What Does Progression In Stages Mean
There are many different types of dementia and all of them are progressive. This means symptoms may be relatively mild at first but they get worse with time, usually over several years. These include problems with memory, thinking, problem-solving or language, and often changes in emotions, perception or behaviour.
As dementia progresses, a person will need more help and, at some point, will need a lot of support with daily living. However, dementia is different for everyone, so it will vary how soon this happens and the type of support needed.
It can be helpful to think of dementia progressing in three stages:
These are sometimes called mild, moderate and severe, because this describes how much the symptoms affect a person.
These stages can be used to understand how dementia is likely to change over time, and to help people prepare for the future. The stages also act as a guide to when certain treatments, such as medicines for Alzheimers disease, are likely to work best.
How Can You Help Your Loved One With Alzheimer’s Disease
If you are or will be taking care of a loved one with Alzheimer’s, start learning what you can expect. This can help you make the most of the person’s abilities as they change. And it can help you deal with new problems as they arise.
Work with your loved one to make decisions about the future before the disease gets worse. It’s important to write a living will and a durable power of attorney.
Your loved one will need more and more care as the disease gets worse. You may be able to give this care at home. Or you may want to think about using assisted living or a nursing home.
Ask your doctor about local resources such as support groups or other groups that can help as you care for your loved one. You can also search the Internet for online support groups. Help is available.
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:
- Memory loss
- 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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What Causes Alzheimer’s Disease
Alzheimer’s disease happens because of changes in the brain. Some of the symptoms may be related to a loss of chemical messengers in the brain, called neurotransmitters, that allow nerve cells in the brain to communicate properly.
People with Alzheimer’s disease have two things in the brain that are not normal: amyloid plaques and neurofibrillary tangles. Experts don’t know if amyloid plaques and neurofibrillary tangles are side effects of Alzheimer’s disease or part of the cause.
How Is Alzheimer’s Disease Diagnosed And Evaluated
No single test can determine whether a person has Alzheimer’s disease. A diagnosis is made by determining the presence of certain symptoms and ruling out other causes of dementia. This involves a careful medical evaluation, including a thorough medical history, mental status testing, a physical and neurological exam, blood tests and brain imaging exams, including:
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Beyond Memory Loss: How To Handle The Other Symptoms Of Alzheimer’s
There is a lot of talk about the emotional pain patients and caregivers suffer when a loved one loses memories to Alzheimers. But what about the other symptoms? Here are tips from a Johns Hopkins expert on what to watch for and how to manage.
#TomorrowsDiscoveries: From Dysfunctional Cells to Disease Dr. Rong Li
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.
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Are There Limitations To The New Research
The study focused mainly on the replication of tau. It did not explore other pathologies that cause Alzheimers. Additionally, it did not explore the very early stages of the disease.
While the findings are relevant for developing new treatments, theyre not necessarily relevant for developing preventive approaches, according to Knowles.
We cannot exclude that spreading might be relevant at the very early stages of the disease, and are actively working to investigate this issue, Knowles said.
How Important Are The Stages Of Dementia
The stages of dementia are just a guide and there is nothing significant about the number three. Equally, dementia doesnt follow an exact or certain set of steps that happen in the same way for every person with dementia.
It can be difficult to tell when a persons dementia has progressed from one stage to another because:
- some symptoms may appear in a different order to the stages described in this factsheet, or not at all
- the stages may overlap the person may need help with some aspects of everyday life but manage other tasks and activities on their own
- some symptoms, particularly those linked to behaviours, may develop at one stage and then reduce or even disappear later on. Other symptoms, such as memory loss and problems with language and thinking, tend to stay and get worse with time.
It is natural to ask which stage a person is at or what might happen next. But it is more important to focus on the person in the present moment. This includes their needs and how they can live well, and how to help them with this.
For more support on living well with dementia see The dementia guide: living well after diagnosis or Caring for a person with dementia: a practical guide .
And for more information about treatment and support for the different types of dementia go to the following pages:
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Stage : Mild Cognitive Impairment
Clear cognitive problems begin to manifest in stage 3. A few signs of stage 3 dementia include:
- Getting lost easily
- Noticeably poor performance at work
- Forgetting the names of family members and close friends
- Difficulty retaining information read in a book or passage
- Losing or misplacing important objects
- Difficulty concentrating
Patients often start to experience mild to moderate anxiety as these symptoms increasingly interfere with day to day life. Patients who may be in this stage of dementia are encouraged to have a clinical interview with a clinician for proper diagnosis.
What Affects The Speed Of Progression
The speed at which dementia progresses varies a lot from person to person because of factors such as:
- the type of dementia for example, Alzheimers disease tends to progress more slowly than the other types
- a persons age for example, Alzheimers disease generally progresses more slowly in older people than in younger people
- other long-term health problems dementia tends to progress more quickly if the person is living with other conditions, such as heart disease, diabetes or high blood pressure, particularly if these are not well managed
- delirium a medical condition that starts suddenly .
There is no way to be sure how quickly a persons dementia will progress. Some people with dementia will need support very soon after their diagnosis. In contrast, others will stay independent for several years.
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How Long Can A Person Live With Alzheimers Disease
The time from diagnosis to death varies as little as three or four years if the person is older than 80 when diagnosed, to as long as 10 or more years if the person is younger.
Alzheimers disease is currently ranked as the sixth leading cause of death in the United States, but recent estimates indicate that the disorder may rank third, just behind heart disease and cancer, as a cause of death for older people.
Currently, there is no cure for Alzheimers disease, though there has been significant progress in recent years in developing and testing new treatments. Several medicines have been approved by the U.S. Food and Drug Administration to treat people with Alzheimers.
