Alzheimers, Alzheimers Care Massachusetts, The Senior Care network

Just Forgetful or is it Alzheimer’s?

Learning about cognitive decline, dementia, and the clinical and behavioral stages of Alzheimer’s disease is confusing and depressing to say the least. But there are several resources available to help.

Alzheimer’s disease is a form of dementia that affects millions of seniors in the United States. Some resources outline the seven stages of the disease, but it may be less complicated to think of the progression of the disease in three general stages — mild (early-stage), moderate (middle-stage), and severe (late-stage). Since Alzheimer’s affects people in different ways, each person will experience symptoms – or progress through Alzheimer’s stages – differently. The stages give us a general idea of how behavior and abilities change and often overlap, making it difficult to “place” an individual in a particular stage.

Keep in mind, too, that while the symptoms of the disease worsen over time, the rate at which Alzheimer’s disease progresses varies. The disease can create changes in the brain years before any signs of the disease are noticed. This preclinical Alzheimer’s disease phase can last for years.

Early Stage

In the early stages of Alzheimer’s, individuals may function independently. They may drive, work and be part of social activities. However, at the same time, they may have memory lapses, such as forgetting familiar words or the location of everyday objects.
Friends, family or neighbors may begin to notice difficulties. Some common difficulties include:
• Greater difficulty performing tasks in social or work settings
• Losing or misplacing a valuable object
• Increasing trouble with planning or organizing
• Problems coming up with the right word or name
• Trouble remembering names when introduced to new people
• Forgetting material that one has just read
During a detailed medical interview, doctors may be able to detect problems in memory or concentration

Middle Stage

Usually the longest stage, Moderate Alzheimer’s can last for many years. A greater level of care will be required as the disease progresses. People in this stage may confuse words, get frustrated or angry easily and act in unexpected ways. They may refuse to bathe or have difficult expressing thoughts and performing routine tasks. At this point, symptoms will be noticeable to others and may include:

• Forgetfulness of events or about one’s own personal history, such as being unable to recall their address or telephone number or the high school or college where they graduated
• Confusion about where they are or what day it is
• The need for help choosing proper clothing for the season or the occasion
• Changes in sleep patterns, such as sleeping during the day and becoming restless at night
• Feeling moody or withdrawn, especially in socially or mentally challenging situations
• Personality and behavioral changes, including suspiciousness and delusions or compulsive, repetitive behavior like hand-wringing or tissue shredding
• Trouble controlling bladder and bowels in some individuals
• An increased risk of wandering and becoming lost

Late Stage

In the final stage of this disease, individuals may no longer be able to carry on a conversation. They may be able to say words or phrases, but communicating pain is difficult. They lose their ability to respond to their environment and eventually, to control movement. Memory and cognitive skills continue to worsen and personality changes may take place. Individuals need extensive help with daily activities. In Late Stage Alzheimer’s, individuals may:

• Lose awareness of recent experiences as well as of their surroundings
• Have increasing difficulty communicating
• Experience changes in physical abilities, including the ability to walk, sit and, eventually, swallow
• Require a high level of or full-time assistance with daily activities and personal care
• Become vulnerable to infections, especially pneumonia

Resources are available to inform, educate, and guide those with Alzheimer’s disease and their caregivers.
The Alzheimer’s Association – Find a chapter near you:
Caring Advocates – Dealing with advance care planning:
The Mayo Clinic – Information on the stages of Alzheimer’s:
Alzheimer’s Disease Fact Sheet. (2013, October 17). National Institutes of Health.

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