Alzheimer's Disease

Stages of Alzheimer’s Disease

John Trevey on Aug 7, 2022

Stages of Alzheimer's Disease - The Breckinridge - Lexington, KY

The journey with Alzheimer’s disease is different for each individual. Some live only a short time after diagnosis. Some live for twenty or more years. Some progress quickly through the disease, others slowly. Symptoms — which ones, when they arrive and to what degree — vary too.

While each Alzheimer’s journey is unique, specialists have identified five general stages of Alzheimer’s disease. Knowing these stages can help in early intervention and identifying the best treatment and course of care for you or a loved one.

The five stages of Alzheimer’s disease

1. Preclinical Alzheimer’s disease

This stage begins before symptoms of Alzheimer’s appear, such as memory loss or changes in personality and behavior. With advanced research, we now know that Alzheimer’s can appear in the brain long before the disease is noticeable to you or others.

Genetic testing, biomarkers, neuroimaging and blood tests can all indicate whether or not someone has Alzheimer’s disease in this stage.

Genetic Testing

Three genes with rare variations have been identified that cause Alzheimer’s, including APOE-e4, which has the strongest risk correlation to Alzheimer’s disease. Genetic testing with an at-home kit, such as the 23andMe genetic health risk test, can determine if someone carries a gene variant like APOE-e4.

23andMe - The Breckinridge - Lexington, KY

Biomarkers

Biomarkers are measurable indications found through different tests indicating someone has early signs of a disease.

Biomarkers - The Breckinridge - Lexington, KY

For Alzheimer’s disease, testing the cerebrospinal fluid, the liquid around the brain and spinal cord, for the ratio levels of two proteins—beta-amyloid and phosphorylated tau—can indicate whether or not someone has preclinical Alzheimer’s disease.

Stages of Alzheimer's Disease - The Breckinridge - Lexington, KY

Neuroimaging

Magnetic resonance imaging (MRI) and positron emission technology (PET) scans capture images of the brain that can show early indications of Alzheimer’s disease.

Frontotemporal Dementia

Structural imaging using an MRI can detect signs of neurodegeneration in the brain such as shrinking in the hippocampus, a part of the brain crucial to retaining memory.

Functional imaging performed by a PET scan or a functional MRI can reveal if there is reduced brain cell activity in certain areas of the brain that would indicate Alzheimer’s disease.

Molecular imaging tests, which can be performed by a PET scan, can detect the beta-amyloid and tau proteins in the brain, determining if someone has Alzheimer’s before the structure of the brain has changed.

2. Mild cognitive impairment due to Alzheimer’s disease

The Mayo Clinic defines mild cognitive impairment (MCI) as “the stage between the expected cognitive decline of normal aging and the more serious decline of dementia.”[i]

MCI can be caused by Alzheimer’s disease or other conditions such as nutritional deficiencies, autoimmune disease, metabolic imbalance, a brain tumor and more.

MCI typically causes issues with thinking, reading, learning, remembering, reasoning, and attention span but not to the degree that these issues interfere with daily tasks and activities.

Testing can be done to determine if MCI is caused by Alzheimer’s or another condition.

3. Mild dementia due to Alzheimer’s disease

Dementia in and of itself is not a disease, rather it is a group of symptoms caused by another disease, such as Alzheimer’s, which is the No. 1 cause of dementia.

Mild dementia due to Alzheimer’s disease is the stage when Alzheimer’s is most commonly diagnosed because this is typically the stage when symptoms become evident to family members and doctors.

Signs and Symptoms of Alzheimer’s Disease

What Are The Early Signs of Dementia? - The Breckinridge - Lexington, KY

Short-term memory loss: difficulty remembering recent events or information
Poor judgment: making poor decisions due to a loss of sound judgment and reasoning skills
Difficulty with problem-solving or completing tasks: an inability to do complex tasks such as balancing a checkbook and an inability to follow through with daily tasks after they are started
Misplacing items: misplacing valuable items more frequently and not being able to remember where they are
Change in personality: withdrawing in social gatherings or feeling angry or irritable more often
Getting lost more frequently: getting lost on the way to places that were once familiar

These symptoms indicate that memory loss and other symptoms have begun to interfere with daily life, making the disease much more prominent and noticeable.

4. Moderate dementia due to Alzheimer’s disease

At this stage of Alzheimer’s, the symptoms that began in the mild dementia stage grow more severe. Memory loss and confusion increase. Basic personal details, like your birthday, may become difficult to remember. Personality and behavior changes are more evident at this stage. Many grow suspicious of their caretakers and loved ones or think they are seeing or hearing things that aren’t there.

At this stage, many may need help with activities of daily life (ADLs), such as going to the bathroom, changing clothes and eating.

5. Severe dementia due to Alzheimer’s disease

Throughout every stage of Alzheimer’s disease neurons in the brain are deteriorating, shrinking the brain.

During the final stage of Alzheimer’s, the disease has affected every area of the brain needed for daily functioning. This causes a patient to not be able to communicate coherently, to need assistance with all ADLs and not be able to physically move or sit up on his or her own. Eventually, someone with severe dementia due to Alzheimer’s will lose the ability to swallow and control his or her bowels.

Because Alzheimer’s is a degenerative disease of the brain, it is ultimately fatal. Fortunately, aggressive research has led to advancements in medication and early intervention. Knowing the stages of Alzheimer’s and what to expect can help you or your loved ones create a plan that will result in the best quality of life possible at every stage of the disease.

