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Senior with Alzheimer's Disease

The 7 Stages of Alzheimer’s Disease

Updated: April 23, 2015 by Catharine D. Allado

If you or your Loved One has received a diagnosis of Alzheimer’s disease, you may be wondering what to expect with the disease as it takes its course. There are three main stages of Alzheimer’s Disease and we will help you understand today the characteristics.

Statistics show that those suffering from Alzheimer’s Disease have an average life span of eight years. From the time of diagnosis, the actual life expectancy range can go from three years to all the way up to twenty years.


In This Article:

Main The 3 “Main Stages” of Alzheimer’s Disease
Early Stage Alzheimer’s Signs and Symptoms
Mid Stage Alzheimer’s Signs and Symptoms
Late Stage Alzheimer’s Signs and Symptoms

The Main Stages of Alzheimer’s Disease

Early-stage Alzheimer’s (Mild)
Memory loss or other cognitive deficits are noticeable, yet the person can compensate for them and continue to function independently.

Mid-stage Alzheimer’s (Moderate)
Mental abilities decline, the personality changes, and physical problems develop so that the person becomes more and more dependent on caregivers.

Late-stage Alzheimer’s (Severe)
Complete deterioration of the personality and loss of control over bodily functions requires total dependence on others for even the most basic activities of daily living.

It is important to understand that because the stages of Alzheimer’s Disease overlap, it is difficult to definitively place a person in a particular stage. Those suffering from this disease can vary in the length of time spent in each stage. Unfortunately, the progression is always toward a worsening of symptoms.

The stages identify groups of symptoms that reflect more and more brain decay and increasing dependence on caregivers. Sadly, the end result of Alzheimer’s Disease is death, whether caused by the inability of the brain to keep the body going, or by another disease or injury along the way.

No matter what stage the individual is in at the time of diagnosis, apathy is a major problem from the beginning until the very end. More than forty percent (40%) of people in early-stage Alzheimer’s Disease show a lack of interest, initiative, and emotional involvement. In the last stage of Alzheimer’s, more than ninety percent (90%) of the patients become apathetic.

Early-Stage Alzheimer’s Disease Signs & Symptoms

The focus of early-stage Alzheimer’s is cognitive decline. The Alzheimer’s patient, as well as family, friends, co-workers, and medical practitioners, start to notice the changes. Memory and concentration problems are evident and measurable by cognitive tests. Communication issues surface.

Changes in personality and a few idiosyncratic behaviors begin to appear. As a result, the person’s performance suffers both at home and at work. The apathy and lack of engagement that is characteristic of all three stages begins here.

Early signs and symptoms could include any of the following:

Cognitive and memory problems begin to appear…

  • Confusion

  • Forgets names and words; might make up words, or quit talking to avoid mistakes

  • Repeats questions, phrases or stories, in the same conversation

  • Forgets their own history, recent personal events, and current events

  • Less able to plan, organize, or think logically

  • Increasing difficulty with routine tasks such as planning dinner, grocery shopping, paying bills

  • Increasingly unable to make decisions; defers to others’ choices

  • Poor judgment; decline in problem-solving skills

  • Money and math problems

  • Disoriented in time and place; may become lost in familiar places.

  • Trouble concentrating and learning new things; avoids change

  • Withdraws from social and mental challenges

  • Misplaces valuable possessions; hides things or puts things away in strange places and then forgets where they are​ located

Communication problems are observed…

  • May converse “normally” until a memory lapse occurs

  • Begins to have difficulty expressing themselves

  • Even if unable to speak well, can respond to what you tell them–to your emotional reactions, and to humor

  • Increasing difficulty comprehending reading material

Personality changes are evident…

  • Apathetic, withdrawn, avoids people

  • Anxious, irritable, agitated

  • Insensitive to others’ feelings

  • Easily angered when frustrated, tired, rushed, or surprised

Idiosyncratic behaviors start to develop…

  • Hoards, checks, or searches for objects of little value

  • Forgets to eat, or eats constantly, or eats only one kind of food

When Alzheimer’s has been diagnosed early, the loss of abilities is often mild. However, with a little help from a caregiver or Loved Ones, the individual can continue living independently much as they did before.

In this early stage, some people experience minor physical compensations, such as falling asleep easily, or immunity to colds, but these positive aspects of Alzheimer’s Disease are short-lived. In fact, by the time this condition is diagnosed, some of the problems described above may have already progressed. It is almost to the point where the individual is already in the middle stage of the disease, needing considerable caregiver support.

Mid-Stage Alzheimer’s Disease Signs & Symptoms

The focus of mid-stage Alzheimer’s is a decline in the functioning of numerous body systems at once and steadily increasing dependence on caregivers. In mid-stage Alzheimer’s disease, the cognitive problems of early Alzheimer’s become worse and new ones develop. Memory and cognition problems become severe, communication becomes warped, and the personality is transformed.

The patient has a marked change in appearance and hygiene as they become less and less able to take care of themselves. Physical problems increase including problems with voluntary control of the body while the person’s health declines. Wandering, aggressiveness, hallucinations, and paranoia also appear.

Studies show that this middle stage of Alzheimer’s is the longest of all three. It is also important to note: Those suffering from this disease who are able to recognize their own decline are especially at risk for becoming suicidal during this stage.

The range of problems that may occur include the following:

Significant cognitive decline and memory problems continue…

  • Forgets recent events, forgets their own history. When they can’t remember something, they may make up something instead.

