Early Stage Symptoms of Mom’s AD

As my mother’s advocate and caregiver, one of the questions I’ve always had, at every stage of her disease, is wondering where she is on the disease progression. I started reading about Alzheimer’s disease (AD) back in 2009 when I actively noticed my mother’s early stage symptoms. Most literature describes the three broad stages as Mild (Cognitive Impairment), Moderate or middle stage AD and finally, Severe or late stage AD. I followed and logged everything about my mother so I could try to understand and anticipate her needs as well as the levels of care she would require.

While this exercise was helpful in understanding the disease, I craved more information about time. I was always muttering to myself, “How much time do we have?” In other words, I wanted to know how long each stage lasted. This is a huge issue for any family or caregiver for an Alzheimer’s patient. From everything that I read, time is the least understood component. I’ve read that life expectancy can be anywhere from 8 years to 20 years from the time of diagnosis. That’s quite a variation and, on either end of that spectrum, it’s a substantial demand on family and caregivers. It’s nothing short of life changing to the patient’s loved ones.

Mom showed initial symptoms of mild cognitive impairment in September 2009

My mother was actually the one who alerted me to her memory issues. She was commenting quite often about what she couldn’t remember, whether it was an event in her life, a person or a place. It was obviously disturbing her and she was aware of her growing problem. My father did acknowledge at the time that she was having some mild memory issues but it was nothing serious to be concerned about. He rationalized that it was all part of aging.

Dad pointed to the fact that my mother was still able to live independently. She was able to keep up with the house, she was still taking good care of herself and always dressed well and looked nice, she was still cooking and using the computer and doing her crossword puzzles. Mom read the paper every day and talked about politics and so forth. There was very little to be concerned about or so he thought. I was concerned and I sensed my mother was hiding her concern.

Global Deterioration Scale defines 7 stages of AD

According to the Global Deterioration Scale, developed by Dr. Barry Reisberg, mom was in Stage 2 of Alzheimer’s disease, Normal Aged Forgetfulness. Under this scale, stages 1 through 3 are pre-dementia stages with stages 4 through 7 being the dementia stages. So my mother wasn’t symptomatic of the disease at this point.

By June of 2010 I saw major changes in mom’s early stage symptoms

Noteworthy changes included:

• In 9 months, my mother’s short term memory became significantly impaired. She no longer acknowledged the things she couldn’t remember. She was repeating herself a lot and asking the same questions over and over.
• My father no longer let her cook or use kitchen appliances. He confessed that he was afraid she would hurt herself with hot pans and knives, etc. Of course, I have no way of knowing if something happened to initiate this decision.
• My mother was noticeably having more difficulty with grooming. She was choosing outfits that would previously have been odd to her. She chose colors that didn’t go together and she was not as neat as she had always been.
• Mom displayed behaviors that were not like her. She was argumentative, which seemed to stem from her frustration. She was suspicious of my father and of me about so many things. Mom was paranoid every time she found me speaking with my father about anything. For some reason she thought I was trying to take her away from my father.
• While my mother was still able to ride her bike and live her life under my father’s watchful eye, she was struggling with normal daily tasks, thinking through problems and executing simple plans. This felt to me like a distinct turning point.

Per my observations, mom declined through mild stage in under a year

As I’ve reviewed my log 10 years later, I’m struck by how quickly my mother progressed through the early stage symptoms of Alzheimer’s disease. It was, in fact, less than a year between the time I figured it out and the time when she was truly impaired. I have discussed in other articles the signs that I missed before I knew what was going on. But it’s hard to say how much I missed and over what time frame. I’m highly intuitive and sense even subtle changes.  So I believe that what I missed may have been due to my mother actively hiding things and my father enabling her to do this.

According to my notes and understanding, mom’s early stage symptoms that I tracked were indicative of stages 2 and 3 of the 7 stage GDS.  She progressed through this mild stage of Alzheimer’s disease in less than 1 year.