloid PET imaging in community clinics and other non-academic settings, and demonstrates for the first time how much impact this technology has in real-world dementia care,” Rabinovici said.

The newly published results from the first phase of the IDEAS study focused on how amyloid PET scans altered physician diagnosis and treatment plans for the 11,409 participants who completed the study. As the study’s primary endpoint, the scientists collected data on how physicians altered participants’ medication prescriptions and counseling about safety and future planning. As a secondary endpoint, the researchers evaluated whether PET imaging results caused physicians to alter participants’ diagnoses. Finally, several exploratory endpoints included physician decisions about referrals to Alzheimer’s clinical trials.

The newly published data reveal that physicians changed their clinical management of more than 60 percent of patients in the study, more than double the number the authors had predicted in advance.

In participants who joined the study with mild cognitive impairment and whose brain scans revealed the presence of significant amyloid deposits, clinicians were twice as likely to prescribe Alzheimer’s drugs following PET imaging (~40 percent prior to imaging vs. ~82 percent following imaging). In those with dementia and significant amyloid buildup on PET scans, prescriptions of these drugs rose from ~63 percent to ~91 percent after the study. Doctors discontinued the use of these drugs in some patients whose scans revealed little amyloid deposition. In addition, for approximately one quarter of study participants, physicians changed non-Alzheimer’s drug prescriptions and counseling recommendations based on PET imaging results.

PET scans that revealed no significant amyloid buildup led physicians to rule out Alzheimer’s disease for approximately one in three patients who had previously been given an Alzheimer’s diagnosis. On the other hand, PET scans that showed significant amyloid plaque buildup led to a new diagnosis of Alzheimer’s disease in nearly half of patients who had not previously been diagnosed with the disease.

The researchers also discovered that one-third of participants who had previously been referred to Alzheimer’s clinical trials showed no sign of amyloid buildup based on PET imaging, which generally rules out Alzheimer’s disease as the cause of their cognitive symptoms. Based on the imaging results, physicians were able to ensure that nearly all patients referred to Alzheimer’s trials were amyloid-positive (93 percent), which is critical to these trials’ success.

“Accurate diagnoses are critical to ensure patients are receiving the most appropriate treatments. In particular, Alzheimer’s medications can worsen cognitive decline in people with other brain diseases,” said Rabinovici. “But perhaps more fundamentally, people who come into the clinic with concerns about memory problems want answers. An early, definitive diagnosis may allow individuals to be part of planning for the next phase of their lives and to make decisions that otherwise would eventually need to be made by others.”

The IDEAS team is currently analyzing data on the study’s second phase, which will examine how amyloid PET scans affect health outcomes following the scan. The researchers are using CMS claims data to document hospitalization rates and Emergency Department visits for IDEAS participants, and comparing them to participants with similar neurologic problems but who did not undergo amyloid PET. They plan to publish their findings in 2020. In addition, the researchers are developing a second study (known as New IDEAS) to include more people with both typical and atypical clinical presentations of Alzheimer’s and recruit a study group that better reflects the racial and socioeconomic diversity of the national population.

Hilarity for Charity Shares Grandma Bev's Story

My husband and I have been supporters of Hilarity for Charity since 2014. This non-profit was created by actors Seth Rogen and his wife Lauren Miller-Rogen.  I love their mission statement.

"Hilarity for Charity® (HFC) is a nonprofit movement, led by Seth Rogen and Lauren Miller Rogen, dedicated to raising awareness, inspiring change, and accelerating progress in Alzheimer’s care, research, and support through the engagement of millennials."

Seth and Lauren have worked hard to raise money and bring awareness to fight this awful disease that has personally affected them both.  More recently they had sent out an email asking their followers and supporters to share their personal Alzheimer's story. I saw the post and submitted the story about my late Grandma Bev. This doesn't encompass Grandma Bev's life story.  It is the unique outcome of what transpired with Grandma Bev's illness, until her passing in 2012 from Alzheimer's.

If you get a moment, please go check out the story I shared.

https://hilarityforcharity.org/stories/brooke-westlake-of-nevada/

Don't forget to  check out the Hilarity for Charity website!
https://hilarityforcharity.org/

Hilarity for Charity has several ways individual can donate to help fight Alzheimer's. Check back often to see when they will have there next annual variety show fundraiser. I cannot wait to go this year! The shows are always funny and they raise money for a great cause. To kick Alzheimer's in the ballz!

Special thanks to Hilarity for Charity and Lauren Miller-Rogen and Seth Rogen for letting my story be told.  Keep up the wonderful work that you both are doing.

Alzheimer’s protein higher in women, may mean higher risk of symptoms

Older women with normal cognition had higher measures of tau, an Alzheimer’s-related protein, than men, a new study finds, indicating that women have a possible higher risk of developing symptoms of the serious brain disease. The NIA-supported study was published online Feb. 4, 2019, in JAMA Neurology.

