Alzheimer's Disease: from normal to "final stage" in 6 months?

Factual Questions
1

I’m interested in the input of nurses, docs, shrinks, and people who have had first hand (or second hand) experience with Alzheimer patients.

Presenting here the case of an 81 year old male (my maternal grandfather): Up until december, he seemed mostly “with it”. He was healthy, jolly, puttering around his house, doing his normal stuff. He was starting to show some mild memory lapses - but nothing really out of the ordinary. Played cards with his daughter and son in law, and seemed to forget some rules, but otherwise was able to think, reason, and plan ahead.

By April, he started having pains in his abdomen. Finally at the end of May, he visited a doctor. He was diagnosed as some prostate problem. Medications were adjusted, surgery was planned. He started exhibiting strange behavior - fainting spells, aggressive outbursts on occasion. He experienced some paranoid hallucinations. Doctor wrote this off as the side effects of the medications he was on and expected recovery after surgery.

Surgery happened in June (unless I am mistaken). His DL was returned to him and he was told he could drive. The condition went from bad to worse. He started having violent outbursts, and the hallucinations became more and more invasive. He started being convinced people were out to kill him.

One night, he drove himself to the police station and told the cops some woman had climbed through his bedroom window and assaulted him. Behavior got more and more erratic. DL was taken away.

His wife, also 81, ended up having him brought to the hospital for an evaluation. He “checked himself out”, went to the bank, emptied out a bank account and walked around town with thousands of dollars in his boxer shorts. He fainted, somewhere along the way, and was brought back to the hospital. It took 3 nurses and a doctor to sedate him and retrieve the money from his pants.

Finally, the diagnosis is Alzheimers Disease, final stages (quite acute dementia by now). What interests me is this: Has anyone ever seen this disease progress THIS fast? Sure, some “tell-tale” signs were there before, but none really before the last 6 months or so. We are now looking at long term care options, of course, and though last week he recognised people, this week he does not anymore. He is getting more and more violent and aggressive, to the point where they have to keep him relatively sedated, andlock his door from the outside at night so he doesn’t wander.

2

First of all, my sympathies for the plight of your family.

Secondly, yes. My maternal grandmother went through these stages in a little less than three months. It was almost frightening.

3

Same here…My mom went down hill very quickly. Maybe a little longer than 6 months, like 8 it seems like.

The scary part is that you mentioned surgery. My mom had a knee replacement, and while she was in the hospital for that is when she really took a major turn for the worse.

Same thing as you mentioned…before the surgery, just some slight forgetfulness. Then, while in the hospital, some bizzare personality changes. Cussing (my mon never cussed), abusive, just overall bizzare behaviour. Of course then she was diagnosed with Alzeimers by a neuro specialist.

In retrospect, we now think that the knee replacement might not have been necessary. She said her knee hurt, it had some arthritis, but I think it was just the onset of the “Alzheimers Shuffle”. Then the surgery and medication had a noticable effect on the disease’s progression. Finally, the recuperation from the surgery made it all the harder to deal with an Alzheimer patient.

Thankfully, mercifully (I know it sounds harsh, but if you’ve never lived with an Alzheimers sufferer) she didn’t last long after the initial, rapid decline. That is one hell of a disease to live with, for the patient and the family. Just hell.

I hope my post isn’t too dreary and depressing, but that is my Alzheimers experience, firsthand.

I wish your grandfather all the best, surely no person deserves this disease.

4

Matey, Rat, thank you.

Somehow, it makes me feel better.

Rat, in a way, I feel exactly like you did. And so does my poor mother - grampa’s had a good life. Been healthy all of it until now. We’re hoping he won’t have to live in this confused, lost, paranoid, awful state for long…

How awful that sounds…

I have a friend, Beth, whose mom has the disease. It was one of the strangest cases ever recorded in Canada. Her mum started showing the signs around 45 years of age. She’s now well into her fifties. This woman had a PhD, was brilliant… and now can’t read anymore, can’t take care of herself, and is quite aggressive. She has nasty outbursts. Her husband just retired, and is still taking care of her every day. She wanders. She gets lost.

When Beth called to wish her a happy birthday a few months back, she didn’t even recognise her own daughter.

