How Do You Know When an Alzheimer's Patient Is Dying?

Alzheimer’s disease is a complex neurological condition marked by gradual loss of neuronal communication and higher mental functions that can adversely affect memory, speech, thinking, language, judgment, and behavior. It is the most common form of dementia that accounts for 60%-80% of all cases.

Alzheimer’s disease manifests initially with mild memory loss and lapses in judgment. As the disease gradually progresses, it can affect higher brain functions. In later stages, balance and coordination, as well as autonomic functions such as heart rate, breathing, digestion, and sleep cycles, are severely affected.

Although Alzheimer’s disease devastates the brain, it does not kill the person. Secondary complications from decline in brain function lead to death.

The majority of people with Alzheimer's disease die from aspiration pneumonia—when food or liquid go down the trachea instead of the esophagus, causing damage or infection in the lungs that develops into pneumonia. 

Moreover, neuronal death eventually leads to problems with swallowing and mobility. This predisposes the affected individuals to the risk of poor nutrition, dehydration, blood clots, falls, and infection.

Several theories have been proposed as to what causes Alzheimer’s disease. Among them, the most widely accepted is that two abnormal structures called plaque and tangles accumulate in brain cells and lead to neuronal cell damage.

• Neuritic plaques: Deposits of an abnormal protein called beta-amyloid that build up in the spaces outside the nerve cells.
• Neurofibrillary tangles: Twisted fibers of another protein called tau protein that accumulate inside cells. The severity of dementia is directly proportional to the deposition of neurofibrillary tangles.

Many studies have shown that these abnormal proteins play a critical role in blocking communication among nerve cells and disrupting the cells’ survival processes.

Nerve cell death progressively causes memory failure, personality changes, and difficulty carrying out daily activities.

Symptoms usually develop gradually and worsen over the years. Symptom progression varies from person to person and mostly manifests as forgetfulness in the initial stages.

One or more of the following symptoms may be present in someone with Alzheimer's disease:

• Memory loss that disrupts daily life such as getting lost in a familiar place or repeating questions
• Inability to recognize familiar faces
• Trouble handling money and paying bills
• Difficulty completing basic tasks at home, work, or leisure
• Decreased or poor judgment
• Misplacing objects and being unable to recall steps to find them
• Changes in mood, personality, or behavior

Medical management can slow the progression of Alzheimer’s disease and improve quality of life for patients and their caregivers. Currently, there is no known cure for AD. Treatment addresses several areas such as:

• Helping patients maintain brain health
• Managing behavioral symptoms such as mood swings, irritability, and forgetfulness
• Regular physical exercises and physiotherapy