Alzheimer’s disease is a progressive brain disease and is the most common form of dementia, a general term used for memory loss and the decline in intellectual and physical abilities. It most commonly is diagnosed in the elderly although there are cases of the disease occurring in people of middle age. There is no known single cause for Alzheimer’s although scientists believe that it occurs due to the chemical and structural changes in the brain which gradually destroy brain cells thus effecting memory, reasoning, learning and eventually body system failure.
This disease affects the body in different stages. In the first stages, family and friends might notice moderate changes in mood, behavior and communication patterns. Common signs of the first stage include forgetting where things are, forgetting recent events and social withdrawal. During the middle stages of Alzheimer’s, the main sign is the need for assistance with most daily living tasks. A person in this stage has decreased judgment and skills in regards to their personal care.
Their memory becomes worse and although they can recall their own name they still have trouble remembering key family members and easily become disoriented on the time and place. The main symptom of the late stages of Alzheimer’s is personality and severe behavior changes. Memory is continuing to decline and a person in this stage often has trouble remembering who their spouse and children are. Sundowning, which is when a person becomes restless and agitated in the late afternoon, is a common sign of the late stages. Almost all daily tasks are needed with assistance.
The final stage of Alzheimer’s occurs when a person can no longer respond to their environment. Their communication is extremely limited as well as their basic functions begin to shut down such as motor coordination and swallowing. Total care is required around the clock during the final stage. The progression of each stage is based on the individual and is different from one person to the next. Often a person can show signs and symptoms of two stages at one time.
There is no cure for Alzheimer’s as of yet but there is medication to help slow down the progression of Alzheimer’s. It won’t stop or reverse the disease but the medications do improve symptom management. The treatment for mild to moderate Alzheimer’s is a medication called cholinesterase inhibitors which help delay or prevent symptoms from becoming worse for a limited time and help control behavioral symptoms. For the moderate to late stage of Alzheimer’s there is a drug that is taken called Namenda which gives patients a better ability to continue their daily tasks of living longer compared to no medication at all.
When treating a patient with Alzheimer’s it is important to be understanding and show empathy. Communication is best by using short words and phrases and nonverbal communication is helpful as well. It is best if these patients have short appointments and undergo simple procedures. After consulting a patients physician, sedation medication could be an option. It is common for patients with moderate to severe Alzheimer’s to have poor dental hygiene because of the lack of interest in caring for oneself.
Patients with Alzheimer’s disease often have an increase in xerostomia, plaque and calculus build up, candidiasis, mucosal lesions, as well as an increase in oral injuries due to falling and accidents with silverware. It is important to quickly restore good oral health during the early stages of Alzheimer’s due to the ongoing nature of this disease. Resources: www. alzheimersdisease. com www. alz. org Dental Management of the Medically Compromised Patient, Seventh Edition.