Trouble is, the woman is very healthy. Other than this, she’s physically fine. How many more years of this does this poor family have ahead of them? They’re going to have to place the mom in a home soon, as the dad can’t take care of her all the time anymore.

In a way, I’m thankful. I had my grampa until he was into his 80s. I miss him. I really do. I know he’ll never be “back”. But, at least I know half his life wasn’t wasted to this nasty disease…

5

elenfair, I offer you my most sincere sympathies.

My mother, who passed away this last February, went from pretty normal last November at Thanksgiving to utterly delusional and paranoid by January, a mere two months.

When the symptoms began to appear I did a lot of research. True Alzheimers supposedly progresses relatively slowly over the course of 2-3 years. I continue to be skeptical of this “fact”.

However, with my mother, for years she carried a rare slow acting viral infection that spread from her lungs to her digestive system, and then (the doctors speculate) to her brain. In addition, the medications she was taking were as likely a culprit for the dementia as anything else.

I certainly am in no position to judge whether there are confounding factors in your grandfather’s case. I only bring it up to note that Alzheimers symptoms don’t necessarily mean an Alzheimer cause.

From personal experience I can attest to the extraordinary difficulty of dealing with a loved one who is no longer mentally “here”.

I hold you and yours up to the light. My thoughts are with you.

6

It is not currently possible to have a conclusive diagnosis of Alzheimer’s disease without dissecting the brain. In general, it is a diagnosis of exclusion. Has your grandfather been checked for bismuth poisoning, just in case?

Journal of Alzheimer’s Disease, vol1 no1.

7

By the way, the extremely rapid rates of dementia progression from normal mentioned in this thread are very atypical of Alzheimers and may actually point to a different cause, altogether. Of course, what may be happening is that dementia has been building up for some time and only only notices when it reaches the final stage.

A study on rates of progression:

http://www.neurology.org/cgi/content/full/59/7/1034

8

Alzheimer’s is not accelerated like this.

Of course, I am not diagnosing anything, but you may be interested to read about Lewy-Body Disease which typically has much more accelerated course than Alzheimer’s.

Anyone with new signs of dementia should be assessed by an internist, geriatrician, or neurologist.

9

Thanks for all the info :slight_smile: Very useful.

Grampa’s been assessed by the neurologist and all that jazz, but as someone pointed out, it’s a diagnosis of exclusion. You go down the list of symptoms, and if nothing pops out as the cause, then you say it’s Alzheimer’s.

:frowning: Oy.

10

Upon reading KarlGauss’ link and a few others…

Lewy-Body Disease sounds like, symptomatically speaking, a perfect match. I will pass on the information to my parents who are out there right now.

The progression was very rapid. One thing that always got me was the hallucinations and the fact that sometimes he seemed perfectly lucid… and the next moment not… and sometimes seemed as if he was in a “dreaming” state.

11

FWIW, the autopsy on my mom confirmed Alzheimers. Whether or not she had any other diseases I guess I’ll never know.

I know she had been prescribed Aricept and it seemed to help, at least to calm her down.

Take a look at The Symptoms on the Right Side of This Page

That exact list, Mild, Moderate, Severe, was an exact description of my mother’s decline. Also, in small print underneath, it says “Stage Lengths may Vary”. I’ll say.

12

From my experience, all I can say is 8 months is better than 8 years. My sympathies. You may heed KarlGauss suggestion that it could possibly be something other than Alzheimer’s. It seems that the big A is now the catch-all diagnosis for dementia. The only true confirmation is usually a PET scan confirmation of plaques and tangles.

13

By the way, right now everything on the market to treat Alzheimer’s should be considered “Zeroeth Generation” drugs. These are all substances that were accidentally noticed to appear to ameliorate symptoms. There is some better stuff currently in the works, with promising investigations towards the possibility of an actual cure–that is, if one particular theory turns out to be true. If that theory isn’t how Alzheimer’s works, then the treatment in question won’t cure it.

It all hinges on whether or not Alzheimer’s is a “triggered” condition with chronic results or a fully chronic condition. If it is the former, then it might be possible to “clear” the plaques (presuming the plaques cause the dementia) and then the body won’t build them up all over again. However, if it is a chronic condition, then the matter is more difficult to address.