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Alzheimer's Disease Symptoms & Stages

On this page, you will find the following:

Symptoms & Stages of Alzheimer's Disease

Alzheimer’s disease usually progresses gradually, lasting from two to twenty years, with an average of seven years. Alzheimer's is difficult to diagnose, so if you suspect that you or someone you know may have this neurological condition, the first step is to see a doctor for a thorough medical exam. Alzheimer’s disease does not affect every patient in the same way. The following stages represent the general course the disease follows, but moving from one stage to another may not be perceptible due to the fact that the symptoms are on a gradual continuum of severity.

Pre-clinical/Pre-symptomatic Stage:
Physical conditions connected to Alzheimer’s disease exist in a person’s body long before symptoms are evident. These conditions are normally defined through the use of “biomarker” tests, like those searching for beta-amyloid and tau proteins in blood and cerebrospinal fluid, and specialized PET and MRI scans. Currently, this stage is only defined in research settings and clinical trials and is unlikely to be given as an official clinical diagnosis by a health professional.

Mild Cognitive Impairment (MCI) Due To Alzheimer’s Disease/Prodromal Stage:
Recently, scientists have identified a condition between normal age-related memory loss and dementia called mild cognitive impairment (MCI). Individuals with MCI have persistent memory problems (for example, difficulty remembering names and following conversations and marked forgetfulness) but are able to perform routine activities without more than usual assistance. MCI often leads to Alzheimer’s, but while all those who progress to some form of dementia go through a period of MCI, not all patients exhibiting MCI will develop Alzheimer’s disease. An official clinical diagnosis of MCI can be given by a health professional.

Dementia Due To Alzheimer’s Disease (Mild, Moderate, Severe Stages):

Mild (Stage 1)
Early in the illness, people with Alzheimer’s tend to lose energy and spontaneity, though often no one notices anything unusual. They exhibit minor memory loss and mood swings and are slow to learn and react. After a while they start to shy away from anything new and prefer the familiar. In this stage, Alzheimer’s patients can still perform basic tasks independently but may need assistance with more complicated activities. Speech and understanding become slower, and patients often lose their train of thought in midsentence. They may also get lost while traveling or forget to pay bills. As they become aware of this loss of control, they may become depressed, fearful, irritable, and restless.

Moderate (Stage 2)
Eventually, people with the illness begin to be disabled by it. Though the distant past may be recalled, recent events become difficult to remember. Advancing Alzheimer’s affects the ability to comprehend location, the day, and the time. Caregivers must give clear instructions and repeat them often. As Alzheimer’s patients’ minds continue to slip away, they may invent words and not recognize formerly familiar faces.

Severe (Stage 3)
During the final stage, patients become more and more unresponsive. Memory becomes so poor that no one is recognizable. Patients lose bowel and bladder control and eventually need constant care. They lose the ability to chew and swallow and become bedridden and vulnerable to pneumonia, infection, and other illnesses. Respiratory problems worsen, particularly when the patient becomes bedridden. This terminal stage eventually leads to coma and death.

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Memory Problems: Is It Alzheimer's?

Mild forgetfulness and memory delays are often part of the normal aging process. Older individuals simply need more time to learn a new fact or to remember an old one. We all have occasional difficulty remembering a word or someone's name; however, those with Alzheimer's disease will find these symptoms progressing in frequency and severity. Everyone, from time to time will forget where they placed their car keys; an individual with Alzheimer's disease may not remember the purpose of the keys. There has been recent interest in a condition called mild cognitive impairment (MCI). Individuals with “amnesic” MCI, the most common form, have memory impairment (for example, difficulty remembering names and following conversations and pronounced forgetfulness), but are able to perform routine daily activities without assistance. These MCI patients generally have normal judgment, perception and reasoning skills. Many people with MCI are at risk for further cognitive decline, usually caused by Alzheimer's disease. However, while all patients who develop some form of dementia go through a period of MCI, not all patients exhibiting MCI will develop Alzheimer's disease.

Symptoms of MCI may include:

  • Memory problems that are noticed by others
  • Poor performance on cognitive tests
  • Depression
  • Irritability, anxiety and sometimes aggressive or apathetic behavior

Many conditions can contribute to the development of memory problems and dementia; Alzheimer's disease is just one of them. A decline in intellectual functioning that significantly interferes with normal social relationships and daily activities is characteristic of dementia, which is most commonly caused by Alzheimer's disease. Alzheimer's disease and multi-infarct dementia (a series of small strokes in the brain) cause the vast majority of dementias in the elderly. Other possible causes of dementia-like symptoms include infections, drug interactions, a metabolic or nutritional disorder, brain tumors, depression or another progressive disorder like Parkinson's disease.

If memory loss increases in frequency or severity, makes an impression on friends and family, begins to interfere with daily activities (for example, employment tasks, social interactions and family chores), seek qualified professional advice and evaluation by a physician with extensive knowledge, experience and interest in dementia and memory problems.

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Visit Your Doctor

Visit your physician if you, your family and friends, notice worsening memory loss that begins to affect normal daily tasks, employment and social interactions. Other signs that may point to Alzheimer's disease include changes in personality, language difficulties, problems with simple mathematical tasks, impairment in gait or movement, and problems with attention and orientation.

A physician with extensive knowledge and experience in dementia and memory problems can perform a thorough evaluation to determine whether someone has dementia, and if so, its potential causes. Other specialists may be called upon for a better diagnosis. Proper medication may be able to slow the progression of the disease and delay cognitive decline. These drugs are generally more effective the earlier they are administered.

Last Review: 04/15/15

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