What are the stages of Alzheimer's disease?

Alzheimer's disease (AD) is the most common form of dementia, a term used to describe a group of symptoms affecting intellectual and social abilities severely enough to interfere with daily functioning

Alzheimer's disease is often thought about in three stages:
  • Mild Alzheimer's disease (also called early-stage). In mild AD, the first stage, people often have some memory loss and small changes in their personality. They may have trouble remembering recent events or the names of familiar people or things. They may no longer be able to solve simple math problems or balance a checkbook. People with mild AD also slowly lose the ability to plan and organize. For example, they may have trouble making a grocery list and finding items in the store.
  • Moderate Alzheimer's disease. This is the middle stage of AD. Memory loss and confusion become more obvious. People have more trouble organizing, planning and following instructions. They may need help getting dressed and may start having problems with incontinence. This means they can't control their bladder and/or bowels. People with moderate-stage AD may have trouble recognizing family members and friends. They may not know where they are or what day or year it is. They also may lack judgment and begin to wander, so people with moderate AD should not be left alone. They may become restless and begin repeating movements late in the day. Also, they may have trouble sleeping. Personality changes can become more serious. People with moderate AD may make threats, accuse others of stealing, curse, kick, hit, bite, scream or grab things.
  • Severe Alzheimer's disease (also called late-stage). This is the last stage of Alzheimer's and ends in the death of the person. In this stage, people often need help with all their daily needs. They may not be able to walk or sit up without help. They may not be able to talk and often cannot recognize family members. They may have trouble swallowing and refuse to eat.
Judith London, MD

The stages of Alzheimer's follow a pattern in terms of expressive communication deficits as well.

In the early stages, people are still able to pull together their thoughts and express them, using alternate phrases to verbally express themselves when they cannot recall the appropriate word. It may take longer for them to complete a thought or transmit an idea. Processing information is more difficult. Yet, at times, the words flow without a problem.

In the moderate stage, thoughts are less structured, often consisting of unrelated parts or fragments. The breakdown in the synapses in the neurons of the brain parallels the breakdown in the connections evident in verbal expression. This creates frustration for both the people with Alzheimer's, and their caregivers who cannot easily ascertain what they say. To express basic ideas that are trapped within their brains, patients may resort to behaviors that exhibit how frustrated they feel. Nursing studies demonstrate that the cause of most aggressive behavior in Alzheimer's is impaired communication.

In late stage disease, there may be an absence of the ability to speak. In my experience, even though there also may be a deficit in being able to recognize others, there still is an unconscious awareness of whether or not someone is kind to them. A gentle tone of voice and a non-verbal approach such as using a soft touch or playing sweet music are soothing.

Regardless of the progression of this disease, communicating and connecting are far beyond words alone and may readily be prevalent throughout the illness.


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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.