What are the 7 stages of Alzheimer’s?

By understanding the progression of the disease, you will be better prepared when it affects your loved one’s life.

21 August 2015
by Lori Cohen

It’s very difficult to determine when someone has Alzheimer’s disease. “Forgetfulness is a very normal condition in the elderly, and it’s very difficult to determine at which point you should worry,” confirms Professor Malan Heyns, the national chairman of Alzheimer's South Africa. “Emotional outbursts or loss of concentration could also be related to stress rather than illness. Most people only seek a diagnosis and help when the behaviour begins to upset the harmony of the family.”

Making a diagnosis is also very difficult. While a simple test can be used as part of the diagnosis (this includes a list of questions, such as asking the patient’s age), Prof Heyns says that very intelligent people may still be able to answer these correctly, even though they are suffering dementia caused by Alzheimer’s disease.

Furthermore, each case is unique. “We know you can expect memory loss and loss in judgment but the disease affects each person differently. One patient may become meek and mild, while another becomes aggressive. Some lose their appetite, while others overeat,” explains Prof Heyns.

However, understanding the progression of the disease by defining it in stages is one way doctors can help a patient and their family to anticipate what is to come so they are able put appropriate support and changes in place. See below for these seven cognitive health phases that map the decline of the disease.

Stage 1: Normal

This state refers to all mentally healthy people, of any age. This is considered a “normal” brain function and relates to an individual who does not have any symptoms of cognition or functional decline, or emotional and mood disturbances associated with dementia.

Stage 2: Normal aged forgetfulness

This stage refers to a person who experiences the symptoms below, but has otherwise “normal” brain function. Over half of people over the age of 65 complain of the symptoms below, but this does not mean they have Alzheimer’s disease. In fact, family and friends are unlikely to even notice these changes:

  • Can't remember names as well as they did previously
  • Keep forgetting where they placed items
  • Sometimes find it hard to concentrate or remember the right word to use when talking

Stage 3: Mild cognitive impairment

The symptoms of impairment are still very subtle, but will become apparent to those around them, so you’ll begin to notice changes in your loved one. Not every person will experience all or some of these deficits, but these are all common for stage 3:

  • Asks the same question repeatedly
  • May forget appointments and appear disorganised
  • If working, their job performance may decline
  • May struggle to concentrate

Stage 4: Mild Alzheimer’s disease

An accurate diagnosis of Alzheimer’s disease can be made at this stage. The following symptoms of impairment could become evident in this stage:

  • Forgets recent important events, such as a family party
  • Can't recall what the correct day of the week or month it is
  • May no longer be able to cope managing their personal finances and other organisational skills such as grocery shopping and food preparation
  • May seem less emotionally responsive, withdrawn or “flat”

Stage 5: Moderate Alzheimer’s disease

In this stage, the decline in abilities will require the assistance of a carer and family support:

  • May begin to wear the same clothing day after day unless reminded to change
  • Can't purchase food or prepare meals alone
  • Can't remember some major life events or details about everyday life such as their address
  • Expresses anger and suspiciousness

Stage 6: Moderately severe Alzheimer’s disease

At this stage, the ability to perform basic activities of daily life becomes difficult:

  • May require assistance in putting on their clothing properly
  • Can’t recall major aspects of their current life such as the weather conditions on the day
  • Can’t bath or carry out personal hygiene like brushing their teeth, or cleaning themselves after toileting without assistance. They may also become incontinent
  • May experience a reduced ability to speak, such as stuttering
  • Will be confused about the names and identities of even close family members
  • Will become fidgety and move items around
  • Will have violent outbursts and other emotional changes

Stage 7: Severe Alzheimer’s disease

At this stage, patients require incessant assistance with basic activities of daily life. Further signs of decline include:

  • Speech loss, apart from a few words
  • Inability to smile
  • Loss of the ability to walk and eventually sit up
  • Joints become rigid

Shop online at Clicks.co.za for vitamins that boost brain function

Omega-3 and folic acid reportedly help with boosting brain function, which is why Clicks' pharmacists have selected the best supplements for you. If you'd like to stock up on your monthly intake through the convenience of online shopping, go here for omega-3 supplements and here for folic acid.

IMAGE CREDIT: 123rf.com