What Are the Stages of Alzheimer’s Disease?
Alzheimer’s is a progressive disease that starts with few, if any, symptoms and works its way towards severe impairment of cognitive, and even physical abilities before the patient dies of the disease. Although it’s important to remember that Alzheimer’s affects everyone differently, it can be helpful to understand the five main stages of Alzheimer’s disease if you or someone you love has been diagnosed, so you can have an idea of what to expect.
Preclinical Alzheimer’s Disease
The first stage of Alzheimer’s is called “preclinical” because the disease starts to affect the brain long before any symptoms appear. In some cases, it can go on for years, or even decades, before the patient starts to show symptoms.
This stage of the disease is characterized by deposits in the brain of amyloid-beta, a protein that has been linked to Alzheimer’s disease. Thanks to new imaging technology, we can now see deposits of amyloid-beta building up in the brain before symptoms appear or parts of the brain start to decay. Because patients in this stage of the disease do not have symptoms, this phase can be identified only in research trials, but it might become key to diagnosing the disease in patients before they show symptoms.
Genetic testing can also be done to give patients an estimate of their likelihood of developing Alzheimer’s disease.
Mild Cognitive Impairment (MCI) Due to Alzheimer’s Disease
The second stage of Alzheimer’s disease also tends to go undiagnosed because the symptoms are usually mild enough to either go unnoticed or they get attributed to something else. At this point, the symptoms are not severe enough to affect the patient’s work or interpersonal relationships, which makes it less likely that someone will report them to a doctor.
People with MCI tend to have trouble remembering appointments or pieces of conversation. Their judgment might also be impaired, making it harder for them to judge how long it will take to complete a task, or to remember the necessary steps to complete a task and the order in which those steps need to be taken.
Even when MCI becomes noticeable, patients with Alzheimer’s disease often go undiagnosed during this stage because MCI can be caused by other things. If the symptoms do warrant medical attention, a diagnosis is dependent on a doctor’s judgment based on their professional review. But, if necessary, the same imaging technology used to diagnose Alzheimer’s in the preclinical stage can be used to identify it in the MCI stage.
Mild Dementia Due to Alzheimer’s Disease
The symptoms in this stage tend to be severe enough to alert friends and family to the fact that something is wrong, so this is the stage when most patients are diagnosed with Alzheimer’s disease. People with mild dementia might experience one or more of the symptoms below:
- Memory loss of recent events – this is when people can’t remember something that just happened, or they ask the same question over and over.
- Impaired judgment, impaired problem-solving abilities, and difficulty performing complex tasks – this is when certain tasks that used to be routine, such as balancing a checkbook or planning an event, suddenly become overwhelming.
- Personality changes – People who were formerly outgoing might suddenly become withdrawn or subdued. Mild-mannered people might show uncharacteristic flares of anger or irritability. Less motivation to complete tasks is also typical in this stage.
- Organizing and expressing thoughts becomes more difficult – People often have trouble finding the right words to express their ideas, or even to identify or describe objects.
- Getting lost or misplacing things – People might start having more trouble finding their way around, even in familiar surroundings. It’s also common for them to lose or misplace items, even valuable ones.
Moderate Dementia Due to Alzheimer’s Disease
People in this stage of the disease usually begin to need help with daily tasks and self-care as they become more confused and forgetful.
This is also when significant changes in personality and behavior tend to appear, and it’s common for people in this stage of the disease to become suspicious. They might become convinced that family members or caregivers are stealing from them, or that a spouse is having an affair.
Hallucinations have also been known to happen in this stage of the disease.
Severe Dementia Due to Alzheimer’s Disease
In the last stage of the disease, the brain has degenerated to the point of impairing physical abilities, including the ability to communicate coherently. People in this stage of the disease need help with self-care, including eating, dressing, and bathing. They may even need help walking, sitting up, and/or holding their head up. In the final stages of the disease, they lose the ability to swallow or control their own bladder or bowel movements.
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