The Different Stages of Alzheimer’s disease

The different stages of Alzheimer's

Alzheimer’s disease typically three general stages: mild, moderate and severe (also referred to as early, middle and late). As Alzheimer’s affects people in different ways, each person may progress through the stages differently and even experience different symptoms.

Although the rate at which Alzheimer’s disease progresses varies between different individuals, the symptoms of the disease tend to worsen over time. The changes in the brain related to Alzheimer’s start years before there are any signs or symptoms of the disease. This time period can last for years, and is referred to as ‘Preclinical Alzheimer’s disease’.

In this article, we will provide an idea of the changes individuals experience once symptoms appear.

It’s important to note that it may be difficult to place a person with Alzheimer’s into a specific stage as stages can overlap.

Early-stage Alzheimer’s disease

In the early stage of Alzheimer’s, a person may still be able to function independently. They may still drive, work and be part of social activities. Despite this, the person may feel as if they are having lapses in their memory, such as forgetting familiar locations of everyday objects, or familiar words.

During this stage, symptoms may not be apparent, but family and close friends may begin to notice some difficulties that their loved one may be experiencing. 

Some common difficulties include:

  • Being unable to articulate the right word or name. 
  • Unable to remember the names of new people. 
  • May have difficulty performing tasks in a social or work setting. 
  • Forgetting a conversation that has just been had.
  • Forgetting material that has just been read.
  • Losing or misplacing objects. 
  • Finding is more difficult to plan and organise. 

Middle-stage Alzheimer’s disease

Middle-stage Alzheimer’s is typically the longest stage of the disease and can last for many years. As the disease progresses, the person with Alzheimer’s will require a greater level of support and care.

During this stage of Alzheimer’s, symptoms of dementia become more pronounced. You may find that the person is confusing their words, becoming more frustrated and angry, and can even act in ways that are out of character. Due to the damage to the nerve cells in the brain, they may also find it difficult to express their thoughts and perform routine tasks without assistance.

Some common symptoms in this stage include (please be aware that symptoms vary from person to person):

  • Being forgetful of events.
  • Feeling moody or withdrawn, especially in challenging situations.
  • Unable to recall information about themselves like their telephone number, address or personal history. 
  • Frequently experiencing confusion about where they are or what day it is.
  • Trouble controlling their bladder and bowels.
  • Changes in sleep patterns; sleeping during the day and restless at night.
  • A growing tendency to wander off and becoming lost.
  • Personality and behavioural changes, including delusions and suspiciousness 
  • Compulsive and/or repetitive behaviour like hand-wringing.

During this stage, the person living with Alzheimer’s will still be able to participate in daily activities as long as assistance is provided. Find out what the person is still able to do and also consider simplifying tasks.

The need for more intensive care will increase during this stage, therefore caregivers may want to consider seeking support/respite from specialists so that they can have a break from caregiving and avoid caregiver stress and burnout.

Late-stage Alzheimer’s disease

In the final stage of the disease, symptoms of dementia are severe. Individuals lose the ability to respond to their environment, to engage in conversation and, eventually, to control movement. They may still say words or phrases, but communicating pain becomes difficult for them.

As memory and cognitive skills continue to worsen, significant personality changes may take place and individuals need extensive care.

During this stage, individuals may:

  • Require constant assistance with daily personal care.
  • ?Lose awareness of their surroundings.
  • Forget recent experiences.
  • Experience changes in their physical abilities, including walking, sitting and swallowing.
  • Have difficulty communicating.
  • Become more vulnerable to infections, especially pneumonia.

Although the person living with Alzheimer’s may not be able to initiate engagement as much during the late stage, they can still benefit from interaction such as listening to relaxing music or if appropriate, receiving reassurance through gentle touch from a loved one.

Contact us today if you have any questions or concerns, or if you would like to speak to a specialist neurologist. We offer a multidisciplinary approach to treat all the variety of symptoms of AD.