Alzheimer’s disease tends to worsen and develop over time. Eventually, Alzheimer’s disease affects most areas of the brain. Judgement, thinking, language, problem-solving, personality and movement, and memory can all be affected by the disease. According to Mayo Clinic, “There are five stages associated with Alzheimer's disease: preclinical Alzheimer's disease, mild cognitive impairment due to Alzheimer's disease, mild dementia due to Alzheimer's disease, moderate dementia due to Alzheimer's disease and severe dementia due to Alzheimer's disease. Dementia is a term used to describe a group of symptoms that affect intellectual and social abilities severely enough to interfere with daily function”. The five Alzheimer’s stages can help you understand what might happen, but these stages are just rough visualizations. Alzheimer’s disease is a continuous process. The experience might be different for each person.
The first stage is known as preclinical Alzheimer’s disease. This stage develops long before any symptoms become apparent. You won’t notice symptoms during this stage, nor will others around you. This stage of Alzheimer’s can last for years, possibly even decades. Though this stage is usually not identifiable as there are no symptoms, new imaging technologies can now identify deposits of a protein called amyloid-beta that is a hallmark of Alzheimer's disease. The ability to identify these early deposits may be especially important for clinical trials and in the near future as new treatments are developed for Alzheimer’s disease.
The second stage is known as mild cognitive impairment (MCI). According to Mayo Clinic, “People with mild cognitive impairment have mild changes in their memory and thinking ability. These changes aren't significant enough to affect work or relationships yet. People with MCI may have memory lapses when it comes to information that is usually easily remembered, such as conversations, recent events or appointments”. People with MCI usually have trouble remembering the number of sequences of steps for a task or the amount of time needed to complete an assignment. MCI does not always connect to Alzheimer’s disease, as MCI can be paired in with other diseases.
The third stage is known as mild dementia. Alzheimer’s disease is often diagnosed in the mild dementia stage. In this stage, family and doctors can clearly identify that a person is having significant trouble with memory and thinking that impacts daily functions. Symptoms also become apparent in this stage of Alzheimer’s disease. According to Mayo Clinic, symptoms may include
Memory loss of recent events. Individuals may have an especially hard time remembering newly learned information and ask the same question over and over.
Difficulty with problem-solving, complex tasks and sound judgments. Planning a family event or balancing a checkbook may become overwhelming. Many people experience lapses in judgment, such as when making financial decisions.
Changes in personality. People may become subdued or withdrawn — especially in socially challenging situations — or show uncharacteristic irritability or anger. Reduced motivation to complete tasks also is common.
Difficulty organizing and expressing thoughts. Finding the right words to describe objects or clearly express ideas becomes increasingly challenging.
Getting lost or misplacing belongings. Individuals have increasing trouble finding their way around, even in familiar places. It's also common to lose or misplace things, including valuable items.
The fourth stage is known as moderate dementia. During the moderate dementia stage of Alzheimer's disease, people grow more confused and forgetful and begin to need more help with daily activities and self-care. People with the moderate dementia stage of Alzheimer's disease may:
Show increasingly poor judgment and deepening confusion. Individuals lose track of where they are, the day of the week or the season. They may confuse family members or close friends with one another or mistake strangers for family. They may wander, possibly in search of surroundings that feel more familiar. These difficulties make it unsafe to leave those in the moderate dementia stage on their own.
Experience even greater memory loss. People may forget details of their personal history, such as their address or phone number, or where they attended school. They repeat favorite stories or make up stories to fill gaps in memory.
Need help with some daily activities. Assistance may be required with choosing proper clothing for the occasion or the weather and with bathing, grooming, using the bathroom and other self-care. Some individuals occasionally lose control of their bladder or bowel movements.
Undergo significant changes in personality and behavior. It's not unusual for people with the moderate dementia stage to develop unfounded suspicions — for example, to become convinced that friends, family or professional caregivers are stealing from them or that a spouse is having an affair. Others may see or hear things that aren't really there.
Individuals often grow restless or agitated, especially late in the day. Some people may have outbursts of aggressive physical behavior.
The final stage of Alzheimer’s is known as severe dementia. In the late stage of the disease, called severe dementia due to Alzheimer's disease, mental function continues to decline, and the disease has a growing impact on movement and physical capabilities.
In late stage severe dementia due to Alzheimer's disease, people generally:
Lose the ability to communicate coherently. An individual can no longer converse or speak in ways that make sense, although he or she may occasionally say words or phrases.
Require daily assistance with personal care. This includes total assistance with eating, dressing, using the bathroom and all other daily self-care tasks.
Experience a decline in physical abilities. A person may become unable to walk without assistance, then unable to sit or hold up his or her head without support. Muscles may become rigid and reflexes abnormal. Eventually, a person loses the ability to swallow and to control bladder and bowel functions.
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