Stage : Moderate Cognitive Declinemild Dementia
The diagnosis of Alzheimers disease can be made with considerable accuracy in this stage. The most common functioning deficit in these persons is a decreased ability to manage instrumental activities of daily life, which may hinder their ability to live independently. For the stage 4 person, this may become evident in the form of difficulties in paying rent and other bills, not being able to write out checks with the correct date or amount without assistance the inability to market for personal items and groceries or order from a menu in a restaurant. Persons who previously prepared meals for family members and/or guests begin to manifest decreased performance in these skills.
Symptoms of memory loss also become evident in this stage. For example, seemingly major recent events, such as a holiday or visit with a relative may not be remembered. Obvious mistakes in remembering the day of the week, month or season of the year may occur.
Persons at this stage can still generally recall their correct current address they can usually correctly remember the weather conditions outside. Significant current events, including the name of a prominent head of state, will likely be recalled easily. Despite the obvious deficits in cognition, persons at this stage can still potentially survive independently in community settings.
Stage : Severe Cognitive Declinemoderately Severe Dementia
At this stage, the ability to perform basic activities of daily life becomes compromised. Functionally, five successive substages are identifiable. Persons initially in stage 6a, in addition to having lost the ability to choose their clothing without assistance, begin to require assistance in putting on their clothing properly. Unless supervised, the person with Alzheimers disease may put their clothing on backward, they may have difficulty putting their arm in the correct sleeve, or they may dress in the wrong sequence.
The total duration of the stage of moderately severe Alzheimers disease is approximately 2.5 years in otherwise healthy persons.
At approximately the same point in the evolution of AD, but generally just a little later in the temporal sequence, AD persons lose the ability to bathe without assistance . Characteristically, the earliest and most common deficit in bathing is difficulty adjusting the temperature of the bath water. Once the caregiver adjusts the temperature of the bath water, the AD person can still potentially otherwise bathe independently. As this stage evolves, additional deficits occur in bathing and dressing independently. In this 6b substage, AD persons generally develop deficits in other modalities of daily hygiene such as properly brushing their teeth.
Stages 6c, 6d, 6e
How Is Alzheimers Disease Treated
Medical management can improve quality of life for individuals living with Alzheimers disease and for their caregivers. There is currently no known cure for Alzheimers disease. Treatment addresses several areas:
- Helping people maintain brain health.
- Managing behavioral symptoms.
- Slowing or delaying symptoms of the disease.
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Difficulty Finding The Right Words
Another early symptom of dementia is difficulty with communicating thoughts. A person with dementia may have a hard time explaining something or finding the right words to express themselves. They may also stop in the middle of a sentence and not know how to continue.
Having a conversation with a person who has dementia can be challenging, and it may take longer than usual for them to express their thoughts or feelings.
Stage : Moderately Severe Cognitive Declinemoderate Dementia
In this stage, deficits are of sufficient magnitude as to prevent catastrophe-free, independent community survival. The characteristic functional change in this stage is early deficits in basic activities of daily life. This is manifest in a decrement in the ability to choose the proper clothing to wear for the weather conditions or for everyday circumstances. Some persons with Alzheimers disease begin to wear the same clothing day after day unless reminded to change. The mean duration of this stage is 1.5 years.
The person with Alzheimers disease can no longer manage on their own. There is generally someone who is assisting in providing adequate and proper food, as well as assuring that the rent and utilities are paid and the finances are taken care of. For those who are not properly supervised, predatory strangers may become a problem. Very common reactions for persons at this stage who are not given adequate support are behavioral problems such as anger and suspiciousness.
Cognitively, persons at this stage frequently cannot recall major events and aspects of their current life such as the name of the current head of state, the weather conditions of the day, or their correct current address. Characteristically, some of these important aspects of current life are recalled, but not others. Also, the information is loosely held, so, for example, the person with moderate Alzheimers disease may recall their correct address on certain occasions, but not others.
What Are The Signs Of Alzheimer’s Disease
Scientists continue to unravel the complex brain changes involved in the onset and progression of Alzheimers disease. It seems likely that damage to the brain starts a decade or more before memory and other cognitive problems appear. During this preclinical stage of Alzheimers disease, people seem to be symptom-free, but toxic changes are taking place in the brain.
Damage occurring in the brain of someone with Alzheimers disease begins to show itself in very early clinical signs and symptoms. For most people with Alzheimersthose who have the late-onset varietysymptoms first appear in their mid-60s. Signs of early-onset Alzheimers begin between a persons 30s and mid-60s.
