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What Stage Of Alzheimer Is The Worst And Why

Alzheimer’s Disease Stages And Symptoms Center

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The signs and symptoms of Alzheimer’s disease depend on the stage of the disease. Some doctors and researchers disagree in regard to the number of stages of Alzheimer’s disease . The Global Deterioration Scale or GDS identifies seven stages of Alzheimer’s disease that include stage 1 , stage 2 , stage 3 , stage 4 , stage 5 , stage 6 , and stage 7 . There is no cure for Alzheimer’s disease, however, there are drugs and therapies to help the symptoms Alzheimer’s disease causes.

Watch For Signs The Person Is In Pain

Always remember that the person with Alzheimer’s may not be able to tell you when he or she is in pain. Watch the person’s face to see if it looks like he or she is in pain or feeling ill. Also, notice sudden changes in behavior such as increased yelling or striking out. If you are unsure what to do, call the doctor for help.

Caregiving In The Early Stages

Although most of your loved ones immediate medical needs can be managed on their own in the early stages, you may need to assist with tasks associated with memory or problem-solving. You may need to remind them of their doctors appointments and to set up the next appointment, along with taking their medications on time and getting refills as needed. You may need to assist them in managing their finances and keeping up with social and work obligations. At times, they may also need help remembering places, people, words, and names. In the early stages, you will want to encourage them to:

  • Maintain their independence
  • Establish a routine to delay the disease from worsening

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Progression To Severe Dementia

End stage Alzheimers, also known as late stage or severe Alzheimers, falls into the last category of the progression of the disease. Breaking up the disease into stages helps explain whats happening medically for both physicians and caregivers. It also helps caregivers prepare, said Sam Fazio, Senior Director of Quality Care and Psychosocial Research at the Alzheimers Association.

We try to talk about the stages as a blueprint that might happen at different points throughout the disease, Fazio told Being Patient. But since this disease is so unique to the individual, you dont want to try to stage people so they come up with a preconceived notion of what might happen. It can be used as a guide, but we should always think about ways that we can connect with people no matter what stage theyre in.

Fazio said that while the final stage may differ for everyone, some of the common symptoms include being unable to connect with other people or the environment, growing more forgetful and becoming withdrawn. These symptoms may start in the middle stage, but become progressively worse in end stage.

The patient may also completely lose the ability to speak or communicate, according to Mayo Clinic. While your loved one may still say certain words or phrases, they may no longer be able to converse like you once used to.

The Progression And Stages Of Dementia

Why Alzheimers Patients Need Such Special Care

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’.

  • You are here: The progression and stages of dementia
  • The progression and stages of dementia

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    What Increases Your Risk

    Certain things make getting a disease more likely. These are called risk factors. Risk factors for Alzheimer’s disease include:

    • Getting older. This is the main risk factor. People rarely have dementia before age 60.
    • A family history of Alzheimer’s disease, especially if one or more of your parents or siblings has the disease.
    • The presence of the apolipoprotein E-4 gene.
    • Having Down syndrome.
    • Injuries to the brain, especially more than one injury that caused you to pass out

    Middle Stage Of Alzheimer’s

    This is typically the longest stage of Alzheimers disease.2 As this stage progresses, the need for additional care might arise and get more significant. Common symptoms of this stage can include1,2:

    • Personality and/or behavioral changes: delusions, compulsions, repetitive behavior, and more
    • Needing assistance with getting dressed and choosing appropriate clothing
    • Difficulty with toileting/controlling bladder and bowel function

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    Tips For Coping With Agitation Or Aggression

    Here are some ways you can cope with agitation or aggression:

    • Reassure the person. Speak calmly. Listen to his or her concerns and frustrations. Try to show that you understand if the person is angry or fearful.
    • Allow the person to keep as much control in his or her life as possible.
    • Try to keep a routine, such as bathing, dressing, and eating at the same time each day.
    • Build quiet times into the day, along with activities.
    • Keep well-loved objects and photographs around the house to help the person feel more secure.
    • Try gentle touching, soothing music, reading, or walks.
    • Reduce noise, clutter, or the number of people in the room.
    • Try to distract the person with a favorite snack, object, or activity.
    • Limit the amount of caffeine, sugar, and junk food the person drinks and eats.

