As discussed in a previous blog article, Alzheimer’s disease is a multi-stage, incurable, progressive disorder that generally progresses over 8-10 years or more, but always results in death. Every individual is different, but the first few stages typically develop and progress rather slowly, but will gradually worsen with time. More often than not, the later years of the disease tend to show a step-wise decline in cognitive, behavior and physical function as the progression continues. Medical experts divide the disease into 7 stages in order to better understand what is taking place in the brain of your loved one, as well as what to expect in the future. Remember, Alzheimer’s disease is different in every person, so these stages are more guidelines than set rules. Symptoms easily overlap and persist in multiple stages, as the disease is a continuous process.
Stage 1: No Impairment. There are physiological changes taking place in the brain, but there are no physical, cognitive or behavioral symptoms. This stage is only identified retrospectively as no symptoms are present.
Stage 2: Very Mild Cognitive Decline. Similar to stage 1, there are very few if any noticeable symptoms, and usually the cognitive decline is associated with aging and barely noticeable effects on short term memory. Stage 2 is also identified retrospectively as screening cannot identify the extremely minor impairment.
Stage 3: Mild Cognitive Decline. Close family, friends, or co-workers usually begin to notice changes in memory in stage 3. With an intense screening, this stage can be identified by medical professionals, but is often inconclusive. Stage 3 is usually associated with the first appearance of mild expressive aphasia (the inability to find the correct word when speaking), occasionally misplacing valuable or important items, and a mild decrease in the ability to perform complex tasks, planning and organizing.
Stage 4: Moderate Cognitive Decline. Stage 4 is generally where a diagnosis of Alzheimer’s disease most often takes place. The issues which arose in stage 3 with short term memory loss and the ability to complete complex tasks becomes increasingly difficult. There are often behavioral aspects which arise, most often frustrations with the individual’s inability to remember or function as they always have, or mild depression and social withdrawal for similar reasons.
To this point, Stages 1-4 are all considered “mild” or “early stage” Alzheimer’s disease. This early stage generally persists anywhere from 4 to 20 years. In retrospective studies, when someone is diagnosed with stage 4 Alzheimer’s disease, there may have been mild signs and symptoms more than 2 decades prior to the diagnosis.
Stage 5: Moderately Severe Cognitive Decline. Short term memory loss is progressively lost and individuals may have increasingly more problems completing daily activities including choosing clothing or remembering their own address. Usually, long term memory remains clear and unaffected in stage 5, and the individual can still feed and toilet themselves.
Stage 6: Severe Cognitive Decline. There are severe lapses in memory in stage 6. Individuals will not be able to recall family names or faces, and they may be increasing confused by their surroundings. There is more dependence on help from others for nearly all activities of daily living including toileting, but most patients can still feed themselves independently. Restlessness often becomes an issue, especially sun downing, and stage 6 also sees the development of incontinence issues. There may be significant behavioral and personality changes in stage 6, such as sever mood swings, delusional or suspicious thoughts, repetitive or compulsive behaviors, as well as wandering.
Stages 5 and 6 are considered “mid-stage” Alzheimer’s disease, and many individuals progress through this phase anywhere from 2-4 years on average. Those with mid stage Alzheimer’s will need increasingly more assistance with normal activities of daily living as the disease slowly progresses.
Stage 7: Very Severe Cognitive Decline. “Late stage” Alzheimer’s disease shows a progression of all the previous cognitive and physical symptoms. Communication is usually impossible as a result of both expressive and receptive aphasia, and many individuals become non-verbal all together. Individuals need assistance with all activities of daily living including toileting and feeding. Physical decline progresses to the point where walking is difficult if not impossible, and eventually even autonomous functions are affected and individuals lose the ability to control any bladder or bowel function, hold their head upright and even swallow. Rate of progression in late stage Alzheimer’s disease varies greatly, but on average is less than 2 years. Many times pneumonia develops as a result of aspirated food and liquids enter the lungs, as the ability to control swallowing is lost.
At this point in time, there is no cure for Alzheimer’s disease, and there are also no true preventative measures. However, there is extensive research in treatment options as well as early diagnosis, and prevention of Alzheimer’s disease. There are countless clinical trials with more drugs and therapeutic regimen being discovered every day. Additionally, experts do agree, daily physical and mental stimulation as well as increasing a person’s socialization to prevent depression can help prevent and slow the progression of Alzheimer’s disease. At Centennial Adultcare Center, our daily program includes multiple physical and cognitive stimulatory activities and games which provide a therapeutic, and entertaining daily program in a safe, caring, social environment for all of our members. Call us at (615) 383-3399 in Nashville, (615)288-8289 in Mt. Juliet, or (615) 713-1339 in Murfreesboro or contact us today, and see how we can assist you and your loved one!