The first symptoms of Alzheimers vary from person to person. Memory problems are typically one of the first signs of cognitive impairment related to Alzheimers disease. Decline in non-memory aspects of cognition, such as word-finding, vision/spatial issues, and impaired reasoning or judgment, may also signal the very early stages of Alzheimers disease. And some people may be diagnosed with mild cognitive impairment. As the disease progresses, people experience greater memory loss and other cognitive difficulties.
Alzheimers disease progresses in several stages: preclinical, mild , moderate, and severe .
Preclinical Alzheimers Or No Impairment
You may only know about your risk of Alzheimers disease due to your family history. Or a doctor may identify biomarkers that indicate your risk.
If youre at risk of Alzheimers, a doctor will interview you about memory difficulties. However, there will be no noticeable symptoms during the first stage, which can last for years or decades.
Abnormal accumulation of a type of protein called tau in the fluid around your brain and spinal cord is associated with the development of Alzheimers disease. Changes in the levels of this protein can occur about 15 years before symptoms start.
Caregiver support: Someone in this stage is fully independent. They may not even know they have the disease.
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Mild Alzheimers Or Moderate Decline
Stage 4 lasts about 2 years and marks the beginning of diagnosable Alzheimers disease. You or your loved one will have more trouble with complex but everyday tasks. Mood changes such as withdrawal and denial are more evident. Decreased emotional response is also frequent, especially in challenging situations.
New symptoms of decline that appear in stage 4 may include:
- losing memory of personal history
- trouble with handling finances and bills
- inability to count backward from 100 by 7s
A clinician will also look for a decline in areas mentioned in stage 3, but there will often have been no change since then.
Caregiver support: Itll still be possible for someone to recall weather conditions, important events, and addresses. But they may ask for help with other tasks such as writing checks, ordering food, and buying groceries.
Preparing For Early Onset Ad
Receiving an early onset AD diagnosis can be worrying. Now is the time to put together a plan so that you have peace of mind for the future when symptoms appear or intensify.
Try creating a plan together with your family, friends, and medical team. It can also be beneficial to meet with a financial planner and a lawyer.
Here are some key things to consider:
- Education. You may find it helpful to learn more about AD and how it progresses. Talk with your doctor and learn about what your care plan could look like in the future.
- Health insurance. Find out which medications and treatments are covered by your plan.
- Future care costs. What will your medical and care expenses be? This may include professional home care of safety equipment for the home.
- Disability insurance. What is covered by your employer? What documentation is needed?
- Loss of income. Will you be able to keep working? If so, for how long? Will someone in your family need to stop working in order to become a caregiver?
- Power of attorney. Who will have the authority to make health, financial, and legal decisions for you when you cant any more?
- Support. Try finding a support group specifically for people with early onset AD and their caregivers. Their life situations are likely to be more similar to yours.
Its important to have a detailed, realistic plan for your future care. This will allow you to be more confident as you navigate through the stages of AD.
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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
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:
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:
Signs Of Mild Alzheimers Disease
In mild Alzheimers disease, a person may seem to be healthy but has more and more trouble making sense of the world around him or her. The realization that something is wrong often comes gradually to the person and his or her family. Problems can include:
- Poor judgment leading to bad decisions
- Loss of spontaneity and sense of initiative
- Taking longer to complete normal daily tasks
- Repeating questions
- Increased sleeping
- Loss of bowel and bladder control
A common cause of death for people with Alzheimers disease is aspiration pneumonia. This type of pneumonia develops when a person cannot swallow properly and takes food or liquids into the lungs instead of air.
There is currently no cure for Alzheimers, though there are medicines that can treat the symptoms of the disease.
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Key Points About Early
Alzheimer disease commonly affects older people, but early-onset Alzheimer disease can affect people in their 30s or 40s.
It affects memory, thinking, and behavior.
Although there is no known cure, early diagnosis and treatment can lead to better quality of life.
Stay healthy with a good diet and regular exercise.
Avoid alcohol and other substances that may affect memory, thinking, and behavior.
Dementia Stages: How Fast Dementia Progresses Stages Of Dementia And More
Dementia is a progressive impairment of cognitive function caused by damage to the brain. Over time, a person with dementia will have increased difficulty with memory, understanding, communication, and reasoning.
Healthcare providers frequently speak about a persons dementia in terms of stages. This can be helpful for communicating with family or other healthcare providers regarding the persons illness, and it is important for determining an appropriate care plan.
How Fast Does Dementia Progress?
