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Most People with Alzheimer’s Have Mild or Moderate Disease

January 25, 2021

Just over half of people with Alzheimer’s disease have mild illness, according to a new analysis. Thirty percent have moderate disease, and about 20 percent have severe disease.

Those are the findings from researchers at Boston University School of Medicine, who analyzed medical records of thousands of participants in the Framingham Heart Study, a long-running study that followed more than 5,000 adults living in Framingham, Mass., over many years. Study participants ranged in age from 50 to 94.

The findings are important, because interventions for Alzheimer’s disease are most effective in the earlier stages of the illness. For example, numerous studies suggest that lifestyle measures like a heart-healthy diet and regular exercise may help to slow disease progression in people with early Alzheimer’s. Likewise, people with mild or moderate Alzheimer’s may benefit from programs like art or music therapy, or day-care services that can provide social outlets and help to ease anxiety.

Mild, or early-stage, Alzheimer’s disease is generally defined as a stage when hallmark symptoms like memory impairment become evident. Grocery shopping, preparing meals, organizing and managing finances become increasingly difficult, though many people with early Alzheimer’s can continue to work, drive, socialize and live independently.

With moderate, or middle-stage, disease, people may forget their address or phone number, lose track of time, wander and get lost in known places, in their own neighborhood, or have difficulty with simple tasks such as dressing themselves. Increasingly, they need assistance with everyday activities like showering, getting dressed and going to the bathroom. They may confuse family members, and mood and personality changes and behaviors like agitation or aggression may worsen. Living alone becomes very hard or impossible.

With severe, or late-stage, disease, the person needs help eating, drinking, sitting up and walking. Carrying on a conversation, even walking, become difficult. Someone in the late-stage of Alzheimer’s requires round-the-clock care.

Because most cases of Alzheimer’s are mild to moderate, that means most people with Alzheimer’s can benefit from such measures. Lifestyle and self-care measures may also benefit those with mild cognitive impairment, or MCI, a brain disorder that often progresses to full-blown Alzheimer’s.

Experts also believe that many of the new Alzheimer’s treatments being tested may also be most effective in the earliest stages of the disease, before damage to the brain becomes extensive and irreversible.

The findings underscore the urgency of finding effective new treatments to reverse, halt or slow the progression of Alzheimer’s disease.

“Early intervention in MCI or the mild stage of Alzheimer’s dementia has been the primary focus for Alzheimer’s disease research and drug development in recent years,” said study author Rhoda Au, professor of anatomy and neurobiology at Boston University. “It is crucial to determine risk factors or develop therapies that could alter the disease trajectory to improve individuals’ quality of life and alleviate the socioeconomic burden. Any drug treatment that is effective might help prevent their Alzheimer’s disease from getting worse.”

By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Marc Flajolet, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.

Source: Yuan Jing; Maserejian, Nancy; Liu, Yulin; et al: Severity Distribution of Alzheimer’s Disease Dementia and Mild Cognitive Impairment in the Framingham Heart Study. Journal of Alzheimer’s Disease, Dec. 20, 2020

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