The 7 stages of Alzheimer’s Disease and what they mean for you

Millions of individuals worldwide are afflicted with the degenerative brain ailment known as Alzheimer’s disease. It accounts for between 60 and 80 percent of all instances of dementia, making it the most prevalent cause. 

It is essential for patients, carers and medical professionals to comprehend the stages during which Alzheimer’s disease develops.

There are seven distinct stages in the progression of Alzheimer’s disease, each with its special traits and difficulties. 

The course of the illness may significantly affect people and their loved ones, starting with the preclinical stage, where small changes in the brain take place and ending with the later stages of severe cognitive loss. 

We can better understand how the disease develops by examining the symptoms, cognitive changes and care issues specific to each stage.

What is Alzheimer’s disease?

A progressive neurological condition, Alzheimer’s disease predominantly impacts the brain and causes memory loss and cognitive deterioration. 

Dementia, a condition defined by a deterioration in cognitive function severe enough to impair everyday activities, is most frequently caused by this.

Alzheimer’s disease is thought to be brought on by a confluence of hereditary, environmental and lifestyle factors, however, its specific etiology is still not entirely known. 

Beta-amyloid plaques and tau tangles, two aberrant proteins, build up in the brain due to the disease [1]. 

These protein clumps prevent neurons from functioning normally, which causes neuronal aging and eventual cell death.

The symptoms of Alzheimer’s disease can vary from person to person, but they generally worsen over time. 

Some of the common symptoms include:

Memory loss

Having trouble recalling freshly acquired knowledge, regularly overlooking significant dates or events, relying on memory aides or asking the same questions repeatedly.

Cognitive decline

Reduced capacity for critical thinking and problem-solving, inability to focus or follow discussions, and difficulties making decisions or figuring out solutions.

Language problems

Finding it difficult to explain oneself or to comprehend others, having trouble reading or writing and having problems with these.

Disorientation

Trouble identifying faces, navigating well-known roads, and becoming lost in familiar locations.

Mood and behavior changes

Depression, anxiety, irritability, agitation, social withdrawal, changes in personality or behavior.

A decline in self-care abilities
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A decline in self-care abilities

Putting personal hygiene last, forgetting to eat or take prescriptions, and having trouble with ADLs.

Now that we have listed some possible symptoms that people with Alzheimer’s might experience let us move forward and discuss the 7 different stages of the disease.

The 7 stages of Alzheimer’s

1. Preclinical Alzheimer’s

Subtle changes occur in the brain even before obvious symptoms appear in the preclinical stage of Alzheimer’s disease, sometimes referred to as early-onset Alzheimer’s.

Advanced imaging methods and biomarker analyses can identify these changes, giving important information about how the illness develops.

Subtle brain changes and early symptoms

In particular brain areas, the preclinical stage begins depositing aberrant proteins including beta-amyloid plaques and tau tangles. 

Tau tangles are twisted fibers that collect within brain cells, whereas beta-amyloid plaques are sticky clusters of protein fragments that accumulate between nerve cells [2]. Neuronal function is disrupted, and these alterations hamper intercellular communication.

Despite these changes, people in this period usually do not suffer from severe cognitive decline or memory loss. However, scientists have discovered several possible early symptoms that could point to preclinical Alzheimer’s. 

Subtle alterations in memory, attention and executive functioning may be among these symptoms. 

For instance, people may periodically forget recent events, fail to focus on tough activities, or have trouble planning and addressing problems.

2. Mild Cognitive Impairment (MCI)

The second stage of Alzheimer’s development is Mild Cognitive Impairment (MCI). Individuals go beyond the cognitive changes associated with aging during this stage and experience observable changes. 

MCI is frequently seen as a period between normal aging-related cognitive decline and the more severe cognitive impairments linked to Alzheimer’s disease.

Characteristic symptoms and cognitive decline

Mild cognitive abnormalities perceptible to the individual and others around them but do not severely interfere with everyday functioning are a hallmark of MCI. 

Typical signs include:

  • Memory problems

People may have problems remembering recent discussions or occurrences, losing things more frequently, or recalling crucial facts.

  • Language difficulties

It could get harder to express yourself, find the correct words, or keep up with conversations.

  • Impaired thinking and decision-making

Complex jobs may become more challenging, taking more time and effort. 

Examples include managing funds or preparing events.

3. Mild Alzheimer’s disease

The change from moderate cognitive impairment (MCI) to the start of mild Alzheimer’s disease is what defines stage 3 of the disease. 

People go through a more noticeable stage of cognitive decline and functional impairments at this point, affecting how they live their everyday lives.

Progressive memory loss and cognitive decline

A notable impairment in memory function is one of the characteristic signs of mild Alzheimer’s disease.

Individuals could have trouble recalling the names of familiar persons or recent events, or they might quickly repeat queries or anecdotes [3]. 

It’s also possible that other cognitive processes like attention, language and problem-solving skills will be impacted.

Challenges in communication and problem-solving

Individuals in stage 3 may experience more communication challenges as the condition worsens. They could find it difficult to formulate cohesive ideas, follow discussions, or find it challenging to find the correct words. 

Additionally, decision-making and problem-solving skills may be compromised, making it difficult to perform complicated activities or manage funds.

4. Moderate Alzheimer’s disease

The cognitive function has significantly decreased by stage 4 of Alzheimer’s disease, and the need for assistance with daily tasks has grown. 