It is important to note that dementia progresses at different speeds for every person, and for different types of dementia. The most well-known form of dementia, Alzheimers disease, is just one specific type of dementia, and tends to have the slowest progression of all types. Some factors that affect the rate of progression include:
- Repeated infections
What are the Stages of Dementia?
There are a few different systems used to grade dementia — at the most basic there is early, moderate, and end. Many providers use the system developed by Dr. Barry Reisberg of New York University which includes 7 stages. The Reisberg scale is also known as the GDS or Global Deterioration Scale for Assessment of Primary Degenerative Dementia. This scale focuses primarily on cognitive abilities.
Dementia Stages in the Reisberg Scale
Dementia Stages in the FAST Scale
Dementia Stages in the CDR Scale
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Very Mild Impairment Or Common Forgetfulness
Alzheimers disease mainly affects older adults over the age of 65. At this age, its common to have slight functional difficulties such as forgetfulness.
But for people with stage 2 Alzheimers, this decline will happen more quickly than it will for similarly aged people without Alzheimers. For example, a person may forget familiar words, a family members name, or where they placed something.
Caregiver support: Symptoms at stage 2 wont interfere with work or social activities. Memory troubles are still very mild and may not be apparent to friends and family.
Stage : Moderately Severe Decline
During the fifth stage of Alzheimers, people begin to need help with many day-to-day activities. People in stage five of the disease may experience:
- Difficulty dressing appropriately
- Inability to recall simple details about themselves such as their own phone number
- Significant confusion
On the other hand, people in stage five maintain functionality. They typically can still bathe and toilet independently. They also usually still know their family members and some detail about their personal histories, especially their childhood and youth.
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Stage : Subjective Memory Lossage Related Forgetfulness
Many people over the age of 65 complain of cognitive and/or functional difficulties. Elderly persons with these symptoms report that they can no longer remember names as easily as they could 5 or 10 years previously they can also have trouble recalling where they have recently placed things.
Various terms have been suggested for this condition, but subjective cognitive decline is presently the widely accepted terminology. These symptoms by definition, are not notable to intimates or other external observers of the person with subjective cognitive decline. Persons with these symptoms decline at higher rates than similarly aged persons and similarly healthy persons who are free of subjective complaints. Research has shown that this stage of subjective cognitive decline lasts 15 years in otherwise healthy persons.
What Causes Dementia
In essence, dementia is caused by damage to the nerve cells in your brain.
But dementia is not one single condition. Its essentially an umbrella term that covers a wide range of cognitive disorders. This includes Alzheimers disease, which accounts for 60 to 80 percent of cases, according to the Alzheimers Association.
Damage to nerve cells in the brain can have many causes, including but not limited to:
- the accumulation of specific types of proteins in the brain
- lack of blood flow to the brain
- trauma to the head
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When To See A Gp
If you’re worried about your memory or think you may have dementia, it’s a good idea to see a GP.
If you’re worried about someone else’s memory problems, encourage them to make an appointment and perhaps suggest that you go along with them.
Memory problems are not just caused by dementia they can also be caused by depression, stress, medicines or other health problems.
A GP can carry out some simple checks to try to find out what the cause may be, and they can refer you to a specialist for more tests if necessary.
Read more about diagnosing Alzheimer’s disease.
Page last reviewed: 05 July 2021 Next review due: 05 July 2024
Symptoms Of Mild Cognitive Impairment
Some people have a condition called mild cognitive impairment, or MCI. It can be an early sign of Alzheimers. But, not everyone with MCI will develop Alzheimers disease. People with MCI can still take care of themselves and do their normal activities. MCI memory problems may include:
- Losing things often
- Forgetting to go to events or appointments
- Having more trouble coming up with words than other people the same age
Learn more about Alzheimer’s disease from MedlinePlus.
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Misplacing Things And Losing The Ability To Retrace Steps
People with Alzheimer’s may put things in unusual places like sticking a phone in the microwave, or car keys in the bathroom cabinet. They may accuse others of stealing because they can’t remember that they were the one who misplaced the item.
If things start disappearing or things start popping up in odd places and your loved one doesn’t have a toddler or dog in the house, there may be cause for concern.
New Problems With Speaking Writing Or Understanding Words
We all have times where we’re searching for the right word. Hence the phrase, “It’s on the tip of my tongue.”
But a person with Alzheimer’s will likely have trouble following or joining a conversation, and struggle with vocabulary, such as finding words or calling things or people by the wrong name. They also tend to repeat themselves without being aware of it.
It may also be increasingly difficult to follow along with books, movies or TV shows, especially when they are long or complex.
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