Personality Changes In The Moderate Stage
Perhaps the most noticeable changes in people with Alzheimers occur at the moderate stage and involve behavior and personality. Key behavioral signs of this stage include wandering, irritability, and aggression. In many cases, those with Alzheimers resist any attempt at caregiving or assistance and may feel that friends, family, or caregivers are stealing from them or trying to harm them. They may also see or hear things that are not there.
Alzheimers Affects Everyone Differently
Alzheimers is the disease of our time that most people fear as we age .
Rightly so, considering the progression between stages of Alzheimers is not linear.
Some caregivers report their loved ones seem to be in two stages at once, while others stagnate for years before progressing at a rapid rate without any warning signs.
But theres good news:
The fact that youre reading this article is amazing. With over half of adults unaware of the risks of dementia, you are doing your job in educating yourself.
Being proactive in knowing what to expect from each stage and getting help from loved ones makes it easier for both the person who lives with Alzheimers and those close to them.
While theres no way to pinpoint the exact experience and progression rate, learning how individuals respond to the different phases and stages of Alzheimers teaches you what symptoms might come next and prepares you and your loved ones as best you can for its challenges.
Like with any of lifes challenges, its worth preparing mentally, emotionally and physically for the stages of Alzheimers.
You and your loved ones will benefit greatly.
Stage : Severe Decline
People with the sixth stage of Alzheimers need constant supervision and frequently require professional care. Symptoms include:
- Confusion or unawareness of environment and surroundings
- Inability to recognize faces except for the closest friends and relatives
- Inability to remember most details of personal history
- Loss of bladder and bowel control
- Major personality changes and potential behavior problems
- The need for assistance with activities of daily living such as toileting and bathing
- Wandering
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What Are The Average Life Expectancy Figures For The Most Common Types Of Dementia
The average life expectancy figures for the most common types of dementia are as follows:
- Alzheimers disease around eight to 10 years. Life expectancy is less if the person is diagnosed in their 80s or 90s. A few people with Alzheimers live for longer, sometimes for 15 or even 20 years.
- Vascular dementia around five years. This is lower than the average for Alzheimers mostly because someone with vascular dementia is more likely to die from a stroke or heart attack than from the dementia itself.
- Dementia with Lewy bodies about six years. This is slightly less than the average for Alzheimers disease. The physical symptoms of DLB increase a persons risk of falls and infections.
- Frontotemporal dementia about six to eight years. If a person has FTD mixed with motor neurone disease a movement disorder, their dementia tends to progress much quicker. Life expectancy for people who have both conditions is on average about two to three years after diagnosis.
To find out about the support available to someone at the end of their life, and to their carers, family and friends, see our End of life care information.
You can also call Alzheimers Society on 0333 150 3456 for personalised advice and support on living well with dementia, at any stage.
Dementia Connect support line
Stage Four: Moderate Alzheimers And Dementia
When Alzheimers and dementia worsen, the individual’s ability to care for him or herself steadily declines, and they require help with daily activities. Capability continues to deteriorate, with significant changes to cognitive ability. Notably, it is at this point that Alzheimers disease affects long-term memory. People in this stage may even fail to recognize close relatives. Reading and writing skills slowly worsen, along with physical coordination, increasing the likelihood of falls.
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Caregiving During The Early Stages
During the early stages of dementia, patients typically experience very mild symptoms. Because most people continue to function independently, the symptoms may not even be noticeable in the very beginning.
As dementia progresses through the early stages, patients likely experience:
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Mild forgetfulness
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Difficulty staying on task and focusing
As a caregiver, you can simply provide support and companionship. You might also consider beginning to make plans for the future as the disease progresses.
Stages Of Disease Progression
Because the specific symptoms of Alzheimer’s can vary from person to person, and the disease progresses at different rates, doctors use a system of stages to help determine the level of impairment and need for further care.
Some experts label as many as seven different stages of Alzheimer’s disease, ranging from normal to very severe, often with overlapping symptoms that could make it difficult for the average person to distinguish one stage from another. Other experts break the progression of disease down into just three or four distinct stages.
Paul Rosenberg, MD, Associate Director of the Memory and Alzheimer’s Treatment Center at Johns Hopkins Bayview Medical Center, says it is much less confusing for family members to understand these four distinct stages, beginning with mild cognitive impairment, which may or may not indicate Alzheimer’s disease, followed by mild, moderate, and severe dementia, if Alzheimer’s disease is present.
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How Is Alzheimers Disease Diagnosed
Doctors use several methods and tools to help determine whether a person who is having memory problems has Alzheimers disease.
To diagnose Alzheimers, doctors may:
- Ask the person and a family member or friend questions about overall health, use of prescription and over-the-counter medicines, diet, past medical problems, ability to carry out daily activities, and changes in behavior and personality.