[i] Mayo Clinic, Understanding Alzheimer’s: Your Guide to Brain Health, p.22.

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Continuing an Environment of Caring in Times of COVID-19

Safety of Residents and Staff

As the coronavirus (COVID-19) pandemic continues to evolve, our communities are focused on keeping our Residents and staff safe while also maintaining Resident engagement and daily fulfillment. We are taking a cautious approach, balancing the highest level of safety within the least restrictive environment.

We will continue to follow and augment State and C.D.C. safety recommendations:

Screening: We screen every employee every day. We require our staff to complete a questionnaire (inquiring about possible symptoms, recent travel and exposure), have their temperature and oxygen level checked before entering the building. Staff are also required to clean their cell phones, keys and wash their hands while being observed. We monitor our Residents’ health closely with temperature and oxygen level checks at least twice a day. We help our Residents wash their hands throughout the day and encourage them to wear a mask or face covering.

Cleaning: We have enhanced our cleaning products with regard for their effectiveness in killing COVID-19 particles and proper sanitization and disinfection, using the EPA’s specific list of disinfectants for use against the coronavirus. We are using this list and training staff on how long cleaning solutions must be kept on a surface before wiping it off to ensure its effectiveness. We prioritize cleaning high-touch areas and horizontal surfaces, cleaning them several times a day.

Physical Distancing: We encourage 6 foot distancing between Residents and with staff unless they are providing direct care to a Resident.

Testing: We test all Residents and staff for COVID-19 every three weeks, and more as needed. Our nurses utilize a PCR test, which we send to a private lab to expedite results.

Physical Changes: We have installed ultraviolet lights in our air conditioners that supply air to the common areas of the houses. This method is believed to be helpful in killing bacteria that is cycled through the systems and pushed back into the house. We’ve also enhanced our HVAC filters to near HEPA levels, trying to add additional layers of protection to keep COVID-19 out of the building. Most importantly, air purifiers have been added to common areas and each resident room.

PPE: Staff members wear masks at all times and we encourage Residents to wear masks when outside their rooms. We also encourage physical distancing between our Residents. Staff wears additional protective equipment when deemed necessary while caring for our Residents. Staff are continually trained on when and how to use personal protective equipment (PPE).

Individual Needs Stay Paramount

The uncertainty surrounding COVID-19 affects us all. At our communities, we are not letting it stop us from safely offering a life well-lived. Above all, we are providing the utmost attention to the safety and well-being of our Residents. Our Program has always revolved around the individualized needs of each Resident and this has not changed during COVID-19. Residents are still able to connect with each other and staff while maintaining a safe physical distance. Weather permitting, we enjoy the patio and large backyard. We continue to keep our Residents engaged through cognitive, physical, recreational experiences. We offer enjoyment and connection throughout the day even during these unprecedented times.

Visitors

Since early March we have restricted facility access to prevent the spread of COVID-19.

Essential Visitors: Healthcare providers including physicians, home health, private duty services, physical therapy and hospice staff have not been allowed in the communities unless there is an acute, essential need for our Residents. These services continue as needed through FaceTime, tele-med and phone conversations. If physical access is absolutely necessary, the individual will complete our questionnaire and screening for temperature and oxygen stats. No one is allowed in the community if they fail to meet our screening criteria.

Families: We are happy to help schedule window visits, FaceTime, Zoom and phone calls with your loved ones based on what is allowed and prudent. To ensure the proper support from our staff, our visits are scheduled ahead of time.

Tours and Move-Ins

Tours: We recognize that regardless of the changes with COVID-19, your need for senior living hasn’t changed. For the safety of you, our Residents and staff, we are currently offering virtual tours where you can see our community, as well as meet our staff. Please contact our Community Relations Director to set up a virtual tour.

Move-Ins: We are accepting a limited number of move-ins (unless otherwise instructed by public health department). New Residents must be tested for COVID-19 prior to move-in. Upon admission, we will place a new resident in their room to quarantine as an additional precaution.

We will share community-specific information with residents and families as our quarantine measures continue to evolve with new information of COVID-19.

We are honored to care for your family member and loved one.

Comments we’ve received from our families during COVID-19.

“We appreciate all of your efforts. Your team clearly is a leader in the response to COVID. Thank you for keeping our loved ones safe.”

Joseph

“Thank you, thank you, thank you for ALL you have done and are doing to keep the residents and staff in a safe environment! The continuous learning and improvements empower caregivers and families to do better at home and in our communities.”

Tommy

“I appreciate you taking the time to update us and share them with my family living in AL, GA, VA, MD, FL…we are extremely grateful and comforted by your proactive and decisive measures! We’ll continue to keep you in prayer for health, safety and more.”

Rebecca

“In keeping with the parade theme you had, the employees there are super heroes. They are plowing forward in the midst of this horrible virus and taking care of their patients selflessly. I just wanted to acknowledge their bravery and dedication and thank them from the bottom of my heart for the goodness in their hearts and their dedication to their patients and jobs.”

Abigail

“Thank you! You locked down early & your diligence has paid well.

The Bader support group continues meeting once a month by Zoom. We all appreciate you so much. Everyone comments on how grateful we are that our parents are at The Breckinridge!

We appreciate everything: sending us pictures, calls, alerts to bring supplies/clothes as needed, staying in virtual contact with hospice.
Blessings to each of you.”

Marsha

“Thank you for all y’all and all the staff are doing for my mom and the other residents. We truly appreciate your hard work.”

Carol