Stages of Alzheimer Disease
Alzheimer disease is a type of brain disorder. It causes memory loss, confusion, and
changes in personality, and gradual loss of independence. It is the most common type of
dementia. At first, people with this disease have only a small amount of memory loss
and confusion. This is called cognitive decline. But over time, these symptoms get
more severe.
The disease progresses through 3 main stages of symptoms. In the final stage, people
with Alzheimer disease may be unable to talk with family members or know what is going
on around them.
This disease can’t be cured. Healthcare providers and caregivers often focus treatment
on slowing the process and ensuring a good quality of life for everyone involved.
Facts about Alzheimer disease
Alzheimer disease is becoming more common as the general population gets older and
lives longer. Alzheimer disease often affects people older than 65. A small number
of people have early-onset Alzheimer disease, which starts when they are in their
30s or 40s.
People live for an average of 4 to 8 years after their diagnosis. But they can live
as long as 20 years, depending on other factors. The disease can progress quickly
in some people and more slowly in others.
No one knows what causes Alzheimer disease. Genes, environment, lifestyle, and overall
health may all play a role.
Stages of Alzheimer disease
The stages of Alzheimer disease usually follow a progressive pattern. But each person
moves through the disease stages in their own way. Knowing these stages helps healthcare
providers and family members make decisions about how to care for someone who has
Alzheimer disease.
Preclinical stage
Changes in the brain begin years before a person shows any signs of the disease. This
time period is called preclinical Alzheimer disease and it can last for years.
Mild, early stage
Symptoms at this stage include mild forgetfulness. This may seem like the mild forgetfulness
that often comes with aging. But it may also include problems with concentration.
A person may still live independently at this stage but may have problems:
The person may be aware of memory lapses. Their friends, family, or neighbors may
also notice these difficulties.
Moderate, middle stage
This is typically the longest stage, often lasting many years. At this stage, symptoms
include:
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Increasing trouble remembering events
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Problems learning new things
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Trouble with planning complicated events, like a dinner
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Trouble remembering their own name, but not details about their own life, such as
address and phone number
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Problems with reading, writing, and working with numbers
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Making bad decisions or having poor judgment
As the disease progresses, the person may:
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Know that some people are familiar but not remember their names, or forget the names
of a spouse or child
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Lose track of time and place
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Need help choosing the right clothing, getting dressed, and doing daily activities,
such as brushing teeth
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Become moody or withdrawn, or have personality changes, such as hallucinations, paranoia,
or delusions
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Be restless, agitated, anxious, or tearful, especially in the late afternoon or at
night
Physical changes may occur as well. Some people have sleep problems. Wandering away
from home is often a concern.
Severe, late stage
At this stage, a person:
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Loses many physical abilities, including walking, sitting, eating
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May lose bowel and bladder control
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May be able to say some words or phrases but not have a conversation
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Needs help with all activities all the time
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Is unaware of recent experiences and of their surroundings
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Is more likely to get infections, especially pneumonia
Diagnosis
The early signs of Alzheimer disease may not be obvious to anyone except the person
with the disease and the people closest to them. Even then, the symptoms may be confused
with normal changes that come with age.
To make a diagnosis, healthcare providers usually do an interview that uses several
types of tests to find out how well the person’s brain is working. These are often
memory tests. They may seem like puzzles or word games. The healthcare provider might
also take a health history and order some tests to check for other possible causes
of memory loss or confusion. These tests may include brain scans, such as CT, MRI,
or PET scans. The provider might talk with family members about symptoms they have
noticed.
Treatment
Treatment varies based on a person’s age, overall health, health history, symptoms,
and preferences. Some medicines can slow the progress of the disease in some people.
These may work for a few months to a few years.
Treatment might also be needed to help with depression or anxiety. Sleep disorders
can also be treated.
Caregivers and family members may benefit from therapy and support groups.
Prevention
Experts don’t know how to prevent Alzheimer disease. Most experts advise a healthy,
active lifestyle as the best way to protect your brain’s health. This includes taking
part in physical and mental activities. Quitting smoking can also reduce your risk
of getting dementia. Treatment of underlying health conditions helps reduce the risk
of developing Alzheimer disease. It is important to work with your healthcare provider
to treat obesity, depression, diabetes, or high blood pressure, Head injury can also
increase the risk of getting Alzheimer disease. So wear a helmet during at-risk activities.
Managing Alzheimer disease
People with Alzheimer disease need to follow a full treatment plan to protect their
health. Even though a loved one may have this disease, it is still important that
they take care of their physical health.
Finding help
You and your family may have many questions about living with Alzheimer disease. You
can find information and support through the Alzheimer’s Association at www.alz.org.