The Progression of Alzheimer’s Disease: What Are the Stages?
Alzheimer’s: A Progressive Disease
It’s difficult to watch a loved one live with Alzheimer’s disease. Whether it is a parent, a spouse, or a close friend, this irreversible brain disease gets worse with time. Alzheimer’s causes dementia, which refers to the decline in thinking, memory, and reasoning abilities that characterize the disease.
Although researchers are continuing to unravel the mystery of the disease, there is no cure yet for Alzheimer’s. Some interventions may slow the progression of the disease, but the continual decline cannot be stopped. By knowing what to expect, you can be better prepared for what is to come.
The Global Deterioration Scale
The stages of Alzheimer’s progression can be simply categorized as mild, moderate, and severe. There is also another, more detailed scale for these stages. The Global Deterioration Scale, or GDS, includes seven stages, with numbers four through seven referring to clinical dementia.
The GDS is useful for doctors to track the progression of their patients’ disease. It’s also useful for caregivers to understand where their charges are, how impaired their cognitive abilities are, and what they are still capable of doing.
Stage 1: No Impairment
The first stage of Alzheimer’s and dementia includes no noticeable mental deficits. If you know someone with Alzheimer’s, you may never have noticed any symptoms until he or she reached stage two. During stage one, the patient can still function normally, has no memory problems, can reason as well as ever, and during an interview evaluation, shows no signs of dementia. Someone in the first stage is fully independent.
Stage 2: Very Mild Decline
During stage two of Alzheimer’s disease, the patient may begin to display some worrisome signs of dementia. The first and most noticeable signs during this stage are usually related to memory. They may start forgetting where they put familiar items like keys or a wallet. They may also begin to forget the names of people they know.
The memory troubles at this stage are still very mild, and do not necessarily show up on a professional evaluation. Someone in stage two can typically still engage normally in social activities and at work.
Stage 3: Mild Decline
By stage three, diagnosing someone with Alzheimer’s or dementia is still difficult. The symptoms are worsening, but are not yet serious. In addition to the common memory problems of stage two, they may also start forgetting new information. For instance, the patient might forget something they just read, or the name of a person they met minutes prior.
At work, or in social situations, other people may begin to notice symptoms at this stage. Work performance may start declining, and the patient may start to have trouble making plans or staying organized.
Stage 4: Moderate Decline
Stage four marks the beginning of diagnosable dementia caused by Alzheimer’s. In this stage, diagnosis can happen during a doctor interview or evaluation. The symptoms become much clearer and include moderate memory deficits and difficulty with complex tasks like balancing a checkbook, paying bills, or planning a party.
It is also during stage four that the patient may begin to exhibit mood changes associated with Alzheimer’s. They may become moody and depressed. They are also likely to withdraw from others, especially when in a challenging situation.
Stage 5: Moderately Severe Decline
By stage five of Alzheimer’s the patient is no longer able to survive without at least some assistance. They likely have difficulty remembering their personal information, such as their address and phone number. They may begin to become disoriented with respect to time and place. Personal hygiene and care may still be possible but likely require some prompting.
Stage 6: Severe Decline
By stage six the patient is in serious decline. Memory becomes much worse. The patient may even lose awareness of their surroundings and forget the names of people closest to them. Personality is also likely to change at this stage. This includes moodiness, suspicion, paranoia, and delusions.
Personal care is impossible without help by this stage. A stage six patient needs help with daily tasks and hygiene. They may also start to sleep more during the day and wander at night. It is possible that they might walk away from their room or home and get lost.
Stage 7: Very Severe Decline
During the seventh stage of Alzheimer’s the patient has declined so much that they can no longer converse, respond to their environment, or control their own movements. They may still be able to talk, but will not likely make sense or interact with anyone. During this late stage of the disease, they may also be unable to sit upright without support. Muscles at this stage become rigid and even swallowing may be difficult.
Prevention and Treatment
Although there is no cure for Alzheimer’s, great strides are being made in treatments and preventions that can slow the progression of the disease. Dietary changes, supplements, exercises for the body and mind, and medications can have positive impacts on the symptoms of the disease. These treatments can also potentially extend the time spent in the earlier stages.
Caring for someone with Alzheimer’s disease is a daily challenge. Caregivers need help and support, as well as time off from assisting patients. Support groups can help caregivers learn best practices, strategies for coping with difficult situations, and can give them a place to let off some steam.
Disease Fact Sheet. (2013, October 17). National
Institutes of Health. Retrieved November 25, 2013, from http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-fact-sheet
● Alzheimer’s Stages: How the Disease Progresses. (2013, January 4). Mayo Clinic. Retrieved November 25, 2013, from http://www.mayoclinic.com/health/alzheimers-stages/AZ00041
● Seven Stages of Alzheimer’s. (2013). Alzheimer’s Association. Retrieved November 25, 2013, from http://www.alz.org/alzheimers_disease_stages_of_alzheimers.asp#stage1
● The Global Deterioration Scale for Assessment of Primary Degenerative Dementia. (1983). Florida Health Care Association. Retrieved November 25, 2013, from http://www.fhca.org/members/qi/clinadmin/global.pdf