Understanding the Seven Stages of Alzheimer’s Disease

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Understanding the Seven Stages of Alzheimer’s Disease

According to the Centers for Disease Control and Prevention, Alzheimer's disease is a progressive disease involving generalized brain degeneration that impacts thought, memory, and language. Since the disease affects people differently, not everyone with Alzheimer's will share the same symptoms or disease advancement rate, but the seven primary stages of Alzheimer's serve as a general progression model for the disease.

Following an Alzheimer's diagnosis, patients typically live for around eight years. However, people with Alzheimer's can reasonably live anywhere between 3 and 20 years. This segment outlines the essential symptoms that encompass the seven stages of mental degeneration caused by Alzheimer's, starting from normal brain function and ending with severe cognitive impairment. This progression structure comes from a system created by Dr. Barry Reisberg, a Professor of Psychiatry at the New York University Langone Medical Center.

In alignment with Dr. Reisberg's framework, this segment breaks down Alzheimer's in terms of mild, moderate, moderately severe, and severe symptoms and describes how these symptoms correspond to the early, mid, and late stages of the disease.

Stage 1 Symptoms: Normal Brain Function (No Mental Impairment)

Stage 1 individuals are mentally unimpaired, and they demonstrate no memory issues during a professional medical examination.

Stage 2 Symptoms: Very Mild Cognitive Regression

In stage 2, individuals exhibit the earliest indications of Alzheimer’s; these signs may be mistakenly viewed as regular age-related changes. Minor memory lapses are not unusual at this stage, especially when it comes to forgetting well-known terms or names and the whereabouts of eyeglasses, keys, or other commonplace items. These issues, however, are not typically noticeable to family, friends, or colleagues or identifiable during a medical interview by a health care professional.

Stage 3 Symptoms: Mild Cognitive Regression

In stage 3, also known as early-stage Alzheimer’s, the disease can be diagnosed in some, but not all, individuals with symptoms:

Cognitive deficiencies are being recognized by family, friends, or colleagues. A thorough medical examination or clinical testing may be able to detect concentration or memory problems. Common complications include:

  • Problems remembering words or names that are evident to relatives or close friends.
  • A decrease in the capacity to recall names after meeting new individuals.
  • Misplacing or losing valuable or everyday items.
  • A reduction in one's ability to organize or plan.
  • Problems with performance in professional or social contexts are evident to family, friends, or colleagues.
  • Retaining very little information after reading or viewing text or images.

Stage 4 Symptoms: Moderate Cognitive Regression (Early-Stage or Mild Alzheimer’s Disease)

In stage 4, a detailed medical examination identifies apparent defects in the areas listed below:

  • Reduced ability to complete complicated tasks, such as preparing a dinner party, paying bills, and managing funds.
  • Lack of awareness of current events or recent happenings.
  • Reduced ability to recall personal history.
  • Impaired ability to execute complex cognitive arithmetic, such as counting backward from 80 by 6s.
  • An introverted or subdued appearance may be evident, specifically in mentally or socially stressful settings.

Stage 5 Symptoms: Moderately Severe Cognitive Regression (Mid-Stage or Moderate Alzheimer’s Disease)

Stage 5 involves significant memory gaps and cognitive function abnormalities. Affected individuals will require notable help with everyday tasks. During a detailed medical examination, individuals may show the following symptoms:

  • Inability to recollect critical information, such as their phone number, present address, or high school/college graduation date.
  • Become confused about where they are or about the date, day of the week, or season.
  • Difficulty with less challenging mental arithmetic, such as counting backward from 20 by 2s or 30 by 3s.
  • Require assistance with selecting appropriate attire for the season or event.
  • Able to retain a great deal of personal information, including their name and the names of their spouse and children.
  • Typically require no help with eating or toileting.

Stage 6 Symptoms: Severe Cognitive Regression (Mid-Stage or Moderately Severe Alzheimer’s Disease)

In stage 6, memory problems worsen, considerable personality changes may develop, and significant support is needed to complete everyday tasks. At this stage, individuals may:

  • Inaccurately recall personal history, yet they usually remember their name.
  • Lose the majority of their awareness of recent events and experiences and their environment.
  • Periodically forget essential names, like their spouse or caregiver, but can usually tell the difference between those with familiar and unfamiliar faces.
  • Tend to wander and get lost.
  • Require assistance with toileting activities, such as cleaning, flushing, or proper tissue disposal.
  • Show increasing episodes of urinary or fecal incontinence.
  • Require assistance with appropriately dressing; if left unaided, dressing mistakes are likely to occur, such as placing shoes on the incorrect feet or putting on pajamas without first removing outside clothing.
  • Display considerable changes in personality, including hallucinations (hearing or seeing things that aren't there); delusions and suspiciousness (e.g., claiming that someone is impersonating their doctor); or obsessive, repetitive actions (such as tapping a surface or ripping paper).
  • Experience disturbances with their sleeping or waking cycle.

Stage 7 Symptoms: Very Severe Cognitive Regression (Late-Stage or Severe Alzheimer’s Disease)

In this last stage of the disease, affected individuals lose their capacity to speak, respond to their surroundings, and, eventually, control their movement.

  • Individuals often lose their ability to speak in a perceivable manner; however, recognizable terms and sentences may be spoken occasionally.
  • Individuals cannot walk without support; they lose their ability to sit without assistance, smile, and keep their heads up.
  • Muscles become tight, reflexes grow irregular, and swallowing becomes difficult.
  • Individuals require assistance with eating and toileting, and they experience frequent urinary incontinence.

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