Alzheimer's Disease: A Long Goodbye
MaisuZenwaveAlzheimer's disease is a neurodegenerative disorder that primarily affects older adults. It is chronic and progressive in nature, and its early symptoms are often subtle and easily overlooked. The disease is characterized by gradually worsening memory impairment, aphasia, loss of the ability to perform purposeful complex activities, difficulty recognizing previously familiar objects through specific senses, impaired visuospatial abilities, diminished abstract thinking and calculation skills, and changes in personality and behavior.
Below are some basic facts about Alzheimer's disease:
How is Alzheimer's disease classified? Based on disease progression, it is divided into three stages: early, middle, and late. This classification helps with diagnosis and the development of treatment plans for patients.[1]
Which parts or organs does it affect? The disease primarily affects brain tissue. As it progresses, complications can involve multiple organ systems throughout the body, including the lungs and urinary tract.
Is it contagious? No.
Can it be cured? Will it recur?
Currently, there is no cure for this disease.
Since the disease cannot be cured, there is no concept of recurrence.
Is it hereditary? It can be hereditary in some cases. There is a rare inherited form of Alzheimer's disease that accounts for less than 1% of all cases and typically follows an autosomal dominant pattern of inheritance.[2]
The disease usually has an insidious onset and progresses continuously, primarily manifesting as cognitive decline and non-cognitive neuropsychiatric symptoms [3].
What are the common symptoms?
Pre-dementia stage: Daily life and work are essentially unaffected.
1.Mild memory impairment
2.Mildly reduced ability to learn and retain new information
3.Mild impairment in attention, executive function, language, and visuospatial abilities
Early stage: Social functioning (i.e., work skills) declines, but basic living skills are maintained, and the ability to live independently remains relatively intact. This stage lasts approximately 3 years.
1.Memory impairment: Recent memory decline appears first, with patients often forgetting daily activities and commonly used items. As the disease progresses, remote memory also declines, meaning patients forget events and people from long ago.
2.Visuospatial impairment: Some patients may experience this, getting lost when going out and being unable to accurately copy three-dimensional figures.
3.Executive dysfunction: Patients easily become fatigued, anxious, and negative when facing unfamiliar and complex tasks.
4.Personality changes: Patients may become neglectful of personal hygiene, slovenly, irritable, quick-tempered, selfish, and suspicious.
Middle stage: Patients can no longer live independently. This stage lasts approximately 2 years.
1.Further memory decline: Frequent forgetting, inability to remember their own name or the names of relatives, failure to recognize close family members, etc.
2.Marked visuospatial impairment: For example, being unable to find their own room at home.
3.Apraxia: Previously mastered knowledge and skills show obvious decline. Work skills are gradually lost, and daily living skills such as dressing, washing, and eating are progressively impaired.
4.Decline in abstract thinking, logical thinking, and comprehensive analysis.
5.Language impairment: Repetitive speech, possibly progressing to aphasia.
6.Decline in calculation ability.
7.Agnosia: Inability to recognize common objects, such as not knowing what a car is called when seeing one.
8.Neuropsychiatric symptoms: Patients who were previously introverted may become irritable, excited, euphoric, and talkative; those who were previously extroverted may become silent, withdrawn, and lose interest in everything. Delusions and hallucinations may occur. Loss of shame (e.g., urinating or defecating in inappropriate places).
Late stage: Patients completely lose the ability to care for themselves, and various behaviors deteriorate.
1.The above symptoms gradually worsen.
2.Neuropsychiatric symptoms: Emotional apathy, inappropriate laughing and crying.
3.Loss of speech ability.
4.Difficulty swallowing.
5.Urinary and fecal incontinence.
6.Rigidity or flexion paralysis of the limbs.
7.Bedridden and silent all day.
Complications and Systemic Effects
Although Alzheimer's disease primarily affects brain tissue, as the disease progresses, complications can involve multiple organ systems throughout the body. Common complications include pneumonia, pressure ulcers, urinary tract infections, malnutrition, and systemic failure.[4] These complications are often the primary cause of death in patients.
Alzheimer's disease is a long goodbye — patients gradually bid farewell to their memories, their abilities, and their loved ones, while family members face a long and arduous caregiving journey. Currently, there is no cure for this disease, and no vaccine to prevent it. However, early detection, early diagnosis, and early intervention can slow disease progression and improve the quality of life for both patients and their families. If an elderly person around you shows signs of significant memory decline, personality changes, or getting lost, please seek medical attention promptly. Understanding, patience, and companionship are the greatest gifts we can offer them.
[1]Wang ZY, Xin JW,et al.Clinical Evaluation of the Revised Biological and Clinical Staging Criteria for Alzheimer Disease in China. Neurology. 2026 Jul 14;107(1):e218184. doi: 10.1212/WNL.0000000000218184. Epub 2026 Jun 18. PMID: 42314105.
https://pubmed.ncbi.nlm.nih.gov/42314105/#1
[2] Kakkar A, Singh HA,et al.Comprehensive Review of Genetic Risk Factors for Alzheimer's Disease Development. Curr Gene Ther. 2025 Sep 19. doi: 10.2174/0115665232397101250916050247. Epub ahead of print. PMID: 40990281.
https://pubmed.ncbi.nlm.nih.gov/40990281/
[3]Honig LS,Mayeux R. Natural history of Alzheimer's disease. Aging (Milano). 2001 Jun;13(3):171-82. doi: 10.1007/BF03351476. PMID: 11442300.
https://pubmed.ncbi.nlm.nih.gov/11442300/#1
[4]Todd S, Barr S, Passmore AP. Cause of death in Alzheimer's disease: a cohort study. QJM. 2013 Aug;106(8):747-53. doi: 10.1093/qjmed/hct103. Epub 2013 May 7. PMID: 23653484.