    Here are some things you can do:

    • Slow down and try to relax if you think your own worries may be affecting the person with Alzheimers.
    • Try to find a way to take a break from caregiving.

    How Is It Treated

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    There is no cure for Alzheimer’s disease. But there are medicines that may slow symptoms down for a while and make the disease easier to live with. These medicines may not work for everyone or have a big effect. But most experts think they are worth a try.

    As the disease gets worse, you may get depressed or angry and upset. The doctor may also prescribe medicines to help with these problems.

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    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.

    Late Stages Of Alzheimers Disease Symptoms

    The needs of the person with Alzheimers become much more demanding as the disease progresses. In the late stages of Alzheimers, the person with the disease loses the ability to respond appropriately and is unable to converse with others. They will also develop an inability to control movements like sitting, standing and walking.

    Here are some other common symptoms of the disease that can occur:

    • Catches colds and infections easily
    • Day/night reversal of sleep pattern
    • Difficulty communicating
    • Difficulty using the toilet independently
    • Eventually requires help with activities of daily living, 24 hours per day
    • Eventually unable to walk
    • Hoarding, rummaging
    • Inability to sit and eventually to swallow
    • Incontinence
    • Loss of awareness of surroundings
    • Needs help walking
    • Needs progressively more help with personal care
    • Personality changes such as aggression, anxiety, hostility,;irritability or uncooperativeness
    • Repetitive questioning
    • Sundowners
    • Verbally aggressive or demanding behavior
    • Wandering

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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.

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    A Person With Dementia Doesnt Always Fit Into One Stage


    Dementia affects each person in a unique way and changes different parts of the brain at different points in the disease progression.

    Plus, different types of dementia tend to have different symptoms.

    For example, someone with frontotemporal dementia may first show extreme behavior and personality changes. But someone with Alzheimers disease would first experience short-term memory loss and struggle with everyday tasks.

    Researchers and doctors still dont know enough about how these diseases work to predict exactly what will happen.

    Another common occurrence is for someone in the middle stages of dementia to suddenly have a clear moment, hour, or day and seem like theyre back to their pre-dementia abilities. They could be sharp for a little while and later, go back to having obvious cognitive impairment.

    When this happens, some families may feel like their older adult is faking their symptoms or just isnt trying hard enough.

    Its important to know that this isnt true, its truly the dementia thats causing their declining abilities as well as those strange moments of clarity theyre truly not doing it on purpose.

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    Using The Gds To Measure Dementia Progression

    As the disease progresses, different signs and symptoms will become increasingly obvious. While there are several scales to measure the progression of dementia, the most common scale is the Global Deterioration Scale for Assessment of Primary Degenerative Dementia . The scale is also known as the Reisberg Scale. According to the GDS, there are seven different stages of Alzheimers disease correlating with four distinct categories: no Alzheimers, mild Alzheimers , moderate Alzheimers , and severe Alzheimers .

    What You Can Do For Your Loved One

    As an individual with dementia declines, you can help them by providing a loving and supportive presence. Sit with them. Hold their hand. Play music they enjoy.

    One of the greatest gifts you can give your loved one is helping to get their affairs in order. Ensure that financial and healthcare powers of attorney are put in place, so you can make decisions when your loved one is no longer able. Look into funeral arrangements before you need them, so you dont need to make important decisions in a time of crisis.

    Talk to your loved ones physician about the possibility of palliative care support in the home and hospice care when your loved one is ready.

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    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
    • Disorientation
    • 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.

    What Are The Main Types Of Dementia

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    Alzheimers disease is the most common cause of dementia, accounting for around 2 out of every 3 of cases in older people. Vascular dementia is another common form, while dementia with Lewy bodies and frontotemporal dementia are less common.

