Stages of Alzheimer Disease

Alzheimer disease is a brain disorder that causes memory loss, confusion, and changes in personality, and gradual loss of independence. It is a type 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 usually 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 8 years after their symptoms appear. But the disease can progress quickly in some people and slowly in others. Some people live as long as 20 years with the disease.

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 his or her 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:

• Remembering a name

• Recalling recent events

• Remembering where he or she put a valuable object

• Making plans

• Staying organized

• Managing money

The person may be aware of memory lapses and their friends, family or neighbors may also notice these difficulties. 

Moderate, middle stage

This is typically the longest stage, usually lasting many years.  At this stage, symptoms include:

• Increasing trouble remembering events

• Problems learning new things

• Trouble with planning complicated events, like a dinner

• Trouble remembering their own name, but not details about their own life, such as address and phone number

• Problems with reading, writing, and working with numbers

As the disease progresses, the person may:

• Know that some people are familiar, but not remember their names, or forget the names of a spouse or child

• Lose track of time and place

• Need help choosing the right clothing, getting dressed, and with daily activities, such as brushing teeth

• Become moody or withdrawn, or have personality changes, such as hallucinations, paranoia, or delusions  

• 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:

• Loses many physical abilities, including walking, sitting, eating.

• May lose bowel and bladder control

• May be able to say some words or phrases, but not have a conversation

• Needs help with all activities all of the time

• Is unaware of recent experiences and of his or her surroundings

• 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 feelings of 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 recommend a healthy, active lifestyle as the best way to protect your brain’s health.

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.