Alzheimer’s disease ranks the fourth leading cause of death among the elderly, only after heart disease, cancer and stroke. Insufficient public awareness, widespread misunderstandings about early identification, treatment and daily care often cause patients to miss the optimal treatment window.

Epidemiological Data

Overseas surveys show the prevalence of Alzheimer’s among people over 65 ranges from 5% to 15%, rising sharply with age and exceeding 30% for those above 80.

China currently has over 5 million Alzheimer’s patients, with 300,000 new cases annually on average.

Real Clinical Cases

Case 1: Elderly mother wandered off, worrying the whole family

A 68-year-old woman from Huayuan New Village has lived with Alzheimer’s for more than three years. She sometimes grabs strangers’ hands affectionately and invites them home. One morning, she went missing. Her family searched frantically for half a day and finally found her near Baiyun New Village. To prevent recurrence, her children hired a full-time caregiver to accompany her 24 hours a day.

Case 2: Father forgot to pick up granddaughter twice in one week

Ms. Xu’s 65-year-old father frequently suffers memory loss. Within a single week, he forgot to collect her daughter from school twice, leaving the timid child crying alone at school. He often skips medication, forgets grocery shopping, and even searches for the teacup while holding it.

Case 3: Retired female cadre dares not go to the market

A retired female cadre was hospitalized for pneumonia and confided to doctors about severe recent memory loss: she clearly remembers events from long ago yet cannot recall recent happenings. Constant miscalculations of change stopped her from shopping at wet markets, forcing her to only visit supermarkets. Tests confirmed mild cognitive impairment (early Alzheimer’s), yet her children refused to accept the diagnosis and rejected treatment.

Expert Interpretation from Qian Ke, Deputy Director, Cadre Ward III, Changzhou First People’s Hospital

Alzheimer’s Is Not Normal Aging

Alzheimer’s disease, also known as Alzheimer’s dementia, refers to irreversible intellectual decline and impaired social adaptability caused by organic brain lesions in old age. Its core symptoms are amnesia and cognitive deterioration, damaging the brain’s abilities of thinking, memory and language expression.

Many family members mistakenly take senile confusion as an inevitable sign of aging, which is a false perception.

Is poor memory equal to Alzheimer’s?

Elderly people process memories slower than younger generations, but mild forgetfulness does not mean dementia. Nevertheless, memory loss is often the earliest warning sign of Alzheimer’s. Suspicious manifestations include:

1. Near-total loss of recent memory; cannot recall recent events even with reminders

2. Disorientation: unable to tell the date, season or location, frequently getting lost

3. Indifference to memory deterioration, accompanied by slow thinking, limited vocabulary and delayed responses

4. No willingness to seek medical help for cognitive decline

High-risk Populations for Alzheimer’s

1. Advanced-age seniors: The disease mostly occurs after 60, with higher risk as age increases. Around 10 out of 100 people aged 65–75 develop it, while 20–30 per 100 over 80 are affected.

2. People with family history: The disease carries hereditary risk, especially for early-onset cases. Relatives of patients have several times higher odds of developing Alzheimer’s or other neurological disorders.

3. Females: Women have slightly higher incidence, partially attributed to longer average lifespan.

4. Other risk factors:

- Low educational attainment

- Long-term use of aluminum cookware or high aluminum intake from food

- History of traumatic brain injury

- Deficiencies in certain trace elements and vitamins

Staged Symptoms of Alzheimer’s

The disease develops insidiously and progresses chronically, easily overlooked by families.

Early-stage symptoms

- Prominent loss of recent memory

- Difficulty learning new knowledge

- Inability to express thoughts with appropriate words

- Dramatic mood swings and personality changes

- Growing struggles with daily tasks: budgeting, finding one’s way outdoors, locating personal belongings

Patients in early phase can still maintain basic social interaction, yet intervention should start immediately upon spotting these signs. Without treatment, symptoms advance gradually.

Middle and late-stage symptoms

- Loss of long-term memories

- Reliance on others for bathing, eating, dressing and toileting

- Disruptive behaviors: unfriendliness, uncooperativeness, verbal or physical aggression

- Frequent disorientation, even unable to find the bedroom or bathroom at home

- Late-stage patients lose mobility and self-care capacity, prone to malnutrition, pneumonia and pressure sores

Treatments and Care

The exact root cause of Alzheimer’s remains unclear. Early detection and intervention are the core of prevention and control. Standard medication, professional care can ease suffering, improve quality of life, reduce accidents and lower caregivers’ burden.

1. Pharmacological treatment

Two major categories of drugs are used clinically:

(1) Medications to relieve symptoms and slow disease progression

Cholinesterase inhibitors serve as first-line drugs to boost cholinergic nerve transmission, including donepezil hydrochloride, rivastigmine and tacrine (rarely used now due to severe liver toxicity).

Other adjuvant options such as vitamin E and ginkgo biloba extracts require further clinical verification.

As a chronic progressive disorder, long-term consistent medication is required to alleviate symptoms, delay deterioration and sustain life quality.

(2) Drugs for behavioral disturbances

Antipsychotic, antidepressant and anti-anxiety medicines reduce hallucinations, agitation, depression and anxiety. All must be taken strictly per medical advice; abrupt withdrawal is forbidden.

Medication reminders for caregivers: Supervise every dose personally instead of trusting patients’ claims of having taken pills. Store medicines securely to prevent accidental overdose.

2. Psychological care (core auxiliary therapy)

Caregivers should master psychological intervention skills to preserve patients’ cognition and social capacity and slow memory loss.

1. Reminiscence therapy: Encourage seniors to recall joyful and fulfilling past experiences to relieve sadness and depression. Communicate calmly, offer concise sincere answers to repeated questions, and avoid arguments.

2. Alleviate anxiety: Early Alzheimer’s brings complicated psychological fluctuations requiring timely counseling. Identify the source of repetitive questions to resolve underlying worries.

3. Connect patients to real life: Arrange moderate outdoor walks, park visits and TV time to help them stay engaged with the outside world and avoid isolation in distant memories.

Caregivers shall maintain regular communication with doctors for professional guidance.

3. Daily behavioral care

Daily routine management effectively preserves self-care ability, delays brain degeneration and improves well-being.

- Establish fixed daily schedules: regular mealtimes, toilet routines, sleep and wake-up hours to reverse reversed day-night rhythms (avoid excessive daytime napping and midnight agitation). Short walks after dinner followed by light TV viewing are recommended. Assign simple achievable chores to sustain independence.

- Physical exercise: Moderate workouts prevent cerebrovascular and neurological diseases and slow brain aging, especially beneficial for early patients. Exercise gradually under supervision; stop activity and seek medical help if discomfort arises.

- Mental stimulation: Arrange reading, radio and TV time to activate thinking and maintain cognitive vitality. Frequent communication delays cerebral function decline.