    It is possible to have more than one type of dementia at the same time. Alzheimers is sometimes seen with vascular dementia or dementia with Lewy bodies. You might hear this called mixed dementia.

    The symptoms of dementia vary depending on the disease, or diseases, causing it. You can read more about the symptoms associated with different types of dementia on the Alzheimers Society website ;.

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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.

    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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    How Is Alzheimer’s Disease Diagnosed

    Your doctor will ask about your past health and do a physical exam. He or she may ask you to do some simple things that test your memory and other mental skills. Your doctor may also check how well you can do daily tasks.

    The exam usually includes blood tests to look for another cause of your problems. You may have tests such as CT scans and MRI scans, which look at your brain. By themselves, these tests can’t show for sure whether you have Alzheimer’s.

    The Stages Of Alzheimers Disease

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    The only certainty when diagnosed with Alzheimer’s disease is that a seniors condition will progressively worsen. The national Alzheimers Association has developed a very useful staging system to use as a frame of reference when coping with AD.

    Alzheimer’s disease constantly keeps doctors, family members and caregivers on their toes. It is instinctive for humans to want a roadmap or some sort of guide to help get us through a journey or a difficult situation. We strive to know what lies ahead to help ensure that we are adequately prepared. Following a serious medical diagnosis like Alzheimers disease , it is only natural to explore the subject with some research. What can we expect and when can we expect it?

    Keep in mind that the following staging system is not foolproof, but it can give caregivers a general idea of where their aging loved one falls along the Alzheimers disease spectrum. Seniors with Alzheimers are not guaranteed to follow these stages in a direct line. No matter how much we would like to know exactly what stage someone is in and what symptoms will develop next, we cannot. No two Alzheimers patients are exactly the same. To make matters even more complex, a patients symptoms often vary from day to day. Today, a loved one may seem like they are in stage five, and tomorrow their behaviors and symptoms may align more closely with stage four or stage six.

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    What We Know About Dementia

    The National Institute on Aging says that dementia affects approximately 3.4 million Americans, or 13.9 percent, of the U.S. population ages 71 and older and is usually caused by brain damage associated with Alzheimers disease, vascular dementia or Parkinsons disease. And in Canada, the number of people living with dementia is expected to rise 66% by the time we reach 2031.

    It is important to differentiate the various types of dementia; for about 70% of patients, a diagnosis of dementia will be accompanied by a diagnosis of Alzheimers disease. Although these terms are often used interchangeably, Alzheimers and dementia are not one in the same. Dementia is a loss of brain function that refers to a group of illnesses.

    Although dementia may be a symptom of Alzheimers, it may have other underlying causes, such as Picks disease, hypothyroidism or head trauma. While Alzheimers is the leading cause of dementia, vascular dementia, which is often caused by stroke, accounts for about 17% of all dementia cases.

    While people will experience dementia differently, most people with dementia share some of the same symptoms that may come and go.

    Stage : Normal Outward Behavior

    Alzheimerâs disease usually starts silently, with brain changes that begin years before anyone notices a problem. When your loved one is in this early phase, they won’t have any symptoms that you can spot. Only a PET scan, an imaging test that shows how the brain is working, can reveal whether they have Alzheimer’s.

    As they move into the next six stages, your friend or relative with Alzheimer’s will see more and more changes in their thinking and reasoning.

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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.

    Causes Of Agitation And Aggression


    Most of the time, agitation and aggression happen for a reason. When they happen, try to find the cause. If you deal with the causes, the behavior may stop. For example, the person may have:

    Look for early signs of agitation or aggression. If you see the signs, you can deal with the cause before problem behaviors start. Try not to ignore the problem. Doing nothing can make things worse.

    A doctor may be able to help. He or she can give the person a medical exam to find any problems that may cause agitation and aggression. Also, ask the doctor if medicine is needed to prevent or reduce agitation or aggression.

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