Stages of Alzheimer's
It is difficult to place a patient with Alzheimer's disease in a specific stage. However, symptoms seem to progress in a recognizable pattern and these stages provide a framework for understanding the disease. It is important to remember they are not uniform in every patient and the stages often overlap.
1. First stage - 2 to 4 years leading up to and including diagnosis.
- Recent memory loss begins to affect job performance.
- What was he or she just told to do?
- Confusion about places - gets lost on way to work.
- Loses initiative -can't start anything.
- Loses spontaneity, the spark or zest for life.
- Mood/personality changes - patient becomes anxious about symptoms, avoids people.
- Poor judgment - makes bad decisions.
- Takes longer with routine chores
- Trouble handling money, paying bills.
- Forgets which bills are paid. Can't remember phone numbers.
- Loses things; can't remember grocery list.
- Arrives at wrong time or place, or constantly rechecks calendar.
- "Mother's not the same - she's withdrawn, disinterested".
- She spent all day making dinner and forgot to serve several courses.
- She paid the bills three times over, or didn't pay for three months.
2. Second Stage - 2 to 10 years after diagnosis [longest stage]
- Increasing memory loss and confusion.
- Shorter attention span.
- Problems recognizing close friends and/or family.
- Repetitive statements and/or movements.
- Restless, especially in late afternoon and at night.
- Occasional muscle twitches or jerking.
- Perceptual motor problems.
- Difficulty organizing thoughts, thinking logically.
- Can't find right words - makes up stories to fill in blanks.
- Problems with reading, writing and numbers.
- May be suspicious, irritable, fidgety, teary or silly.
- Loss of impulse control - sloppy - won't bathe or afraid to bathe - trouble dressing.
- Gains and then loses weight.
- May see or hear things that are not there.
- Needs full-time supervision.
- Can't remember visits immediately after you leave.
- Repetitive movements or statements.
- Sleeps often; awakens frequently at night and may get up and wander.
- Perceptual motor problems - difficulty getting into a chair, setting the table.
- Can't find the right words.
- Problems with reading, numbers - can't follow written signs, write name, add or subtract.
- Suspicious - may accuse spouse of hiding things, infidelity, may act childish.
- Loss of impulse control - sloppier table manners. May undress at inappropriate times or in the wrong place.
- Huge appetite for junk food and other people's food; forgets when last meal was eaten, then gradually loses all interest in food.
3. Terminal Stage - 1 to 3 years.
- Can't recognize family or image of self in mirror.
- Loses weight even with good diet.
- Little capacity for self care.
- Can't communicate with words.
- May put everything in mouth or touch everything.
- Can't control bowels or bladder.
- May have seizures, experience difficultly with swallowing, skin infections.
- Looks in mirror and talks to own image.
- Needs help with bathing, dressing, eating, and toileting.
- May groan, scream or make grunting sounds.
- Sleeps more.
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