7 Stages of Alzheimer’s
The seven stages of Alzheimer’s are helpful in finding the words to discuss Alzheimer’s. Caregivers find them particularly useful in support groups, as well as in conversations with doctors and other professionals.
Although the progression of Alzheimer’s disease can be slowed down today thanks to today’s medications, it cannot as of yet be stopped. The process is described in general terms as going through 3 steps:
For more meaningful terms between professionals, caregivers and patients, a more detailed process has been characterized in seven stages. The seven stages are based on a system developed by Barry Reisberg, M.D., clinical director of the New York University School of Medicine’s Silberstein Aging and Dementia Research Center.
STAGE 1 – NORMAL
This system calls a mentally healthy person at any age “Stage 1”.
No memory problems
No problems with orientation
person – your name, who you are;
place – what country, state, city you live in, where you are;
time – what day, date, season it is
No problems with judgment
No difficulties with communication skills
No problems with daily activities
STAGE 2 – NORMAL AGED FORGETFULNESS
More than half of all people ages 65 and older complain of cognitive difficulties. This is considered a normal part of aging.
Occasional lapses in memory, usually undetectable to family and friends
Slight cognitive problems, also undetectable to friends and family, might also not be visible on medical exam
STAGE 3 – MILD COGNITIVE IMPAIRMENT
At this point, there are mild changes in memory, communication skills and/or behavior, noticeable to family members and friends. Symptoms might be picked up by an alert physician. Many people will not decline further than this point. Notwithstanding, a majority do progress to Mild Alzheimer’s within two to four years.
Problems remembering names, words for objects
Difficulties functioning at work and in social settings
Problems remembering newly-read material
Misplacing important items with increasing frequency
Decline in organizational skills and the ability to plan
Repeating questions and evident anxiety
STAGE 4 – MILD ALZHEIMER’S
Cognitive symptoms are more obvious now. A neurologist can confidently diagnose Alzheimer’s disease and treat it with medications that have been proven effective in slowing it down.
Difficulty remembering personal details, recent events
Some confusion possible (ie: might put towel in fridge)
Impaired mathematical ability, financial management (trouble managing a checkbook – for those who did not have trouble managing one before)
STAGE 5 – MODERATE ALZHEIMER’S
This is the stage at which it is not possible for a person with Alzheimer’s to live alone.
Severe memory loss, e.g., may not remember basic personal contact information such as current address or phone number
Disorientation (not knowing the day/date/season, and/or location/country/state/city)
No longer safe to cook, even if the sufferer can manage or remember the logistics of the process, due to severe short-term memory difficulties and confusion
Wandering risk; might get lost once leaving the home
Decreased personal hygiene skills
Increased desire to sleep is common
STAGE 6 – MODERATELY SEVERE ALZHEIMER’S
It is at this stage that family members often suffer the most, because the loved one with Alzheimer’s loses much of the ability to recognize those around him or her, even a spouse, sibling, parent or child. Personality changes are common as well.
Severe memory loss continues to intensify
Withdrawal from surroundings
Reduced awareness of recent events
Problems recognizing loved ones, although it is still possible to differentiate between those who are familiar and those who are not
“Sundowning”, if it has not yet begun, makes its appearance at this point – this is the phenomenon of increased restlessness and agitation toward sundown (hence the name), in the late afternoon and evening hours
Bathroom management becomes difficult; at this stage it often is necessary to switch to diapers due to incontinence, wetting and other such problems using the bathroom independently
Shadowing, extreme anxiety, following a loved one around the house due to fears of being alone
Repetitive, compulsive behavior (verbal and/or nonverbal)
STAGE 7 – SEVERE ALZHEIMER’S
This is the final stage of Alzheimer’s disease, at which the long goodbye comes to an end. Even though the Alzheimer’s person may somewhere inside really hear and understand what is being said, he or she can no longer respond, other than possibly to speak a word or phrase.
Communication is very limited
Physical systems begin to deteriorate
Gross motor coordination shuts down, may not be able to sit
Swallowing may become difficult, choking is a risk
The last stage of Alzheimer’s disease, as with any other illness, is a very individual matter and no two journeys end the same way. People with Alzheimer’s seem to experience little physical pain. What is certain, however, is that every Alzheimer’s journey ends – as does every other. May they all be peaceful and pain free.
A FRESH PERSPECTIVE
For a new, insight-filled perspective on the stages of Alzheimer’s, check out the video:
Teepa Snow Illustrates Alzheimer’s Stages
In this video, Teepa Snow shows what to expect, while keeping the focus on the person, not the disease.