Alzheimer’s Stages and How the Disease Progresses

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Alzheimer’s disease doesn’t progress at a predictable rate. For some people, the symptoms will develop slowly over more than a decade, while for others, the disease can seem to worsen rapidly in just a few years. According to the Mayo Clinic, people with Alzheimer’s live eight to 10 years after diagnosis on average, though some live twice as long. While Alzheimer’s stages aren’t crisply demarcated—and everyone’s experience with the disease’s progression will be unique—doctors have identified three main stages that most people with the disease experience.

Stage 1: Mild Alzheimer’s

In this stage, which typically lasts two to four years, a person with Alzheimer’s may or may not even notice they’re developing the condition. Bouts of forgetfulness may get written off as “senior moments,” especially if longer-term memories are still intact. At this point, family members may begin to notice something is off about a loved one, and doctors may be able to make an initial, watch-and-wait diagnosis. Symptoms at this stage can include:

  • Frequent memory lapses, such as forgetting names or misplacing things
  • Difficulty performing everyday tasks that were once easy, such as paying bills or grocery shopping
  • Taking longer than usual to perform routine tasks, such as making a pot of coffee or sorting the mail
  • Difficulty multitasking, such as carrying on a conversation while cooking or driving
  • Difficulty solving problems when tasks can’t be completed in the usual manner
  • Poor judgement or decision-making

Stage 2: Moderate Alzheimer’s

By now, there’s usually no question that a person is suffering from Alzheimer’s. Doctors will often run memory tests and perform brain scans to make a more definitive diagnosis. People may remain in this stage for a few years or more than a decade, depending on how the disease progresses. During this stage, patients with Alzheimer’s may become increasingly frustrated or withdrawn as they begin to come to terms with the diagnosis. Caregivers may need to begin coordinating supervised care. Symptoms can include:   

  • Increased memory loss, including forgetting parts of personal history
  • Confusion (for example, not knowing where they are or what day or season it is)
  • Difficulty with language, reading and writing, and working with numbers
  • Changes in personality and mood, including suspiciousness, delusions, and angry outbursts
  • Impulsive behavior, like undressing at inappropriate times
  • Greater risk of wandering off or getting lost
  • Needing help with daily activities like choosing appropriate clothing for the weather, bathing and grooming, or using the bathroom
  • Restlessness and agitation, especially late in the day
  • In some people, trouble controlling bowel and bladder function

Stage 3: Severe Alzheimer’s

As cognitive function continues to decline—and in this stage the decline can be more rapid as well—people may have a hard time having even basic conversations. Around-the-clock care will be necessary for the patient’s own safety, as people at this stage are unable to eat, go to the bathroom, move around, and perform other daily activities by themselves. While this final stage tends to be briefer than other stages, it can still span several years.

  • Losing the ability to walk, sit, hold up their head, swallow
  • Inability to communicate
  • Groaning, moaning, or grunting
  • Seizures
  • Sleeping more
  • No longer recognizing family or friends or responding to surroundings
  • Becoming more vulnerable to infections, especially pneumonia
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