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Moderate AD is marked by a more pronounced decline in abilities of patients suffering from the disease. Tasks that were once easy can become frustratingly hard and independence can be quickly lost. There are some medications and therapies that could help.

Alzheimer's Disease is a disease marked by 3 distinct phases. The first stage is the early stage of AD and marked by mild cognitive impairment. This is a term that is quite unspecific and makes it hard to diagnose. As the disease worsens, the next stage to worry about would be the moderate form of AD. Here, we will focus on Stage 2 of Alzheimer's Disease: the moderate stage. After reading this, you will know about what symptoms to expect and what types of treatment options are available to help manage this phase of AD. 

The symptoms of moderate Alzheimer's disease 

As AD transitions from mild cognitive impairment seen in Phase 1 of the disease to Phase 2, a new trigger term emerges for the disease. This term would be referred to as "moderate dementia."

In medicine, dementia is described as any decline in a patient's mental abilities that can lead to some type of difficulty in carrying out his daily living. With a condition like moderate dementia, a patient should expect a pretty substantial shift in their life as they are unable to carry out some of the basic daily living skills that they once mastered without difficulty.

This can become quite frustrating and the symptoms can manifest very rapidly in some cases. The most noticeable symptoms that you would notice at the start would be problems with urination. The medical term for this is called incontinence. This means that a patient will wet themselves before they are able to make it to the bathroom. As you can imagine, this can be quite embarrassing and frustrating for patients at the onset of the disease.

As moderate dementia progresses, the next symptoms that start to arise would be problems with speech. Patients will find themselves struggling to find the right words or phrases in a sentence.

Moderate forgetfulness and memory loss are also likely seen with this period. 

The explanation for why this happens is because of plaque (the misfolded protein) build-up that is synonymous with AD. At the early stages of AD, only the neurons that send signals between different parts of the brain are damaged. This leads to delays and slight declines in normal functioning but because we have so many different neuron connections in the brain, the symptoms are quite minor at the beginning. These neurons will continue to be damaged until ultimately, regions of the brain become affected.

This can lead to more widespread changes like changes in personality, memories or behavior

Moderate stage of Alzheimer's disease will be typically the longest stage of the disease and the decline depends almost entirely on a case-by-case basis.

As the decline grows worse, it may even become difficult for patients to recognize family and friends. At this stage, patients will eventually also lose the natural ability of impulse control that our brains control every day. As a result, patients may start to do seemingly bizarre things like undressing in public or saying vulgar statements. Complex tasks that require multiple steps like getting dressed are almost impossible to do alone at this stage so the help of a spouse or child will be paramount during this stage. 

What treatments are available 

As you know by now, there is no treatment option available that can outright cure Alzheimer's Disease. A step-wise decline will happen regardless of what interventions are done but patients can greatly benefit from some therapies currently available to depress the speed of this decline. This can give valuable time to you and your family to still spend quality time together. 

Medications for Alzheimer's disease 

There is a combination of medications and therapy that can be done in order to benefit patients at this stage of Alzheimer's Disease. What will be chosen ultimately depends on age, the overall health, past medical history and the severity of the limitations at the moment of initial therapy. These medications go by the names of donepezil, rivastigmine and galantamine. They all work by stopping the degradation of Acetylcholine (ACh), the main chemical signal responsible for sending messages between different neurons in the brain. The effects of these medications, on average, last about 6 to 12 months which is a substantial amount of time considering the course of the disease without therapy. 

In addition to the drugs listed above, Memantine (Namenda) and a combination of memantine and donepezil (Namzaric) are approved by the FDA for treatment of moderate to severe Alzheimer’s. Memantine is prescribed to improve memory, attention, reason, language and the ability to perform simple tasks, and it can be used alone or with other Alzheimer’s disease treatments.

Therapies for Alzheimer's disease 

Beyond medications, there are a few other strategies that can be beneficial to patients suffering from AD as well. This can include behavioral therapy for not only the patient but also their family. This is a great way for families to learn together about what kinds of symptoms to expect and how to react to likely new situations they had never had to experience before. This is also a good way to structure additional assistance in the event that it becomes too burdensome for a loved one to care for the patient alone. Oftentimes, the knowledge of knowing what to expect can help alleviate some of the anxiety and fears of not only the patient but also friends and family who will help provide care. This can keep everyone calm when flare-ups of AD symptoms appear suddenly. 

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