Symptoms of Alzheimer’s disease

Synonyms in a broader sense

Alzheimer’s disease, dementia

The first symptoms are often uncharacteristic headaches, unsystematic dizziness and general weakness in performance. At this stage no diagnosis can be made yet. In the early stages, Alzheimer’s symptoms often manifest themselves as a depressed mood, insomnia, restlessness, anxiety and agitation.

In addition, it is not uncommon for the sufferer to appear apathetic and apathetic, to withdraw socially and to be less careful, so that it may not always be easy to distinguish the clinical picture at this stage from depression. Over the course of a year, Alzheimer’s symptoms develop a creeping forgetfulness, especially the function of the short-term memory is affected relatively early in the course of the disease. The vocabulary of those affected is limited, word finding disorders occur and patients find it difficult to orientate themselves in less familiar surroundings.

Other neuropsychological symptoms of Alzheimer’s disease are a disorder of speech (aphasia), a disorder in the execution of voluntary movements (apraxia) and spatial orientation disorders, so that patients are usually not fully oriented in terms of place and time, and only rarely personally. The perception and change of one subject to another is also considerably reduced and slowed down. Patients persevere strongly, i.e. they persistently stick to a thought content, sometimes even to a word.

The language of the patients’ Alzheimer symptoms becomes increasingly impoverished to the point of certain forms of decay: repetition of phrases or words. This leads to automatic or reflexive repetition of words or sentences that the patient has heard (echolalia), words that have been newly introduced into language use (neologisms), gibberish, i.e. a confused way of speaking, and finally to rhythmic, meaningless repetition of individual syllables (logoclony). Even this last remnant of speech ability is lost at some point and patients sometimes only perform silent, rhythmic movements of the speech muscles.

However, the patient loses not only the ability to speak, but also the understanding of speech after a longer period of illness. A similar pattern can be seen in the patients’ arbitrary movements (motor activity): in the final stage they perform stereotypical wiping movements, plucking, nesting, rubbing, pendulum movements of the head and similar movements. Non-cognitive changes are more often given less consideration, although they can be better treated than cognitive ones.

The accompanying psychological symptoms occur in up to 70% of all patients. These include the already mentioned depressive mood of lack of drive and apathy, as well as restlessness with wandering, shouting and screaming and sleep disorders with frequent waking up. Delusions and (optical) hallucinations occur in about 10-17% of patients.

Aggression against caregivers is also not uncommon. In part, this behaviour can be explained by misperception and misinterpretation, which are encouraged by the memory disorder. However, this personality decline in particular is a great burden for relatives.

The neurological status of most Alzheimer patients is unremarkable at the beginning of the disease. The first neurological Alzheimer symptoms are increased muscle reflexes. In addition, a slowing down of movements (bradykinesis) and increased muscle tension (muscle tone) may occur.

Rapid involuntary muscle twitching (myoclonia) and occasional seizures occur in one in five to ten patients, and half of all patients lose control of their urine and stool about six years after the onset of the disease, becoming incontinent. In the final stage of the disease, patients are bedridden, completely dependent on outside help and unable to communicate with their surroundings.