Stages of Alzheimer's Disease

Alzheimer's disease (AD) is one of the most common cause of mental decline or dementia in older individuals. Alzheimer's disease can cause problems with memory, thinking and behaviour. With time the symptoms worsen and they can become severe enough to interfere with daily tasks. If you or any member of your family is diagnosed with Alzheimer’s, your doctor will try to categorise the disease. Knowing which stage of Alzheimer's disease you are suffering from, can help you to understand the progression of Alzheimer’s symptoms and help the doctor to plan appropriate care. However, all individuals with Alzheimer’s do not progress at the same rate. The time in each stage and the rate of progress of symptoms vary widely from patient to patient, and the symptoms of Alzheimer’s can also vary considerably (that is everyone with Alzheimer’s does not experience all the symptoms).

Based on the symptoms Alzheimer’s disease can be categorised in 3 stages:

Mild/Early Stage

This stage lasts 2-4yrs and the symptoms may include:

• Frequent loss of recent memory such as recent conversations, appointments or events (the person may not even remember them later).
• Shortened attention span.
• Repeating a statement or question again and again.
• Difficulty in expressing and understanding language.
• Difficulty in doing things that involve motor coordination such as writing and using objects.
• Mood changes such as depression and apathy, and mood swings.
• Need of reminders for doing daily activities such as brushing or bathing,
• Probable difficulty in driving.

Moderate/Middle Stage

This stage lasts 2-10yrs and the symptoms may include:

• Can no longer solve or handle problems.
• More significant memory loss. The person may forget personal history and may also not recognise friends and family.
• Speech becomes incoherent, and the person may get confused about current events, time, and place.
• Can get lost even in familiar settings,
• Sleep disturbances.
• Significant changes in mood and behaviour. S/he may experience delusions, aggression, frequent mood swings and uninhibited behaviour. Behaviour may be affected by stress and change.
• Mobility and coordination gets affected due to slowness, rigidity, and tremors.
• Doing everyday activities which involve sequential steps such as operating the washing making or grinder or cooking a meal becomes difficult. May need assistance and reminders to do daily activities.

Severe/Late Stage

This is the most severe stage and may last for 1 to more than 3 yrs. The symptoms may include:

• The patient gets confused about time and place and may not be able to tell past and present, and time of day.
• Has memory problems, and may not be able to communicate (may have severe to total loss of verbal skills).
• Unable to care for self such as may even forget how to do daily activities such as how to brush, dress or bathe.
• Severe sleep disturbances and significant change of sleeping habits.
• May wander away from home.
• Falling becomes a possibility and may become immobile due to rigidity, and tremors.
• May develop incontinence, difficulty in swallowing or walking which may lead to overwhelming infections, such as pneumonia, and other complications.
• Extreme changes in mood and behaviour. The person may have severe hallucinations, delirium, irritability and aggressiveness.
• People in the third stage of Alzheimer’s need round-the-clock support and care.

Besides this way of categorising AD, there are other ways such as the seven stages Global Deterioration Scale, also known as the Reisberg Scale. Alzheimer's disease usually progresses slowly and the person may pass through the various stages over 8 to 15 years (sometimes as long as 25 years).

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