Previous studies have shown that women are at greater risk for developing Alzheimer’s, and that a greater share of women than men have the disease. However, the reasons for this difference are not well understood. The new study, led by researchers at Massachusetts General Hospital, Boston, found that levels of one defining protein seen in Alzheimer’s disease—tau in the entorhinal cortex, an area of the brain involved in memory—were higher in women than in men. The findings add to growing evidence of sex differences in the biological underpinnings of Alzheimer’s.

The researchers examined positron emission tomography (PET) brain scans from two studies, the Harvard Aging Brain Study and the Alzheimer’s Disease Neuroimaging Initiative, with a total of 296 older adults, including 173 women (average age, 74). All subjects demonstrated normal cognitive function when they first received a brain scan to measure tau. They also had PET scans to measure beta-amyloid, another Alzheimer’s-related protein.

Experts believe that people with more beta-amyloid also have more tau, and that these proteins interact early in Alzheimer’s disease progression—years before memory loss and other symptoms appear. The study suggests that this interaction may be stronger in women than in men. Compared to the men’s scans, the women’s scans showed significantly higher tau deposits in the entorhinal cortex in individuals with high beta-amyloid levels. There were neither strong male-female differences in beta-amyloid levels alone nor evidence that APOE ɛ4, a genetic risk factor for Alzheimer’s, interacts with sex to influence tau.

More work is needed to gain a better understanding of sex differences in the biological processes of Alzheimer’s. Small studies such as this one are limited by recruitment procedures and survivor bias (the effects of women generally outliving men). But having similar results across two studies is intriguing and a promising direction for future research.

This research was funded in part by NIA grants PO1AG036694, RO1AG053509, P50AG005134, K23AG049087, and K24AG035007.

Reference: Buckley RF, et al. Sex differences in the association of global amyloid and regional tau deposition measured by positron emission tomography in clinical normal older adults. JAMA Neurology. doi: Published online Feb. 4, 2019.

https://www.nia.nih.gov/news/alzheimers-protein-higher-women-may-mean-higher-risk-symptoms

7 Years without You.....

Dear Grandma Bev,

You earned your angel wings 7 years ago on February 24, 2012. I held you as you left and made your way to heaven. You were an amazing woman whom I loved to laugh with and share future goals. Guess what? I inherited your strong independence and your fierceness for pursuing my interests. You loved to hear about what I was “doing next”. Since your departure, I have had two sons who are adorable. You would have loved to hold them and play with them as a great-grandma. I remember how you loved to take me to see your mom & dad (my great grandma and grandpa Orr). I had the pleasure to get to know them as I got older. It saddens me that you did not get the same opportunity to meet your great grandchildren. Since you departed I have been an Alzheimer’s advocate in the fight to help bring awareness and find a cure. Your story is one that you shared alone on your journey before you left, but now families and friends are talking about this disease. There is no more shame, there is a story to be told by all who are living through Alzheimer's, or who caretake for a loved one with Alzheimer’s. I have traveled to Washington D.C. and spoken with senators to get bills passed so more money can be allocated towards research funding to find treatments and a cure.  I have supported my local Alzheimer's chapter for our annual fundraiser for the Walk to End Alzheimer’s. I have supported Hilarity for Charity, which raises money as a 5013c. I have started a blog about this awful disease. I have shared your story/our story and the tragic ending that unfolded. I have cried dozens of tears over your loss. Visited your gravesite several times in Idaho. I have buried your son (my father) who died 3 years after you. I have been angry that you suffered for so long, but I have been happy that you are no longer suffering. Through your guidance on the other side of this life, I have gradualey felt less pain over lossing you but it still hurts and that hurt will never leave. I think about you all the time. I have met some incredible people during my Alzheimer's advocacy journey including Seth Rogen and Lauren Miller-Rogen, Samuel L. Jackson, Maria Shriver, Senator Harry Ried & Chris Maloney. I have met other amazing family and friends that are on the same journey that I was once on before you left. Nikki and Ken Dodson & Carmine. I have won over-all Platform Awards for Woman of Achievement. for my Alzheimer's work. I have made earrings and magnets named after you called Beverly’s angels. They are purple. I sell most of them at a non-profit in Elk City, Idaho. I am currently finishing my masters degree in Criminal Justice at the University of Nevada, Reno. The new viewpoint I brought to this topic was the amount of inmates that are not diagnosed with Alzheimer's and who are more prone to Alzheimer’s. I won a preliminary 3MT speech award last year on the topic thesis topic of Alzheimer’s and Inmates. The next thing I would like to do is create an annual fundraiser in my hometown. It will take work, but I am looking forward to that being my next accomplishment for Alzheimer's advocacy. Thank you for your inspiration. Thank you for being in my life. My goals have not been completed yet. There is much more work to be done. But until we meet again, I just wanted you to know that I miss you and I love you. I hope your getting some good laughs up in heaven.

Love you Grandma Bev.

Love, Brooke

https://bmwphotoproject.blogspot.com/

#endalz #alzheimers #grandmabev #purpledignity #purple #grandma #alzheimerssucks #kickalzintheballz #remembermyphoto