Alzheimer's Disease (AD) is a progressive brain disorder that slowly destroys memory and thinking skills, eventually leading to the inability to perform even simple tasks. It progresses through several stages, each with its own set of symptoms and challenges. Understanding these stages can help individuals and families prepare for the future and access appropriate care. We spoke to our expert Dr Ishu Goyal, Deputy Consultant Neurologist, Sir HN Reliance Foundation Hospital, Mumbai, who explained the seven stages of AD.
According to Johns Hopkins Medicine, initially, individuals afflicted by this condition experience mild memory loss and confusion, a stage known as cognitive decline. However, with time, these symptoms intensify. On average, individuals survive for approximately eight years after symptom onset, though the progression of the disease varies—ranging from rapid advancement in some cases to gradual development in others. Some individuals manage to live with the disease for as long as two decades.
Seven Stages Of Alzheimer's Disease
The disease course of AD passes through these seven stages:
No Cognitive decline
“This is a preclinical stage where the person does not have any memory problems, is working well and is independent. During this stage, the cognitive evaluation is also normal”, said Dr Goyal.
Very Mild Cognitive Decline
Sometimes, a person may experience forgetfulness, such as misplacing things or forgetting a few items on their grocery list. This can be mistaken for normal age-related forgetfulness. However, when evaluated, their cognitive score remains in the normal range and are still able to function independently. “If there is a history of dementia in their family, it is important to evaluate them regularly to detect any signs of dementia at an early stage”, added Dr Goyal.
Also Read: 10 Early Signs And Symptoms Of Alzheimer's And Dementia
Mild Cognitive Decline
In the next stage of AD, people frequently have impaired attention and concentration and forgetfulness becomes more noticeable. They do have an insight into this problem but may not always acknowledge it as an early stage of dementia. This is because even at this stage, they are independent in activities of daily living, although their scores of cognitive assessments may go down below the normal range and still do not drop to the range of dementia.
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Moderate Cognitive Decline
Dr Goyal said, “As the disease advances further, the patient has more profound memory impairments where he may find difficulty in doing complex tasks like maintaining finances, planning travel, and errors in taking his medications although he may still not need assistance for his daily tasks.” They may also show behaviour changes in the form of being withdrawn from social situations and interacting less than usual.
Moderately Severe Cognitive Decline
“At this stage, they begin to lose orientation towards their environment with frequent memory impairments, so they need assistance to take medicines or in making routine decisions like what to wear or where their belongings are kept”, added Dr Goyal. They tend to ask the same things over and over again because they lack the formation of recent memory, causing a lot of discomfort to their caretakers.
Also Read: What Is The Best Treatment for Alzheimer's?
Severe Cognitive Decline
In this penultimate stage, the patient becomes completely dependent on all his activities, fails to remember what he had for his meals, and sometimes even forgets whether they already have had their meals or medication or not. They lose touch with their surroundings and become confused and agitated if their surroundings or caretaker is changed suddenly.
“Since recent memories are not forming, old memories predominate and they tend to repeat things that happened many years back repetitively and often believe that they reside at the place where they spent their childhood. They become more withdrawn and less expressive with frequent mood fluctuations”, highlighted Dr Goyal.
Very Severe Cognitive Decline
In this terminal stage, the patient becomes disconnected, failing to recognise their family members or their house. They may refuse to eat or maintain their hygiene. Eventually, they develop difficulty in moving around, suffer a lack of sleep, and finally lose the ability to swallow, which may lead to aspiration of food particles. This is the most common cause of death in people with AD.
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your expert if you are dealing with any health issues to rule out the complications.]