All of us have or know of close relatives, family members, and friends that have Alzheimer’s disease. That is not unexpected or unusual considering that over five million people are afflicted with it today. In the future, we may see over 14 million Americans with the problem.

In 1900, Alois Alzheimer observed dementia in a woman who quickly deteriorated mentally. After she died, he studied her brain microscopically and found the neurofibril bundles called plaques which are diagnostic of the disease named after him. It was rare back then, but no longer. A small percentage of people under 65 are troubled with it. Almost half of us over 85 are affected by it and one in five has it by age 75.

The disease progresses in several well defined stages based on behavioral changes. We measure the person’s ability in the simple activities of daily living. In the mild stage, we see the onset of forgetting names and events. Some lose memory of appointments. Simple activities of daily living become more difficult. The individual gets lost even in a familiar area. Travel alone becomes impossible. The person has trouble performing multi-task occupations. Using an appliance is unmanageable. Cooking, cleaning or planning anything that requires several steps is no longer feasible. Even making a telephone call is out of the question. As it progresses to the moderate stage, the person has greater trouble caring for himself. They can’t find clothes or put anything away. Often, they put useful things in the garbage. Self grooming is unachievable for them. Often, they are unable to dress appropriately in view of the weather or for a special occasion. They don’t shower or shave or do their hair. These are possible signs of this stage. They may become argumentative. They are not grounded in reality any longer and believe unreal things. They may live in the past and go to work or take care of their children and family of long past. Many times they wander at night and search for relatives or friends, not realizing they have been long dead.

In the severest form of Alzheimer’s disease, the family members cannot even feed themselves. Ambulation may also be difficult. As it progresses, speech and recognition of family members is lost. Bowel and urinary incontinence may happen too.