Progression of Alzheimer-Type Dementia in Institutionalized Patients: A Cross-Sectional Study

Abstract

A gradual deterioration of mental and physical condition is one of the main clinical signs of dementia of the Alzheimer type (DA T). To describe this deterioration, we evaluated 88 institutionalized patients with DA T and plotted their current status on a number of different clinical parameters as a function of time from the estimated onset of dementia. Ratings of speech, cooperation, social contact, and communication were in the very low range in patients with duration of DA T of three years or longer, while the rating of mood was similar regardless of duration of DA T. Half of the patients were unable to dress themselvesfive years after onset of symptoms and unable to sleep regularly six years after onset. By seven years 50% had developed rigidity on passive movement, and by eight years half were unable to feed themselves and to walk without assistance. By nine to ten years, 50% had developed contractures of the limbs and were mute, and by twelve years, half of those who survived had lost eye contact with caregivers.AUTHORS' NOTE: This study was supported by the Veterans Administration. We gratefully acknowledge the assistance of Paula Lyon, M.Ed., and members of the nursing staff, in the data collection. Requests for reprints should be sent to Dr.

Effect of Seizures on Progression of Dementia of the Alzheimer Type

“…Patients are tested every 3 months with the Mini-Mental State examination [10], Language Assessment Scale [11], and M ACC Behavioral Adjustment Seale [ 12]. A physician or a psychologist rates the Mini-Mental State and Language Assessment Scale, while members of the nursing team rate the MACC Behavioral Adjustment Scale.…”

Eating Changes in Mild-Stage Alzheimer's Disease: A Pilot Study

“…The inability to eat is the most life-threatening [2][3][4][5][6] of all the functional impairments in AD, with 50% of the patients losing the ability to feed themselves 8 years after diagnosis [7]. Altered eating behaviors in AD range from walking away from food at the table, to spitting out food, and choking on liquids and solids [8][9][10][11][12].…”

“…As many as 50% of nursing home residents may require feeding assistance ranging from organizing and setting up the meal to total assistance, and 32% of nursing home residents have been reported to have swallowing problems [7]. With two exceptions [18,19], most research has focused on problems associated with institutional caregivers feeding AD residents.…”

Sundowning and Rate of Decline in Mental Function in Alzheimer's Disease

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