Stage : Very Mild Changes
You still might not notice anything amiss in your loved one’s behavior, but they may be picking up on small differences, things that even a doctor doesn’t catch. This could include forgetting words or misplacing objects.
At this stage, subtle symptoms of Alzheimer’s don’t interfere with their ability to work or live independently.
Keep in mind that these symptoms might not be Alzheimer’s at all, but simply normal changes from aging.
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.
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.
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Stage : No Impairment
Research now reveals that AD begins years, if not decades, before the onset of noticeable symptoms. Genetic research and much more sophisticated medical science will no doubt make this an important and focused area of study as we march into the future, searching for a cure. But, for now, most of us will never know if we are in the earliest stages of the disease. Unfortunately, doctors can only diagnose probable AD once symptoms begin to manifest. In fact, a definitive diagnosis can only be made through the post-mortem examination of brain tissue.
Stage : Moderately Severe Dementia
When the patient begins to forget the names of their children, spouse, or primary caregivers, they are most likely entering stage 6 of dementia and will need full time care. In the sixth stage, patients are generally unaware of their surroundings, cannot recall recent events, and have skewed memories of their personal past. Caregivers and loved ones should watch for:
- Delusional behavior
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Talking With A Doctor
After considering the persons symptoms and ordering screening tests, the doctor may offer a preliminary diagnosis or refer the person to a Cognitive Dementia and Memory Service clinic, neurologist, geriatrician or psychiatrist.Some people may be resistant to the idea of visiting a doctor. In some cases, people do not realise, or else they deny, that there is anything wrong with them. This can be due to the brain changes of dementia that interfere with the ability to recognise or appreciate the changes occurring. Others have an insight of the changes, but may be afraid of having their fears confirmed.One of the most effective ways to overcome this problem is to find another reason for a visit to the doctor. Perhaps suggest a check-up for a symptom that the person is willing to acknowledge, such as blood pressure, or suggest a review of a long-term condition or medication.Another way is to suggest that it is time for both of you to have a physical check-up. Any expressed anxiety by the person is an excellent opportunity to suggest a visit to the doctor. Be sure to provide a lot of reassurance. A calm, caring attitude at this time can help overcome the person’s very real worries and fears.Sometimes, your friend or family member may refuse to visit the doctor to ask about their symptoms. You can take a number of actions to get support including:
- talking with other carers who may have had to deal with similar situations
- contacting your local Aged Care Assessment Team
Risk Factors And Prevention
Although age is the strongest known risk factor for dementia, it is not an inevitable consequence of biological ageing. Further, dementia does not exclusively affect older people young onset dementia accounts for up to 9% of cases. Studies show that people can reduce their risk of cognitive decline and dementia by being physically active, not smoking, avoiding harmful use of alcohol, controlling their weight, eating a healthy diet, and maintaining healthy blood pressure, cholesterol and blood sugar levels. Additional risk factors include depression, social isolation, low educational attainment, cognitive inactivity and air pollution.
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What Are The Symptoms Of Early
For most people with early-onset Alzheimer disease, the symptoms closely mirror those of other forms of Alzheimer disease.
Withdrawal from work and social situations
Changes in mood and personality
Severe mood swings and behavior changes
Deepening confusion about time, place, and life events
Suspicions about friends, family, or caregivers
Trouble speaking, swallowing, or walking
Severe memory loss
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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Stage : Moderate Cognitive Decline
This point in the progression is considered mild or early-stage AD and by now there are definite symptoms of the condition that a careful medical examination can detect. This includes an obvious decrease in knowledge of recent events, both personal and concerning the local community/world. A persons capacity to engage in everyday planning and organizational activities such as balancing a checkbook or planning a dinner for a group of people would also be affected.
Again, remember that it is important to have a baseline performance score on these mental state tests for reference. Knowing how well a person performed similar tasks at an earlier time will help with ongoing comparisons and the detection of worsening symptoms. Some people have always struggled with math and numbers or never exhibited high levels of reading comprehension, but that doesnt mean dementia is present. The important thing to look for is uncharacteristic changes in memory and abilities.
Difficulty Determining Time Or Place
Losing track of dates and misunderstanding the passage of time as it occurs are also two common symptoms. Planning for future events can become difficult since they arent immediately occurring.
As symptoms progress, people with AD can become increasingly forgetful about where they are, how they got there, or why theyre there.
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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:
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
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Common Forms Of Dementia
There are many different forms of dementia. Alzheimer’s disease is the most common form and may contribute to 60-70% of cases. Other major forms include vascular dementia, dementia with Lewy bodies , and a group of diseases that contribute to frontotemporal dementia . Dementia may also develop after a stroke or in the context of certain infections such as HIV, harmful use of alcohol, repetitive physical injuries to the brain or nutritional deficiencies. The boundaries between different forms of dementia are indistinct and mixed forms often co-exist.
How Is Alzheimers Disease Diagnosed
Talk to a doctor if you or a loved one is finding it increasingly difficult to perform day-to-day tasks, or if you or a loved one is experiencing increased memory loss. They may refer you to a doctor who specializes in AD.
Theyll conduct a medical exam and a neurological exam to aid in the diagnosis. They may also choose to complete an imaging test of your brain. They can only make a diagnosis after the medical evaluation is completed.
Theres no cure for AD at this time. The symptoms of AD can sometimes be treated with medications meant to help improve memory loss or decrease sleeping difficulties.
Research is still being done on possible alternative treatments.
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Stages : Very Severe Decline
Stage seven is the final stage of Alzheimers. Because the disease is a terminal illness, people in stage seven are nearing death. In stage seven of the disease, people lose the ability to communicate or respond to their environment. While they may still be able to utter words and phrases, they have no insight into their condition and need assistance with all activities of daily living. In the final stages of Alzheimers, people may lose their ability to swallow.
Need Alzheimers Care?
Difficulties In Thinking Things Through And Planning
A person may get confused more easily and find it harder to plan, make complex decisions or solve problems.
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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
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 .
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Why Is Dementia Progressive
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.
How Quickly Does Dementia Progress
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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What To Do Next After Learning What Stage Of Alzheimer’s Disease Your Loved One Is In
As mentioned, learning about the stage of Alzheimers disease that a loved one is experiencing helps provide perspective and context. This knowledge makes it easier to have conversations with doctors about the patients condition and how to approach future treatment options. Understanding the later stages of the disease also helps when planning for lifestyle changes, new equipment, and other items that may be needed. One of the other major benefits in understanding the overall progression of Alzheimers disease is preparing for future living arrangements, such a memory care community, that could become a preferred option during later stages of the disease. Because the cost of dementia care is high, families should begin planning as soon as possible following a diagnosis.
What Should You Do In The Early Stages Of Dementia
When in the early stages of Dementia, you should meet with your doctor to develop an action plan that can help you and your loved one living with dementia. If you and your loved one reside in Texas, you can also contact me at Your Dementia Therapist. I am an Occupational Therapist consultant who specializes in dementia, and I can help you address your primary areas of concern when caring for your loved one.You will also want to talk with your loved ones and develop a plan for the future while they are still able to do so. This includes assigning a power of attorney and advance decision and advance statements to ensure that all their wishes and preferences can be known in the future.
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