- Conduct tests of memory, problem solving, attention, counting, and language.
- Carry out standard medical tests, such as blood and urine tests, to identify other possible causes of the problem.
- Perform brain scans, such as computed tomography , magnetic resonance imaging , or positron emission tomography , to support an Alzheimers diagnosis or to rule out other possible causes for symptoms.
These tests may be repeated to give doctors information about how the persons memory and other cognitive functions are changing over time.
People with memory and thinking concerns should talk to their doctor to find out whether their symptoms are due to Alzheimers or another cause, such as stroke, tumor, Parkinsons disease, sleep disturbances, side effects of medication, an infection, or another type of dementia. Some of these conditions may be treatable and possibly reversible.
In addition, an early diagnosis provides people with more opportunities to participate in clinical trials or other research studies testing possible new treatments for Alzheimers.
Stage Two: Mild Cognitive Impairment Or Very Mild Decline
As the disease progresses, people with Alzheimers or those close to them may begin to notice mild changes in thinking ability and memory. This may manifest as memory lapses concerning recent events, appointments, or conversations. Other signs that a person is in this stage include forgetting the steps to a task or having difficulty judging how long something will take. While the symptoms are not severe enough to begin affecting daily life, they can be troubling.
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Changes In Mood Emotions And Perceptions
Changes in mood remain in the later stages of dementia. Depression and apathy are particularly common.
Delusions and hallucinations are most common in the late stage of dementia. They are not always distressing but they can explain some changes in behaviour because the persons perception of reality is altered.
People with later stage dementia often respond more to senses than words. They may like listening to songs or enjoy textures. For example, they may like the feel of different types of material.
Stage : Moderately Severe Cognitive Decline
Stage five marks the beginning of moderate dementia. Memory deficiencies are now becoming severe, and people often require assistance with daily living activities. An individual may start to need help with dressing and preparing meals. Some loved ones may choose to limit their assistance so that the individual still feels some degree of independence. For example, a loved one may lay out the individuals clothes for the day, but allow them to dress independently.
If the individual was previously living independently at home, this would have to change. At this stage, the person requires monitoring and can no longer live alone. If a person in stage five doesnt get the support they need from loved ones or hired help, they often develop behavioral problems such as anger and suspiciousness.
Some of the common symptoms in stage five are:
- Forgetting important information, such as a home address and phone number
- Difficulty identifying where they are or what time of day it is
- Forgetting significant life details, such as where they went to school
- Inability to remember significant current-day information, such as the name of the President
- Confusion about picking appropriate types of clothing for the season
- Repeating the same question
- Difficulty with simple arithmetic, such as counting down from 20 by twos
- Wearing the same clothes every day unless theyre reminded to change
Stage five typically lasts 1.5 years.
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How Quickly Does Dementia Usually Progress
There are 7 signs of dementia and each stage where signs present themselves can last for different lengths of time.
Symptoms could progress differently from patient to patient.
Once early dementia hits and loss of cognitive function becomes more noticeable, it becomes easier to identify how quickly dementia might progress.
The Progression And Stages Of Dementia
Dementia is progressive. This means symptoms may be relatively mild at first but they get worse with time. Dementia affects everyone differently, however it can be helpful to think of dementia progressing in ‘three stages’.
The progression and stages of dementia
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Third Dementia Stage: Mild Decline
Family and friends may start noticing some cognitive and memory problems from the patient at the third dementia stage. Performance on both cognitive and memory tests is affected, and physicians can instantly identify impaired cognitive function. Senior citizens at third stage of dementia showcase some symptoms that may include:
- Trouble remembering names of people they meet
- Organizing and planning
- Asking the same question repeatedly
- Losing personal possessions which might include valuables
It is possible that affected adults can begin to experience mild or moderate anxiety during the third stage of dementia, primarily because of the symptoms getting in the way of their everyday life. Should one notice any of the symptoms, it is imperative that the affected individuals go through a clinical interview with a licensed clinician to receive the proper diagnosis. It helps to start an appropriate medical course of action.
Caregivers should also note that it is essential that they try and get rid of any stress that may be affecting the patient. Let them understand what is going on in a kind and loving manner so that they can prepare to embrace the journey ahead. They can also help the patients with memory in some ways such as reminding them to pay their bills and getting them to any appointments they may have on time.
Stage : Very Severe Decline
Many basic abilities in a person with Alzheimer’s, such as eating, walking, and sitting up, fade during this period. You can stay involved by feeding your loved one with soft, easy-to-swallow food, helping them use a spoon, and making sure they drink. This is important, as many people at this stage can no longer tell when they’re thirsty.
In this stage, people with Alzheimer’s disease need a lot of help from caregivers. Many families find that, as much as they may want to, they can no longer take care of their loved one at home. If thatâs you, look into facilities such as nursing homes that provide professional care day and night.
