This makes up almost 70% of the dementia cases. As the most common and most aggressive, Alzheimers is has very clear characteristics



Unknown, might be a combination of genetic, lifestyle and environmental factors


  • Progressive disease
  • Destroys memory and mental functions
  • Cannot be cured
  • Chronic condition



Brain cells degenerate and die, reducing the number of connections and shrinking the brain.


Diagnosis is clinical, ie there isnt a specific test that can be done yet, however the realm of genetics is fast improving to show markers in various types of dementia.

Scan can be done to eliminate other conditions

Medical history and behavioural observation are included in the diagnosis.


Signs and symptoms:

  • Memory loss
  • Confusion
  • Difficulty on performing daily tasks
  • Repeating statements / questions
  • Difficulty in remembering names family and friendships
  • Losing / misplacement personal belongings
  • Progressive inability to take care of themselves
  • Mood and personality changes which might include depression, irritability, emotional outbursts
  • Writing and speaking difficulty
  • Poor judgement


Brain functions which remain until much later:

  • Dancing
  • Story telling
  • Singing
  • Hobbies – knitting, arts and crafts, basic drawing, sticking of pictures, colouring in



Stages of dementia:


  • Memory loss, misplacing personal items – these could be mistaken for “aging”
  • Reduced attention span
  • Short term memory loss
  • Early dementia-
  • Memory and learning compromise becomes more sever.
  • Reduced vocabulary and ability to speak. Words might be jumbled
  • Diagnosis stage


Moderate dementia

  • Deterioration is progressive, affecting ability to be independent. Needs help with hygiene, personal care. Driving and moving around is stopped, and the person needs more care.
  • This is especially imprtant when the person is diabetic requiring insulin and dietary care
  • Needs to take chronic medication
  • Hazards should be removed eg – stairs, gas stoves, car keys.
  • Ong term memory loss
  • Unable to recognise close relatives
  • Emotional changes
  • Apraxia
  • Aimless wandering
  • Advanced dementia:
  • Depends on caregivers for daily caregiverComplete loss of speech
  • Apathy and exhaustion
  • Bedridden
  • Urinary incontinence
  • Death



Other behaviours which might occur as a result of Alzheimers

Insomnia (Insomnia is not a cause of dementia, although it can lead to memory loss, and treatment needs to be per individual case)



  • Pneumonia especially once the person is bedridden due to shallow breathing and lack of postural movement.
  • Urinary tract infection which is increased with the use of catheters
  • Injury and burns due to due instability and falling.


  • Encourage cognitive behaviours such as dancing, artwork and social interaction
  • Treat individual symptoms such as insomnia
  • Give the person something worth waking up for. Eg there is a retirement home in Pretoria, who have encouraged some of the lonelier patients by giving them dolls that need to be looked after.
  • Be patient with the patient!
  • Help the person with regards to keeping their valuables and money safe
  • Provide healthy meals – avoid junk food and sugary snacks as this can aggravate the symptoms.


Living with Alzheimers:

  • A calm and safe environment at home can help the stress management of the affected person
  • Encourage dancing, art work and creative skills such as knitting while they are safe.
  • Eat healthily avoid sugar, increase vegetables, water intake
  • Exercise within reason, practice deep breathing, 10 at a time and then rest to not hyperventilate
  • Keep track of the insulin and dietary requirements for diabetic patients. Alzheimers places diabetic patients are higher risk of diabetic comas as they might forget their insulin injections, as well as reduced hygiene affects their foot care, injuries take longer to heal and there are more medication interactions.
  • Get a medic alert bracelet for the personal
  • Treat other symptoms such as insomnia, depression
  • Make sure there are gate locks on gates going out of the property o avoid wandering into traffic


Practical tips:

  • Keep a list of things that need to be done – daily tasks, appointments and tick them offeringput medication in pill boxes per day to not overdose or forget to take them
  • Keep phone, wallet, bags in the same place at home
  • Ask the Dr to keep the script simple and to a minimum to prevent confusion
  • Schedule according to specific times eg Eat oats daily 8h00 brush teeth at 8h30
  • Walk every day at 9h00,
  • Tea 10h00
  • Sleep 11h00 wake up 12h00, eat sandwich with lettuce and tomato for lunch 13h00,
  • Keep photographs of family and friends visible. Label the photos with names and designation eg James, son
  • Dress in comfortable and well fitting clothes and shoes. Shoes should have good grip
  • Install handrails in showers and bathrooms
  • Remove obstacles or close them off eg stairs, loose bricks








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