Alzheimer's Disease

• Alzheimer's is the most common form of dementia, a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. Alzheimer's disease accounts for 50 to 80 percent of dementia cases.
• Alzheimer's is not a normal part of aging, although the greatest known risk factor is increasing age, and the majority of people with Alzheimer's are 65 and older. But Alzheimer's is not just a disease of old age. Up to 5 percent of people with the disease have early onset Alzheimer's (also known as younger-onset), which often appears when someone is in their 40s or 50s.
• Alzheimer's worsens over time. Alzheimer's is a progressive disease, where dementia symptoms gradually worsen over a number of years. In its early stages, memory loss is mild, but with late-stage Alzheimer's, individuals lose the ability to carry on a conversation and respond to their environment. Alzheimer's is the sixth leading cause of death in the United States. Those with Alzheimer's live an average of eight years after their symptoms become noticeable to others, but survival can range from four to 20 years, depending on age and other health conditions.
• Alzheimer's has no current cure, but treatments for symptoms are available and research continues. Although current Alzheimer's treatments cannot stop Alzheimer's from progressing, they can temporarily slow the worsening of dementia symptoms and improve quality of life for those with Alzheimer's and their caregivers. Today, there is a worldwide effort under way to find better ways to treat the disease, delay its onset, and prevent it from developing.  

Alzheimer's Association

Not everyone will experience the same symptoms or progress at the same rate. This seven-stage framework is based on a system developed by Barry Reisberg, M.D., clinical director of the New York School of Medicine's Silberstein Aging and Dementia Research Center.

Stage 1:   No impairment (normal function). The person does not experience any memory problems. An interview with a medical professional does not show any evidence of symptoms of dementia.

Stage 2:  Very mild cognitive decline (may be normal age-related changes or earliest signs of Alzheimer's disease). The person may feel as if he or she is having memory lapses - forgetting familiar words or he location of everyday objects but no symptoms of dementia can be detected during a medical examination or by friends, family or co-workers.

Stage 3:  Mild cognitive decline (early-stage Alzheimer's can be diagnosed in some, but not all, individuals with these symptoms). Friends, family or co-workers begin to notice difficulties. During a detailed medical interviews doctors may be able to detect problems in memory or concentration. Common stage 3 difficulties include:

• Noticeable problems coming up with the right word or name
• Trouble remembering names when introduced to new people
• Having noticeably greater difficulty performing tasks in social or work settings, forgetting material that has just been read
• Losing or misplacing a valuable object
• increasing trouble with planning or organizing

Stage 4:  Moderate cognitive decline (Mild or Early-stage Alzheimer's disease). At this point a careful medical interview should be able to detect clear-cut symptoms in several areas:

• Forgetfulness of recent events
• Impaired ability to perform challenging mental arithmetic - for example counting backward from 100 x 7s
• Greater difficulty performing complex tasks such as planning dinner for guests, paying bills or managing finances
• Forgetfulness about one's own personal history
• Becoming moody or withdrawn, especially in socially or mentally challenging situations.

Stage 5:  Moderately severe cognitive decline (Moderate or Mid-stage Alzheimer's disease). Gaps in memory and thinking are noticeable and individuals begin to need help with day-to-day activities. At this stage those with Alzheimer's may:

• Be unable to recall their own address or telephone number or the high school or college from which they graduated
• Become confused about where they are or what day it is
• Have trouble with less challenging mental arithmetic such as counting backward from 40 by 4s or from 20 by 2s
• Need help choosing proper clothing for the season or the occasion
• Still remember significant details about themselves and their family
• Still require no assistance with eating or using the toilet

Stage 6:  Severe cognitive decline (Moderately severe or Mid-stage Alzheimer's). Memory continues to worsen, personality changes may take place and individuals need extensive help with daily activities. At this stage individuals may:

• Lose awareness of recent experiences as well as of their surroundings
• Remember their own name but have difficulty with their personal history
• Distinguish familiar and unfamiliar faces but have trouble remembering the name of a spouse or caregiver
• Need help dressing properly and may, without supervision, make mistakes such as putting pajamas over daytime clothes or shoes on the wrong feet
• Experience major changes in sleep patterns - sleeping during the day and becoming restless at night
• Need help handling details of toileting (for example, flushing the toilet, wiping or disposing of tissue properly)
• Have increasingly frequent trouble controlling their bladder or bowels
• Experience major personality and behavioral changes, including suspiciousness and delusions (such as believing that their caregiver in an impostor) or compulsive, repetitive behavior like hand-wringing or tissue shredding
• Tend to wander or become lost

Stage 7:  Very severe cognitive decline (Severe or Late-stage Alzheimer's disease). In the final stage of this disease, individuals lose the ability to respond to their environment, to carry on a conversation, and eventually to control movement. They may still say words or phrases. 

At this stage indivuals need help with much of their daily personal care including eating or using the toilet. They may also lost the ability to smile, to sit without support and to hold their heads up. Reflexes become abnormal. Muscles grow rigid and swallowing is impaired.

REMEMBER: It is difficult to place a person with Alzheimer's in a specific stage as stages may overlap.

 Alzheimers.net

The Alzheimer's Association 24/7 Helpline provides reliable information and support to all those who need assistance. Call us toll-free anytime day or night at 1.800.272.3900.

Our 24/7 Helpline serves people with memory loss, caregivers, health care professionals and the public.

Our highly trained and knowledgeable staff can help you with:

• Understanding memory loss, dementia and Alzheimer's
• Medications and other treatment options
• General information about aging and brain health
• Skills to provide quality care and to find the best care from professionals
• Legal, financial and living-arrangement decisions

Alzheimer's Association