When someone nears the end of their life, hospice may be a good option. That doesn’t necessarily mean moving them to another location. Hospice care can happen anywhere. Itâs a team approach that focuses on comfort, pain management and other medical needs, emotional concerns, and spiritual support for the person and their family.
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Stage : Age Associated Memory Impairment
This stage features occasional lapses of memory most frequently seen in:
- Forgetting where one has placed an object
- Forgetting names that were once very familiar
Oftentimes, this mild decline in memory is merely normal age-related cognitive decline, but it can also be one of the earliest signs of degenerative dementia. At this stage, signs are still virtually undetectable through clinical testing. Concern for early onset of dementia should arise with respect to other symptoms.
Icipating In Alzheimer’s Disease Clinical Trials
Everybody those with Alzheimers disease or MCI as well as healthy volunteers with or without a family history of Alzheimers may be able to take part in clinical trials and studies. Participants in Alzheimers clinical research help scientists learn how the brain changes in healthy aging and in Alzheimers. Currently, at least 270,000 volunteers are needed to participate in more than 250 active clinical trials and studies that are testing ways to understand, diagnose, treat, and prevent Alzheimers disease.
Volunteering for a clinical trial is one way to help in the fight against Alzheimers. Studies need participants of different ages, sexes, races, and ethnicities to ensure that results are meaningful for many people. To learn more about clinical trials, watch this video from NIH’s National Library of Medicine.
NIA leads the federal governments research efforts on Alzheimers. NIA-supported Alzheimers Disease Research Centers throughout the U.S. conduct a wide range of research, including studies of the causes, diagnosis, and management of the disease. NIA also sponsors the Alzheimers Clinical Trials Consortium, which is designed to accelerate and expand studies and therapies in Alzheimers and related dementias.
To learn more about Alzheimers clinical trials and studies:
- Talk to your health care provider about local studies that may be right for you.
Watch videos of participants in Alzheimers disease clinical trials talking about their experiences.
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Progressing Through The Stages
The pace with which someone with Alzheimer’s moves through the stages differs from person to person. Each symptom affects the individual gradually, and not everyone is affected by all of them. On average, an individual with Alzheimers lives four to eight years after diagnosis. However, they may live significantly longer, depending on their overall health and various other factors.
The Stages Of Alzheimers Diseasethree Stage Model
Easier to understand than the seven stages of Alzheimers, the three stage model divides the progression into early, middle, and late stage Alzheimers, or mild, moderate, and severe Alzheimers disease.
Stage One Alzheimers Mild Alzheimers Disease
Not to be confused with younger onset Alzheimers or early onset Alzheimers, mild Alzheimers disease is characterized by some memory loss, especially memory of more recent events. A person in the early stages of Alzheimers will likely be able to carry out the daily activities of living, but may begin to forget familiar words and names when speaking, and have trouble finding things like keys. Judgment and attention span will become impaired. *Early Alzheimers disease, the first stage, should not be confused with early onset Alzheimers. Early onset or younger onset Alzheimers disease is a variant of the disease that can affect people more than a decade earlier than Alzheimers generally strikes.
Stage Two Alzheimers Moderate Alzheimers Disease
The symptoms of moderate Alzheimers disease are in large part an increase in the severity of the symptoms of the first stage. Professional and social functioning continue to deteriorate because of increasing problems with memory, logic, speech, and initiative.
Stage Three Alzheimers Severe Alzheimers Disease
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Why Is Dementia Progressive
Dementia is not a single condition. It is caused by different physical diseases of the brain, for example Alzheimers disease, vascular dementia, DLB and FTD.
In the early stage of all types of dementia only a small part of the brain is damaged. In this stage, a person has fewer symptoms as only the abilities that depend on the damaged part of the brain are affected. These early symptoms are usually relatively minor. This is why mild dementia is used as an alternative term for the early stage.
Each type of dementia affects a different area of the brain in the early stages. This is why symptoms vary between the different types. For example, memory loss is common in early-stage Alzheimers but is very uncommon in early-stage FTD.
As dementia progresses into the middle and later stages, the symptoms of the different dementia types tend to become more similar. This is because more of the brain is affected as dementia progresses.
Over time, the disease causing the dementia spreads to other parts of the brain. This leads to more symptoms because more of the brain is unable to work properly. At the same time, already-damaged areas of the brain become even more affected, causing symptoms the person already has to get worse.
Very Severe Cognitive Declinesevere Dementia
The person is in the final stage of dementia and will need constant care with all daily activities. Early in this stage they may be able to speak a half-dozen intelligible words. As this stage progresses, physical motor skills are compromised to the point where the person can no longer walk independently. Later they lose the ability to sit up and to smile.
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