What Are Complications of Alzheimer's Disease?

Reviewed by: HU Medical Review Board | Last reviewed: June 2019 | Last updated: February 2023

As Alzheimer’s disease progresses and the cognitive impairment gets worse, language can be lost. For example, finding words may be difficult and there may be problems with reading and writing. A person with Alzheimer’s might not be able to communicate how they feel or what’s going on, which can lead to complications. Judgment can also be impaired, including poor decision-making.

In the later stages of the disease, physical functioning often becomes impaired with balance issues or weakness, as well as swallowing problems, all of which can also lead to complications. It’s important to be aware of possible complications that can arise from the effects of Alzheimer’s, in order to keep the patient safe and healthy.

Pneumonia

As Alzheimer’s progresses, movement is limited and/or impaired. This can make one more susceptible to infections, including pneumonia.1 Keeping the teeth and mouth clean from bacteria can help reduce the risk of developing pneumonia. If the person has dentures, make sure they remove and clean them nightly.

The flu can turn into pneumonia, so it’s recommended to get the flu shot each year. There is also a vaccine that patients can get every 5 years to help reduce the risk of getting pneumococcal pneumonia.1 Talk with the doctor about the risk of developing pneumonia, and how one can reduce the risk of getting it and how to stay healthy.

Bedsores

Bedsores occur when a person sits or lies in bed for a prolonged period of time in one position, causing the breakdown of the skin because of prolonged pressure on the area. In the late stages of Alzheimer’s, it is harder to move, so the patient might be lying down or sitting in one place more. They should be moved at least every two hours to boost blood circulation and relieve pressure on certain areas of the body.1

Make sure the person with Alzheimer’s disease is checked every day for any skin issues or breakdowns, and keep their skin clean and dry. Use pillows to get comfortable and relieve pressure, if need be.

Urinary tract and other infections

As mentioned previously, decreased physical movement can make one more likely to develop infections. This includes urinary tract infections, especially if the person is incontinent and may be sitting in wet or soiled disposable absorbent undergarments without realizing it – the bacteria has a chance to develop into an infection.

Caregivers should create a toileting schedule and check disposable absorbent undergarments regularly. Proper hygiene with the entire body, not just with toileting, is essential to stay healthy and reduce the risk of infection.

Falls

Falls in the elderly population are common, and one of the main risk factors for falls is cognitive impairment.2 Older individuals with dementia are two to three times more likely to have a fall because of motor impairment, attention problems, medication side effects, and behavioral symptoms.2 Low blood pressure when standing up is also a potential factor.2 Injuries from falls can be serious, especially that of breaking a hip or head trauma.

Prevention strategies should be used, like getting rid of rugs that can be tripped over, making sure there is no clutter on the floor, and using handrails, walking aids like a walker, or having someone help with mobility. Talk with the doctor and caregivers about ways to reduce the risk of falling.

Malnutrition and dehydration

It’s normal to experience a decrease in appetite if the person with Alzheimer’s activity level decreases, but it’s still important to get enough nutrients and stay hydrated. As Alzheimer’s progresses, the patient might find that they forget to eat or drink, or find that they lose their appetite more often.1 It might also be harder for them to swallow or eat.

Adapt foods by making them thicker so that they can be swallowed easier. Keep a water bottle nearby or eat foods like soup or fruit to make sure the person gets enough fluids. Food and liquid thickeners can be purchased online or at a drug store. Keep an eye on the person’s weight to make sure they’re eating enough to maintain caloric needs.

As with any disease, keep an eye out for complications that can arise from various aspects of Alzheimer’s disease. Things one might not expect or things that don’t seem related may actually result from the cognitive or physical effects of Alzheimer’s. Talk with the doctor about various complications that can arise at different stages of the disease, or specific complications that are related to any other medical conditions the patient might have. Would you like to talk to others in the Alzheimer's community about managing complications of the disease? Reach out in our forums.

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