Stage : Mild Cognitive Impairment Due To Alzheimers Disease
Although senior moments are common occurrences for most older adults, an individual with MCI will experience them at a slightly higher rate. MCI will cause an individual to forget things like familiar words, where they placed something or a family members name. They may have difficulty accurately judging the sequence, number of steps or the time required to complete a task. It becomes more difficult for them to make sound decisions.
Memory troubles are still mild enough that they may not be apparent to the individuals family and friends. Additionally, symptoms at this stage typically dont cause problems at work or in relationships.
Not everyone who has MCI has Alzheimers disease. Based on a review of symptoms, a medical professional can diagnose MCI. The same procedures used to diagnose preclinical Alzheimers disease can be used to determine if the MCI is caused by Alzheimers disease or something else.
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Caring For Someone With Alzheimers Disease
Alzheimerâs disease is called a family disease, because the chronic stress of watching a loved one slowly decline affects everyone. An effective treatment will address the needs of the entire family. Caregivers must focus on their own needs, take time for their own health, and get support and respite from caregiving regularly to be able to sustain their well-being during this caregiving journey. Emotional and practical support, counseling, resource information, and educational programs about Alzheimerâs disease all help a caregiver provide the best possible care for a loved one.
Absolutely the easiest thing for someone to say and the hardest thing to accept is the advice to take care of yourself as a caregiver. As stated by one caregiver, âThe care you give to yourself is the care you give to your loved one.â It is often hard to see beyond the care tasks that await you each morning.
Through training, caregivers can learn how to manage challenging behaviors, improve communication skills, and keep the person with Alzheimerâs safe. Research shows that caregivers experience lower stress and better health when they learn skills through caregiver training and participate in a support group . Participation in these groups can allow caregivers to care for their loved one at home longer.
Now it is time to take action, and take stock of the people, services, and information that will help you provide care. The earlier you get support, the better.
Slowing The Progression Of Symptoms
The same healthy lifestyle changes that are used to prevent Alzheimers disease can also be useful in slowing the advancement of symptoms.
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Stage : Moderate Decline
During this period, the problems in thinking and reasoning that you noticed in stage 3 get more obvious, and new issues appear. Your friend or family member might:
- Forget details about themselves
- Have trouble putting the right date and amount on a check
- Forget what month or season it is
- Have trouble cooking meals or even ordering from a menu
- Struggle to use the telephone
- Not understand what is said to them
- Struggle to do tasks with multiple steps like cleaning the house.
You can help with everyday chores and their safety. Make sure they aren’t driving anymore, and that no one tries to take advantage of them financially.
Scientists Discover New Alzheimers Progression
When old, worn-out parts are in the cell, the lysosome forms a membrane bubble around them. The lysosome then breaks these large parts down into small molecules that are small enough to be transported through the cells membrane to be recycled.
Scientists at Linköping University, in Sweden, have discovered that this recycling does, in fact, have an impact on the symptoms of Alzheimers in the brain. A recent study showed that exosomes are a part of this recycling and removal system and that they both carry beta-amyloid and spread toxic proteins to brain cells.
The spread of the disease follows the way in which parts of the brain are anatomically connected. It seems reasonable to assume that the disease is spread through the connections in the brain and there has long been speculation about how this spread takes place at the cellular level, states Associate Professor, Martin Hallbeck, in the Department of Clinical and Experimental Medicine at Linköping University.
Scientists in the study examined the exosomes collected from the brain tissue of deceased persons. The research team found a much higher level of beta-amyloid in the exposomes from brains with Alzheimers than from the brain tissue of the control group the group without the disease.
More research is needed before the study findings can be put to practical use in developing new drugs or treatment modalities for people with Alzheimers, but it certainly opens the door to new possibilities.
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Stage : Severe Dementia Due To Alzheimers Disease
In the final stage of Alzheimers, mental functions continue to decline and the individual experiences difficulties with movement and physical abilities. They require assistance with most tasks. Many begin to sleep through most of the day and wander at night, although some individuals seem to require very little sleep. As the disease progresses, the individual will spend the majority of their time in bed.
Individuals in this last stage of Alzheimers generally:
- Require assistance with most activities including eating, dressing, grooming, bathing and toileting
- Experience a loss of coherent speech. They come to the point where they can no longer carry on a conversation that makes sense. Eventually, they may not speak at all or may occasionally utter a word or phrase.
- Undergo an increasing decline in physical abilities. They become unable to walk without assistance, then to being unable to sit or hold up their head without support. Muscles can become rigid causing pain when moved. Many individuals with Alzheimers form contractures They develop infantile reflexes such as sucking and laying in a fetal position. They become totally incontinent and eventually lose the ability to swallow.
They may experience more personality and behavior changes including:
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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Stage 4 Late Confusional/mild Alzheimers Disease
Mathematical challenges can cause problems handling finances. Increasingly, the person will forget recent events and conversations, although most people in this stage still know themselves and their family.
Problems carrying out sequential tasks, including cooking, driving, ordering food at restaurants, and shopping are common. The person often withdraws from social situations, becomes defensive, and denies any problems.
Duration: roughly 2 years.
Stage : Mild Dementia
At this stage, individuals may start to become socially withdrawn and show changes in personality and mood. Denial of symptoms as a defense mechanism is commonly seen in stage 4. Behaviors to look for include:
- Difficulty remembering things about one’s personal history
- Difficulty recognizing faces and people
In stage 4 dementia, individuals have no trouble recognizing familiar faces or traveling to familiar locations. However, patients in this stage will often avoid challenging situations in order to hide symptoms or prevent stress or anxiety.
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