What is the life expectancy of an Alzheimer’s patient?

A summary of the evolution of this disease, which deteriorates the brain until it causes death.

Alzheimer's disease is probably one of the most feared diseases in the general population, due to its high prevalence and the devastating effects that its progression has on those who suffer from it. Most people know that this disease causes a progressive deterioration of mental faculties, among which the most well-known and prominent (although not the only one) is that of memory.

There is also a certain notion that, in addition to these losses, Alzheimer's disease is increasingly affecting the subject until death. In this sense, it is common for many people to ask themselves What is the life expectancy of an Alzheimer's patient?. Answering this question is complex, but throughout this article we will try to offer an approximate prognosis based on the average life expectancy of a person with this disease.

What is Alzheimer's disease?

Alzheimer's disease is one of the most common neurodegenerative diseases, which still has no known cause and is becoming increasingly prevalent, partly due to the progressive aging of the population. This disease, which generates dementia, is characterized by the onset of progressive and irreversible deterioration and death of the neurons that populate our brain. that populate our brain, which in turn generates a progressive loss of cognitive faculties.

This dementia does not appear suddenly, but begins to manifest itself insidiously, first affecting the temporal and parietal cortex and eventually spreading to the rest of the cortex and eventually affecting subcortical structures as well. the rest of the cortex and eventually affecting subcortical structures as well.

At the functional level, the most recognizable symptom in Alzheimer's disease is episodic memory loss, together with the presence of anterograde amnesia or inability to retain new information.

In addition, there are also speech problems (initially anomia or inability to find the name of things, but with time the difficulties in this regard progress to aphasia), recognition/identification of faces and objects, and motor and sequencing of movements, which ends up configuring the so-called aphaso-apraxo-agnostic syndrome. Perceptual (e.g. loss of smell) and behavioral (e.g. wandering or loss of impulse control that may lead to some aggressiveness) alterations also appear.

Also delusions of harm are common (some of which may be derived from (some of which can derive from memory problems) and great attentional difficulties, disinhibition or extreme gentleness or emotional disturbances.

Three phases

The progression of deterioration characteristic of this disease occurs in three phases. Initially, difficulties such as anterograde amnesia begin to be seen in the initial phase, problems with memory and cognitive performance and in day-to-day life, problems with problem solving and making judgments, a certain withdrawal and possibly withdrawal.The first phase usually lasts between two and three years, with a certain degree of withdrawal and possibly depressive symptoms such as apathy, depression or irritability. This first phase usually lasts between two and four years.

Subsequently, a second phase is reached, lasting up to five years, in which the aforementioned aphaso-apraxo-agnostic syndrome begins to appear. As mentioned above, this syndrome is characterized by increasing problems in communicating, carrying out sequences of movements and being able to identify stimuli.

There is also spatio-temporal disorientation, now much more marked loss of recent memory and decreased self-awareness. Apathy and depressive symptoms appear, as well as irritability and irritability.There is also irritability and possibly delusions of harm (partly linked to memory loss) and even verbal or physical aggression. Impulse control is much less. Problems also appear in the activities of daily living, making the subject increasingly dependent and requiring external supervision for most activities (although he is still able to perform the most basic ones).

In the third and final stage of this disease, the subject is profoundly impaired. Memory loss may even affect childhood episodes, and the subject may suffer from memory impairment.It can happen that the subject suffers from an ecmnesia in which the person believes that he/she is in a moment of childhood. There is already a severe difficulty of communication (suffering a severe aphasia in which the ability to understand and express is practically nonexistent) and problems to move and walk.

It is common that there is also disinhibition of impulses, incontinence, inability to recognize loved ones and even self-recognition in a mirror. Restlessness and anguish are also frequent, as well as insomnia and lack of response to Pain or aversion. The subject usually ends up bedridden and mute. In this last stage, which ends with death, the subject is totally dependent on the environment in such a way that he/she needs someone to carry out the basic activities of daily life and even to survive.

Life expectancy in Alzheimer's patients

We have seen that the process of deterioration suffered by a person with Alzheimer's disease occurs progressively, leading to bed rest and eventually to death. The period between the onset of symptoms and death can vary greatly from person to person.The period between the onset of symptoms and death can vary greatly from person to person, so that to speak of a specific life expectancy can be complex. However, the average time between one and the other, the life expectancy of Alzheimer's patients, usually ranges between eight and ten years.

However, we must also bear in mind that this figure is only an average that we should take as an approximation: there are cases in which death has occurred much earlier or, on the contrary, people who have lived up to two decades longer since the onset of symptoms. Thus, we cannot fully determine how long a person with this disease will survive.

There are many factors that can alter the vital prognosis. One of them is the fact that keeping the mind active and keeping the person stimulated contributes to prolonging the time in which he or she maintains his or her functions, something that helps to slow down the progress of the disease and improve the person's quality of life. Lack of physical and mental activity, on the contrary, facilitates its progression. There are also some drugs that in principle help and promote the functioning of memory.

In addition, it is also important to have a social support network that can monitor and support the subject (although it is also important that caregivers also have their own space for themselves), or that they can ask for the help they need.

Another element that must be taken into account when assessing the impact of Alzheimer's disease on life expectancy is the age of onset of the disease. It should be borne in mind that although when we think of Alzheimer's disease, the most usual thing to do is to think of an older person, there are also cases in which it appears in an elderly person, there are also cases in which it appears early in life..

In general, people with early or presenile forms of Alzheimer's disease, i.e. those who begin to experience symptoms and are diagnosed before the age of 65, tend to have a worse prognosis and the different stages of the disease tend to follow one another at a faster rate. Conversely, the later the onset of the disorder the less effect it has in reducing life expectancy.

Bibliographical references:

• Förstl, H. & Kurz, A, (1999). Clinical features of Alzheimer's disease. European Archives of Psychiatry and Clinical Neuroscience 249 (6): 288-290.
• Petersen R.C. (2007). The current status of mild cognitive impairment--what do we tell our patients?. Nat Clin Pract Neurol 3 (2): 60-1.
• Santos, J.L. ; García, L.I. ; Calderón, M.A. ; Sanz, L.J. ; de los Ríos, P. ; Izquierdo, S. ; Román, P. ; Hernangómez, L. ; Navas, E. ; Ladrón, A and Álvarez-Cienfuegos, L. (2012). Psicología Clínica. CEDE Manual of PIR Preparation, 02. CEDE. Madrid.