Progression of Alzheimer's disease

People with Alzheimer’s disease differ in the patterns of problems they have, and the speed with which their abilities deteriorate. Their abilities may change from day to day, or even within the same day. What is certain though, is that the person’s abilities will deteriorate over time.

Stages of Alzheimer’s disease

Some of the features of Alzheimer’s disease are commonly classified into three stages or phases. It is important to remember that not all of these features will be present in every person, and that they might occur at different stages for some people. However, it remains a useful description of the general progression of dementia caused by Alzheimer’s disease.

Mild Alzheimer’s disease

Sometimes this stage is only apparent in hindsight. The onset of Alzheimer’s is usually very gradual, and it is often impossible to identify the exact time it began.

The person might:

  • Appear more apathetic, with less sparkle
  • Lose interest in hobbies and activities
  • Be less willing to try new things
  • Be less able to adapt to change
  • Be slower to grasp complex ideas and take longer with routine jobs
  • Become more forgetful of recent events
  • Become confused or disoriented to time and place
  • Become lost if away from familiar surroundings
  • Be more likely to repeat themselves or lose the thread of their conversation
  • Be more irritable or upset if they fail at something
  • Have difficulty managing finances
  • Have difficulty shopping or preparing meals

Moderate Alzheimer’s disease

At this stage the person’s problems are more apparent and disabling. A person with moderate Alzheimer’s is not able to live independently, but requires significant day-to-day support.

The person might:

  • Be very forgetful of current and recent events. Memory for the distant past is generally OK, but some details may be forgotten or confused.
  • Be often confused regarding time and place
  • Become lost more easily
  • Forget names of family or friends, or confuse one family member with another
  • Forget saucepans and kettles on the stove or leave gas lit
  • Be less able to perform simple calculations
  • Show poor judgement and make poor decisions
  • Wander around streets, perhaps at night, sometimes becoming lost
  • Behave inappropriately, for example going outdoors in nightwear
  • See or hear things that are not there or become suspicious of others
  • Become very repetitive
  • Be neglectful of hygiene or eating
  • Be unable to choose appropriate clothing for the weather or occasion
  • Become angry, upset or distressed through frustration

Severe Alzheimer’s disease

At this third stage, the person is severely disabled and needs continuous care for all daily activities.

The person might:

  • Be unable to remember current or recent events, for instance forgetting that they have just had a meal or being unable to recall where they live
  • Be unable to recall important events or facts from their early life
  • Show confused recognition of friends and family
  • Fail to recognise everyday objects
  • Lose their ability to understand or use speech
  • Need help with eating, washing, bathing, brushing teeth, toileting and dressing
  • Become incontinent
  • Be disturbed at night
  • Be restless or fidgety
  • Call out frequently or become aggressive
  • Have difficulty walking and other movement problems including rigidity

Immobility will become permanent, and in the final stages the person will be unable to sit up independently and be bedridden. As a terminal illness, Alzheimer’s disease progresses until the end of life, when extensive care is required.

Remember

Some abilities remain, although many are lost as the disease progresses. The person may still keep their sense of touch and hearing, and their ability to respond to emotion, even in the final stages. At all stages of Alzheimer’s disease, treatments and support services are available to reduce the impact of the problems experienced. These should be utilised to ensure the best possible quality of life for every person affected by Alzheimer’s disease.

More information about the stages of Alzheimer’s disease and what can be done to help the person with Alzheimer’s and their carers is available at memoryloss.org.au

FURTHER INFORMATION

Alzheimer’s Australia offers support, information, education and counselling. Contact the National Dementia Helpline on 1800 100 500, or visit our website at fightdementia.org.au

For language assistance phone the Telephone Interpreter Service on 131 450

Last Reviewed: 1 March 2012
Reproduced with kind permission from Alzheimer's Australia NSW.

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References

Alzheimer's Australia NSW. Progression of Alzheimer's disease. About Dementia Factsheet 14. Last reviewed March 2012. (accessed May 2013).
Alzheimers Australia NSW

Alzheimers Australia NSW

Alzheimer's Australia. We represent the more than 353,800 Australians living with dementia and the estimated 1.2 million Australians involved in their care. We advocate for the needs of people living with all types of dementia, and for their families and carers, and provide support services, education and information.