Significant memory loss and difficulties with everyday activities are common in people with mild Alzheimer’s disease at this stage.

Noticeable memory gaps and confusion

In stage 4, memory loss becomes more noticeable. People may have trouble remembering recent events and identifying familiar faces, even those of close family members and friends. 

They could also show gaps in their knowledge of their past and have trouble recalling their own home or cell phone numbers. 

Disorientation might become more severe when there is confusion regarding the time, place and individuals.

A decline in language skills and executive function

Language problems become more obvious in stage 4. Finding the correct words, making phrases that make sense and following discussions may be challenging for some people. 

It gets harder and harder to communicate and understand difficult concepts. It is challenging to do tasks that require structure and logical thinking because executive functions such as planning, problem-solving and decision-making are severely compromised.

Moderately severe Alzheimer's disease
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5. Moderately severe Alzheimer’s disease

The cognitive function significantly declines in stage 5 of Alzheimer’s disease, also known as moderately severe Alzheimer’s disease, and the need for assistance with everyday tasks increases. 

People at this stage need much help and attention to go through their everyday lives.

Severe memory impairment and disorientation

A person’s ability to recall personal information, such as their address or phone number, becomes severely impaired in stage 5, indicating that their memory impairment has progressed. 

They could be only dimly aware of current affairs, and it might be difficult to recall recent talks or the names of close relatives. 

The disorientation regarding time, place and even one’s identity worsens.

Assistance required for activities of daily living (ADLs)

Moderately severe Alzheimer’s disease patients need assistance with various daily living activities (ADLs). These include washing, dressing, grooming, eating, and restroom use. 

They become much less capable of carrying out these chores independently and depend on caretakers for help and supervision.

6. Severe Alzheimer’s disease

An extreme loss of cognitive function and independence are characteristics of Alzheimer’s disease stage 6. 

Even the most fundamental everyday activities require significant support and monitoring for those with severe Alzheimer’s disease.

Profound memory loss and loss of self-identity

People at stage 6 suffer from severe memory loss, which includes losing personal information like their own name, the names of family members or important life events [4]. 

They could also have trouble identifying familiar persons and remembering details about their past. The person’s self-identity is now becoming more and more masked.

Challenges in physical functioning and mobility

In stage 6, mobility and physical capacity are substantially impacted. 

It may be difficult for some people to walk independently because of their motor skills, coordination and balance issues. Transfers, such as going from a bed to a chair or a wheelchair, could necessitate help. 

Additionally, increased muscular stiffness and weakness have been noted.

7. Very severe Alzheimer’s disease

The ultimate and most severe stage of Alzheimer’s disease is stage 7, its most advanced level. 

People with extremely severe Alzheimer’s disease, often known as this stage, endure a devastating loss of cognitive and physical function and need 24-hour care and assistance.

Total dependence on others for basic needs

Alzheimer’s patients reach stage 7 when they depend on other people for all activities of daily living [5]. 

They become unable to understand verbal communication or speak clearly. They could need help with grooming, eating, and using the restroom.

Communicating through non-verbal cues

Only non-verbal clues, including gestures, facial expressions, or vocalizations, are used to communicate. 

Caretakers must interpret observational signals to comprehend and address the needs of those they care for. 

People may convey their wants or feelings through noises or physical contact.

End-of-life considerations and palliative care

In stage 7, end-of-life issues take center stage. People are more prone to infections, problems and other medical concerns as the disease worsens. 

Palliative care aims to promote comfort, dignity, and quality of life. It entails controlling discomfort, offering emotional support to the person and their loved ones and establishing a calm and encouraging environment.

To meet this period’s specific demands and difficulties, caregivers should collaborate closely with medical experts, especially palliative care specialists. 

Comprehensive care and assistance can also be obtained from hospice care, specializing in end-of-life support.

Conclusion

People with Alzheimer’s need varied support and specialized care as the disease progresses. 

Early identification and intervention during the preclinical and moderate phases of cognitive impairment might present chances for prospective therapies and way-of-life changes. 

Caregiver assistance, safe conditions, and improving the patient’s quality of life are essential as the disease progresses.

Although there is presently no cure for Alzheimer’s, continued research offers hope for future innovations and potential therapies

While waiting, learning more about the phases of Alzheimer’s disease equips us to confront the difficulties with understanding, compassion and empathy.

FAQs

How quickly does Alzheimer’s disease progress?

Alzheimer’s disease can develop in people in a variety of ways. Individuals may have symptoms of the condition for an average of 8 to 10 years after they first appear. However, some people could go through the process more quickly while others can endure a gradual decrease over time.

Can exercise slow the progression of Alzheimer’s?

While there is no known treatment for Alzheimer’s disease, evidence indicates that regular exercise may have benefits in delaying the illness’s course and enhancing cognitive function. Exercises for balance, strength, and aerobic capacity have been linked to possible cognitive advantages and may support general brain health.

Can Alzheimer be prevented?

At present, there is no known way to prevent Alzheimer’s disease entirely. However, certain lifestyle choices may help reduce the risk or delay the onset of the disease.

[1] https://www.nia.nih.gov/health/what-alzheimers-disease
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6417794/
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4185370/
[4] https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers-stages/art-20048448
[5] https://www.webmd.com/alzheimers/guide/alzheimers-disease-stages

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