“How do people actually die from Alzheimer?”
In: Biology
Your brain regulates and controls everything in your body. As it essentially rots away (Alzheimer’s), it loses the ability to do that with increasingly dangerous effects. Eventually the person is unable to do essentially anything and is in a vegetative state before dying. Most people that know what their future holds make sure to have DNRs for such eventualities. I’ve experienced this with two family members. It’s the most horrific disease there is to me, because it takes your mind first and turns you against your loved ones, who you eventually don’t even recognize any longer.
I’ve been a hospice physician for over 20 years and have worked with many many people with Alzheimer’s. Most of them die from impaired swallowing which leads to aspiration pneumonia – this is when food ends up in the lungs which causes pneumonia. They literally forget how to swallow or lose the swallow reflex. This leads to one of two outcomes, the aforementioned aspiration pneumonia or a refusal to eat and drink. Studies show that inserting a feeding tube doesn’t solve this problem as at this point these patients are bedbound.
Patients can forget to eat/drink and slowly starve, often needing a feeding tube but then they also usually become very sedentary and there are a lot of health problems that accompany that. When the disease has severely progressed, your brain can struggle to connect with your body for autonomic functions, so you may even forget how to breathe, won’t know to cough up stuff you’ve aspirated, and your heart may start to have issues.
Here’s an interesting/sad story- My grandfather was always a drinker, and became an alcoholic after he lost my grandmother when he was around 70. He smoked at least a pack a day his entire life- like, starting as a young teenager. He used more swear words than not and was just lost in life. We were starting to notice some dementia symptoms that we assumed were accelerated due to the alcohol abuse.
Well, unfortunately he decided to go driving after drinking one day. He was upset we were trying to take away his truck and license- he was probably 80 yrs old at this point. Well, he put his truck in a ditch and got a traumatic brain injury. (Thankfully no one else was involved)
That took his dementia into full blown Alzheimer’s in just a couple months. The family moved him in with my aunt as a caretaker.
He forgot that he drank. He forgot he smoked. He forgot how to swear. He forgot that he wanted to drive. He became this sweet old man, who loved my aunt’s kiddos and became a great but forgetful grandpa. Every doctor who came out said he- this alcoholic chain smoker- was as healthy as a horse other than his brain. Eventually, like many with degenerative brain diseases, he forgot how to eat and swallow. But lungs and liver worked great until the end!
My mom passed away from Alzheimer’s, I imagine the exact cause of death was her body systems shutting down due to malnutrition/dehydration. She wouldn’t eat or drink and we/her care home were not going to force it. Towards the end she couldn’t walk, speak, feed herself…
Many people think of Alzheimer’s as just being forgetful. But it’s moreso an inability for the brain to process information. They become unable to understand body cues like hunger, thirst, pain. They become unable to carry out motor skills like walking or chewing and swallowing. They also often become combative and resistant to the people trying to care for them.
So what actually kills them?
Dehydration or malnutrition from not feeling hunger and thirst, not understanding what food and drink are, and not being able to swallow safely
Aspiration pneumonia from being unable to swallow safely
Infected pressure sores from being unable to move themselves and either being neglected by caregivers or being combative with their caregivers
Falls from being unable to safely walk
Unmanaged other diseases because they forget or refuse their medications, specialty diets, etc
My mom died from Alzheimer’s in a small care home with 4 other patients with her same illness, she lived a long time, even the advanced stages seemed to drag on and on, eventually she was not coherent enough to understand how to swallow food or water, we didn’t place feeding tubes down her however, we just tried to give her any kind of liquid but to no avail, she ended up going another 6 days without eating anything or barley drinking any water. Idk what seemed more inhumane, the fact that we would have to put tubes down her throat until she died, or just accepting that she wasn’t going to ever eat again and this was the end and to just basically let her be with as much comfort as possible. I remember seeing her for the first time not being able to swallow anymore. I burst out in a complete sobbing mess running out the front door of the care home. But in the end i think the lack of food killed her, i think she could have went just a bit longer if she was placed on feeding tubes. Horrible horrible disease.
Basically it’s a disease that slowly makes your brain function less and less. At the start that’s complex things like memory and problem solving. The dangers start to come when you forget or don’t realize things that are a danger to you. There’s the obvious like leaving the stove on but it’s also not uncommon for people with Alzheimer’s to be extremely dehydrated because they basically forgot to drink water and didn’t realize they were thirsty. The main deadly aspect is mainly these symptoms
As it gets worse and you lose less of your brain you start losing essential stuff like managing your body temp. It’s generally more complex things like that but think of it as your body forgets to tell your heart to beat.
*this is a huge simplification meant for a 5 year old lol*
The risks for old age are still common causes of death in Alzheimer’s, but made worse because it’s neurological condition that eventually impacts everything your brain controls (breathing, swallowing, incontinence). There’s [a ton of guidance for families dealing with it](https://www.alzheimers.org.uk/get-support/help-dementia-care/recognising-when-someone-reaching-end-their-life) So you often die from a respiratory infection (impacting the breathing), wasting (swallowing), UTI (incontinence), complications due to falls (balance), and sometimes from the effects of disorientation (e.g. wandering into the elements, being lost). Cardiovascular deaths and stroke are also extremely common.
Basically, if old age doesn’t get you, dementia will shut down the brain so that living becomes a struggle, and you can’t fight off everything that gets thrown at you (like an infection). Unfortunately Alzheimer’s is fundamentally a fatal disease, and there is no reversing it.
Unfortunately, nobody remembers. By the time they have gotten that far along to tell us, they don’t know they are sick any more.
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