Pauline R.

Basi
NCB-III

THE 4 A’S OF ALZHEMERS

The four A's are four words that describe some of the main symptoms of Alzheimer's disease. The A's represent the
following:

Amnesia
Amnesia refers to memory loss and is often the most easily visible and common sign of Alzheimer's
disease. Memory loss in Alzheimer's disease typically begins with short-term memory and progresses to a
decline in long-term memory.

There are different types of amnesia, including:

 Retrograde amnesia is memory loss that is limited to the period before a head injury occurred or
before a disease such as Alzheimer's developed. Retrograde amnesia hinders the ability to retrieve
the memories that were already stored in the brain.
 Anterograde amnesia is memory loss that is present for events that occur or information that is
presented after a brain injury or a disease develops. The ability to make new memories is impaired
in anterograde amnesia.

Aphasia
Aphasia is a term used to describe impaired communication. Aphasia may be classified as expressive
aphasia, where someone is unable to find the right words or may say them incorrectly, or receptive
aphasia, where the ability to understand, receive and interpret language is impaired.

Aphasia is commonly thought of as the impairment of speech and language, but it also can include the
ability to read and write.

Alzheimer's disease affects both expressive and receptive aphasia. In the early stages of Alzheimer's, there
might be some mild difficulty with finding the right word. As Alzheimer's progresses into the later stages,
speech may become nonsensical and impossible to understand, and it may be difficult to determine how
much of what you say is being comprehended.

Thus, your non-verbal communication—which is an important aspect of interacting with each other when
cognition is intact—becomes that much more important when interacting with someone who is living with
dementia. This can include basic tactics such as remembering to smile to reassure your loved one that you
are there to help her, as well as more advanced non-verbal approaches such as demonstrating a task you
want to have her complete, instead of just verbally telling her.
Apraxia
Apraxia is a deficit in voluntary motor skills. While Alzheimer's is known primarily for affecting cognitive
functioning, it also affects the body's physical ability to function. As Alzheimer's progresses, the ability to
perform certain activities of daily living such as bathing and getting dressed might decline. Activities such
as walking and eating become more difficult in the late stages of Alzheimer's disease.

Due to these changes, people living with Alzheimer's also are at a high risk of falling, and when they do fall,
they are at a higher risk of fracturing their hip. Remaining as active as possible, for as long as possible,
may help delay some of the physical changes in apraxia that develop in Alzheimer's.

Agnosia
Agnosia is the impairment of the ability to receive or correctly understand information from the senses of
hearing, smell, taste, touch, and vision. For example, people with Alzheimer's disease often are less able
to identify smells or understand the feeling of a full bladder. They also might not be able to recognize loved
ones as the disease progresses. Difficulty recognizing or interpreting visual shapes is frequently present in
Alzheimer's disease.

Agnosia may also be auditory, where the sense of hearing is intact but the ability to interpret what the
sound means is impaired.

The presence of agnosia is often part of a cognitive assessment. For example, one task on the mini mental
state exam (MMSE) requires the test-taker to copy an intersecting pentagon figure. Difficulty in this task
reduces the total points the person achieves on this test and can be a sign of cognitive impairment.