  • Increased difficulty in sorting out names and faces of family and friends, but can still distinguish familiar from unfamiliar faces.

  • Still knows their own name, but no longer remembers their own address or phone.

  • Loses track of their own possessions. May take others’ belongings.

  • Can no longer think logically or clearly. Can’t organize their own speaking or follow others’ logic. Can no longer follow written or oral instructions or a sequence of steps. Arithmetic and money problems escalate.

  • Disoriented about the season, the day of the week, the time of day.

  • Disconnected from reality. Does not recognize self in the mirror. May think that a television story is real.


Impaired communication skills worsen…

  • Problems with speaking, understanding, reading, and writing

  • Repeats stories, words, and gestures; repetitive questions

  • May still be able to read, but cannot respond correctly

  • Problems finishing sentences

  • May revert to their first speaking language (and need a multilingual caregiver)

Personality changes become more significant …

  • Apathetic, withdrawn

  • Anxious, agitated

  • Unmannerly, aggressive or threatening

  • Suspicious, paranoid; may accuse spouse of having an affair, or accuse family members of stealing

  • Delusional, has hallucinations. May hear, see, smell, or taste things that aren’t present

  • May have an exaggeration of their normal personality characteristics

Idiosyncratic behaviors evolve…

  • Inappropriate sexual behavior: may mistake another person for their spouse, may disrobe or masturbate in public

  • Rummages through things, hides things

  • Restlessness, pacing, repetitive movements: fingers certain objects over and over; tries doorknobs; hand-wringing; tissue-shredding

  • Wandering, including chatting to oneself while wandering. May wander away from the caregiver and familiar, safe surroundings. (One-quarter to one-half of all people with Alzheimer’s wander.)

  • Disruption of the normal sleep-wake cycle: “sundowning” (naps during the day, active from late afternoon through the night)

Dependence and need for help with the activities of daily living increases…

  • May eat without help, but needs help remembering to drink enough liquids and to eat enough

  • Needs help dressing appropriately for the weather or occasion. May need help putting clothing onto the correct body part.

  • Needs help with grooming: bathing, brushing teeth, combing hair

  • Needs help using the toilet

  • May no longer be safe when left alone: could fall, burn self, poison self, neglect self. Although able to care for self in some ways, needs full-time supervision for safety.

Voluntary control of the body begins to decline…

  • Urinary and fecal incontinence increase over time

  • Has trouble getting comfortable in a chair or on the toilet

  • Muscle twitches


Late-Stage Alzheimer’s Signs & Symptoms

The focus of late-stage Alzheimer’s is the complete deterioration of the personality. Cognitive symptoms worsen, and physical symptoms become profound. The loss of cells in all parts of the brain leads to lack of functioning in all systems of the body. The wild behaviors of earlier stages disappear, replaced by a dulling of the mind and body.

Cognitive and memory problems decline further, and complete dependence on others is necessary …

  • Doesn’t recognize familiar people, including their spouse and family members (a lack of visual ability may contribute to this)

  • Needs complete help with all activities of daily living

  • Requires full-time care

Communication skills are nearly gone…

  • Appears uncomfortable, but cries out when touched or moved

  • Can no longer smile

  • Either doesn’t speak, or speaks incoherently, with just words or phrases

  • May call or cry out repetitively, or groan or mumble loudly

  • Can’t write or comprehend reading material

Voluntary control of the body increasingly disappears…

  • Can’t control their movements. Muscles are rigid.

  • Complete urinary and bowel incontinence

  • Cannot walk, stand, sit up, or hold up their head without assistance. Falls frequently if not assisted or propped well.

  • Bedridden.

  • Can’t swallow easily, may choke on food

  • No more wandering; can’t move voluntarily

Health declines considerably…

  • Frequent infections

  • Seizures

  • Loses weight

  • Skin becomes thin and tears easily

  • Reflexes are abnormal

The body shuts down…

  • May refuse to eat or drink

  • Can’t respond to the environment

  • May quit urinating

  • Little response to touch

  • Sensory organs shut down: the organs may function correctly, but the brain can’t interpret the input.

  • May only feel cold and discomfort

  • Exhausted, sleeps more

Personality changes and idiosyncratic behavior become extreme…

  • Apathetic, withdrawn (continues from early-stage Alzheimer’s)

  • Dulling of the personality

  • May pat or touch things repeatedly

As the end of life approaches, the Alzheimer’s patient may require around-the-clock care. At this point, it will be necessary for Loved Ones to decide whether that care can occur at home or in a facility. The guidance of a physician or a hospice team will be needed.

Note: It is sad and unfortunate, but Alzheimer’s Disease is now the 4th leading cause of death in the United States. Prevention and Detection are right now the only ways we can all fight this deadly disease. Please help us spread the word.

If you found this article to be helpful, please don’t forget to share it, post it in Facebook, Tweet it, or eMail it to your friends and Love Ones so they can learn more and benefit from it. Thank you again for visiting SeniorCareHomes.Com

New Insights into Alzheimer’s Research

Learning how Alzheimer’s Disease starts is key to developing new therapeutics to slow or even prevent the disease. Researchers now believe that a failure in insulin processing in the brain may contribute to the development of Alzheimer’s Disease. If you Google “Memory Special Report Johns Hopkins Health Alerts”, you can stay on top of all the latest medical breakthroughs.


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