Expert: Mary Gordon - 1/11/2007

Question
Is it common for Alzheimers patients to have spells of stopping breathing?

Answer
Here is a description of the last two stages from Dr. Reisberg (the most commonly used set of stages)

Level 6
Severe cognitive decline (Middle Dementia or Moderately Severe AD).
May occasionally forget the name of the spouse upon whom they are entirely dependent for survival. Will be largely unaware of all recent events and experiences in their lives. Retain some knowledge of their past lives but this is very sketchy. Generally unaware of their surroundings, the year, the season, etc. May have difficulty counting from 10, both backward and sometimes forward. Will require some assistance with activities of daily living, e.g., may become incontinent, will require travel assistance but occasionally will display ability to orient in familiar locations. Diurnal rhythm frequently disturbed. Almost always recall their own name. Frequently continue to be able to distinguish familiar from unfamiliar persons in their environment. Personality and emotional changes occur. These are quite variable and include
(a) delusional behavior, e.g., patients may accuse their spouse of being an impostor, may talk to imaginary figures in the environment, or to their own reflection in the mirror;
(b) obsessive symptoms, e.g., person may continually repeat simple cleaning activities;
(c) anxiety symptoms, agitation, and even previously nonexistent violent behavior may occur;
(d) cognitive abulla, i.e., loss of willpower because an individual cannot carry a thought long enough to determine a purposeful course of action.

6a - Requires Assistance dressing
6b - Requires Assistance bathing properly
6c - Requires Assistance with mechanics of toileting
6d - Urinary incontinence
6e - Fecal incontinence

Level 7
Very severe cognitive decline (Late Dementia or Severe AD).
All verbal abilities are lost. Frequently there is no speech at all - only grunting. Incontinent of urine, requires assistance toileting and feeding. Lose basic psychomotor skills, e.g., ability to walk, sitting and head control.
The brain appears to no longer be able to tell the body what to do. Generalized and cortical neurologic signs and symptoms are frequently
present.

7a - Speech ability limited to about a half-dozen intelligible words
7b - Intelligible vocabulary limited to a single word
7c - Ambulatory ability lost
7d - Ability to sit up lost
7e - Ability to smile lost
7f - Ability to hold up head lost   

I don't know where your loved one is in this spectrum, or what other health issues they may have. No, its not a normal part of AD to stop breathing.  People in the final spiral generally stop eating and drinking, lapse into a coma and pass away gently.

If your loved one is doing something worrying that doesn't seem part of the Alzheimer's itself, ask the doctor if he or she has any idea what is causing it.
If it is something that might lead to death, would you treat it, or provide palliative care only (comfort measures) as per hospice. Lots to think about as the illness progresses to its natural end.

Hope this helps.

Mary G.