Alzheimer’s Disease Stages
Learning that you have Alzheimer’s disease changes your life, but not all at once. It progresses slowly over several years, in three general stages – mild, then moderate, and, finally, severe. If you act early, you can have better quality of life in each stage and plan for the changes to come.
The most common early symptom is trouble recalling something you just learned. In this early stage, you may also notice it’s a little harder to remember other things, make decisions, and find your way around new places. Other people may not notice your symptoms at first.
You may find that you:
Forget where you put everyday things
Have trouble with complex tasks, like paying bills or planning a party
Have trouble coming up with the right words sometimes
Feel less social or moody
lf you haven’t already seen a doctor about symptoms like these, do it now. If it is Alzheimer?s, your doctor can prescribe medication to improve your memory and thinking.
Mild Alzheimer’s can last for years. You may be able to live on your own throughout, but you’ll need a good support system. Lean on your family and friends or get advice from your doctor or local Alzheimer’s group on how to get help with shopping, meals, and getting out and about. This is also a good time for you to decide how you want to be cared for as the disease progresses.
To make daily life easier, try these tips:
Always carry a notebook, where you can write down important information such as names, phone numbers, appointments, and your address.
Make “to do” lists, leave yourself reminder notes, and label cupboards with words or pictures to remind you what’s inside.
Have someone call to remind you of things like meal and medication times and to go with you when you go out.
Join a support group. You can talk about how Alzheimer’s affects your life and learn how other people are dealing with it.
Exercise, limit alcohol, and stay involved in activities you enjoy.
This is the longest stage of Alzheimer’s. It can last many years – it?s different from person to person. As your Alzheimer’s evolves, your memory will get worse. You’ll have more trouble with language and thinking clearly. You may:
Not always know family and friends
Lose track of the day of the week or where you are
Forget details in your life, like your address, phone number, or where you went to high school or college
Have trouble putting clothes on in the right order or picking the right clothes, and later bathing and using the toilet
Have poor judgment about your health, finances, or safety
Your personality may also change during this stage. You may:
See or hear things that aren’t there
Suspect people of lying, cheating, or stealing from you
Be depressed or anxious
Become angry or violent
When your Alzheimer’s is moderate, you’ll probably need to live with family or in a residential care setting, or have a trained caregiver in your home. You may need help to get dressed, take your medicines safely, and manage your finances. It may be unsafe for you to use the kitchen and be alone. Your doctor may change your current medication and suggest drug or non-drug ways to deal with personality changes.
Frontotemporal Dementia Signs and Symptoms
In the past, patients with frontotemporal dementia (FTD) often were misdiagnosed with depression, schizophrenia or Alzheimer’s disease. Because some FTD cases still may be misidentified, doctors at the UCSF Center for Memory and Aging say it’s difficult to determine the prevalence of the disorder but they believe FTD is the most common dementia diagnosed in patients under age 60 and is as common as Alzheimer’s disease among patients age 45 to 64.
Early symptoms typically involve personality or mood changes such as depression and withdrawal, sometimes obsessive behavior and language difficulties. Many patients lose their inhibitions and exhibit antisocial behavior.
Doctors at UCSF have identified a small group of patients who develop extraordinary visual or musical creativity, while experiencing language and social impairment.
As FTD progresses, it takes a toll on mental abilities, affecting memory and other functions that are more common in Alzheimer’s disease and other dementias. In Alzheimer’s, one of the first symptoms is memory loss. With FTD, unusual or antisocial behavior as well as loss of speech or language are usually the first symptoms.
In later stages, patients develop movement disorders such as unsteadiness, rigidity, slowness, twitches, muscle weakness or difficulty swallowing. Some patients develop Lou Gherig’s disease or amyotrophic lateral sclerosis (ALS). People in the final stages of FTD cannot care for themselves.
Early signs of frontotemporal dementia may involve the following symptoms:
Apathy or an unwillingness to talk
Change in personality and mood, such as depression
Lack of inhibition or lack of social tact
Obsessive or repetitive behavior, such as compulsively shaving or collecting items
Unusual verbal, physical or sexual behavior
Weight gain due to dramatic overeating (Read more about FTD and binge eating.)
Patients may neglect hygiene and resist encouragement to attend to themselves. They also may lack awareness or concern that their behavior has changed.
At the UCSF Memory and Aging Center, doctors have found a small group of FTD patients who develop new creative skills in music and art. The artistic talents developed when brain cell loss occurred predominantly in the left frontal lobe, which controls functions such as language. It is believed that the right side of the brain regulates more abstract reasoning.
Mild cognitive impairment
Mild cognitive impairment is a notable change in thinking skills that’s limited, for the most part, to a narrow set of problems, such as impairment only in memory. Changes in concentration, attention or mental quickness may also be observed. Mild cognitive impairment generally doesn’t prevent a person from carrying out everyday tasks and being socially engaged.
Researchers and physicians are still learning much about mild cognitive impairment. For many people, the condition eventually progresses to Alzheimer’s disease or another disorder causing dementia.
Other people experience little progression in memory loss, and they don’t develop the whole spectrum of symptoms associated with dementia.
In late-stage Alzheimer’s, you may no longer be aware of where you are or remember your life history. Your physical abilities are also affected, and you may not be able to carry out simple tasks. You may:
Be unable to speak more than a half dozen words
Need help walking and later be unable to sit up, smile, or hold up your head
Have trouble controlling your bowels or bladder
Wander and get lost
Know familiar faces but have trouble remembering their names
Have more personality changes
Have habits like wringing your hands or shredding tissues
When Alzheimer’s is most severe, your brain seems unable to tell your body what to do. You may sit on the toilet, forgetting what to do there, or hold food in your mouth, not remembering how to swallow. As your body shuts down, you may spend most or all of your time in bed.
When your Alzheimer’s is severe, you will need a great deal of help with daily activities and personal care. In order to get the care you need, you may need to live in an Alzheimer’s care setting. Hospice care can keep you comfortable in the final months of the disease.
How Alzheimer’s Stages Vary
This is how Alzheimer’s generally evolves, but your disease may progress differently. Changes in your abilities may come on slower or faster than another person’s. People with Alzheimer’s live an average of about 8 years after their symptoms are noticeable. Depending on your age and health, you could live as long as 20 years.
U.S. National Library of Medicine