Alzheimer's Disease: Progression of the Disease, Three Stages

A person in this stage will usually be aware of the diagnosis and will be able to participate in decisions affecting future care.

Symptoms can include mild forgetfulness and communication difficulties, such as finding the right word and following a conversation. Some people stay involved in activities while others become passive or withdrawn. The individual may also be frustrated by changing abilities and may become depressed or anxious. It is important to monitor the emotional well-being of the person.

Abilities Affected	Typical Symptoms
Mental Abilities	mild forgetfulness difficulty learning new things and following conversations difficulty concentrating or limited attention span problems with orientation, such as getting lost or not following directions communication difficulties such as finding the right word
Moods and Emotions	mood shifts depression
Behaviours	passiveness withdrawal from usual activities restlessness
Physical Abilities	mild co-ordination problems

Middle stage

This stage brings a further decline in the person's mental and physical abilities. Memory will continue to deteriorate as the person forgets personal history and no longer recognizes family and friends. Increased confusion and disorientation to time and place will result in requiring assistance in many daily tasks, such as dressing, bathing, using the toilet.

In this stage, some people become restless and pace or wander. Registering the person with the Safely Home™ -- Alzheimer Wandering Registry program will provide peace of mind should she become lost.

In response to the loss of abilities, a person may react in a number of ways. For example, he or she may become less involved in activities or repeat the same action or word over and over again. It can be helpful to understand more about the disease and develop strategies to deal with these situations. Your local Alzheimer Society can provide education, resources and support.

Abilities Affected	Typical Symptoms
Mental Abilities	continued memory problems forgetfulness about personal history inability to recognize friends and family disorientation about time and place
Moods and Emotions	personality change confusion anxiety/apprehension suspiciousness mood shifts anger sadness/depression hostility
Behaviours	declining ability to concentrate restlessness (pacing, wandering) repetition delusions aggression uninhibited behaviour passiveness
Physical Abilities	assistance required for daily tasks (e.g., dressing, bathing, using the toilet) disrupted sleep patterns appetite fluctuations language difficulties visual spatial problems

Late stage

In this last stage, the person becomes unable to remember, communicate or look after herself. Care is required 24 hours a day. Eventually, the person will become bed-ridden, have difficulty eating or swallowing, and lose control of bodily functions. This stage eventually ends with the person's death, often from secondary complications such as pneumonia.

Abilities Affected	Typical Symptoms
Mental Abilities	loss of ability to remember, communicate or function inability to process information severe speaking difficulties severe disorientation about time, place and people
Moods and Emotions	possible withdrawal
Behaviours	non-verbal methods of communicating (eye contact, crying, groaning)
Physical Abilities	sleeps longer and more often becomes immobile (bed-ridden) loses ability to speak loses control of bladder and bowels has difficulty eating and/or swallowing unable to dress or bathe may lose weight

The Three Stages

Early stage

Middle stage

Late stage