How Alzheimer's disease progresses through its 7 stages
Alzheimer's disease is one of the most common forms of dementia, which is a progressive decline in cognitive function. It eventually affects the entirety of the brain, influencing memory, thinking, judgement, language, problem-solving, personality, and movement. Alzheimer's disease can result in the inability to perform basic daily tasks such as grooming or even having a conversation.
According to the NHS, it is one of the most prevalent diseases among people over the age of 65 in the UK. Alzheimer's disease and other forms of dementia are estimated to affect 1 in 14 people over 65 and 1 in 6 individuals over 80. However, approximately 1 in 20 Alzheimer's disease patients is younger than 65 years old. This is known as young-onset or early-onset Alzheimer's.
If you are able to recognise the signs of each stage, you can help your loved one manage Alzheimer's disease if they are exhibiting early symptoms. In this article, we will examine the seven stages of Alzheimer's disease in great detail.
Here are Alzheimer's disease's seven stages:
Stage 1: Preclinical Alzheimer's disease or no signs of dementia
Alzheimer's disease begins subtly, with brain changes occurring long before anyone is aware of a problem. This stage of Alzheimer's lasts for years, maybe even decades. Though at this stage it is difficult to spot symptoms, with the help of modern technologies such as PET scans, we can determine whether a person has Alzheimer's or not.
As the risk of Alzheimer's disease rises with age, it becomes essential to undergo screening at regular intervals to detect the earliest symptoms.
As the person moves into the next six stages, there will be noticeable changes in their thinking and reasoning. If you notice a change in one of the cognitive abilities, the individual may have entered the second stage.
Stage 2: Very mild cognitive decline, age-related forgetfulness
Many individuals over the age of 65 report cognitive and functional difficulties. Individuals in this stage report that they tend to forget the name and can't recall it as easily; they also face difficulty recalling where they have placed things.
However, even at this stage, the person might not show any noticeable signs of Alzheimer's disease, although they might be slowly picking up small changes. At this stage, the mild symptoms of Alzheimer's disease may not impair a person's ability to work or live independently.
People with these symptoms decline at a faster rate than individuals of comparable age and health who are also free of subjective complaints. According to research, this phase of subjective cognitive decline in otherwise healthy individuals lasts 15 years.
Stage 3: Mild cognitive impairment (MCI)
Persons in this stage start showing noticeable changes in their thinking and reasoning. These subtle deflects may be manifested in different ways, such as:
- Forgetting something they just read
- Repeating the same question
- Facing trouble making plans and organising
- Difficulty remembering names when meeting new people
Furthermore, the ability to perform executive functions is also compromised. For example, if a person is still working in complex occupational settings, their job performance declines. Those who must acquire new job skills experience an apparent decrease in capabilities.
A person with MCI who is unemployed but who leads a complex lifestyle, such as party planning, may experience a decline in their ability to plan such events. This might be an early sign of Alzheimer's disease, and they should seek medical attention promptly to determine this. Blood tests and MRIs can help determine if a person's cognitive decline is the result of Alzheimer's disease or another condition.
Some people with MCI will also find it difficult to concentrate, and they may begin to experience anxiety disorders, which may be overtly evident. The average total duration of the MCI stage in otherwise healthy individuals is 7 years and might not be evident until midway or nearing the end of this stage.
The management of individuals at this juncture includes counselling on the desirability of continuing in a complex and demanding occupation. Sometimes, a "strategic withdrawal" in the form of retirement can alleviate psychological tension and lessen both personal and manifest anxiety.
Stage 4: Mild dementia, Moderate cognitive decline
The diagnosis of Alzheimer's disease can be made with considerable accuracy at this stage as thinking and reasoning deficits become more obvious. One of the most common deficits is that the person's ability to carry out daily activities declines drastically, which makes it difficult for them to live an independent life. For example, people in this stage might have difficulty paying bills, struggling to use the telephone, or having trouble putting the correct date and amount on a check.
During this stage, memory loss symptoms also become more pronounced. A person at this stage with an evident cognitive deficit may still be able to live independently in the community with assistance.
In this stage of Alzheimer's disease, the person often seems less emotionally responsive than previously. The person sought out the psychological defensive mechanism known as denial, as they were aware of their condition but not ready to accept it.
From the very beginning of this stage, a diagnosis of Alzheimer's disease can be made with certainty. According to studies, the duration of this stage lasts for 2 years in an otherwise healthy person.
Stage 5: Moderate dementia, Moderately severe decline
In this stage, deficits are quite significant, making it difficult for the person to live in a catastrophe-free, independent community. In this stage of Alzheimer's disease, the person's daily activities are disrupted as they lose track of where they are and what time it is and have trouble remembering their address and phone number. Some people with Alzheimer's disease begin to wear the same clothes day after day until they are told to change. This stage of Alzheimer's disease lasts for an average of approximately 1.5 years.
An individual in this stage of Alzheimer's disease will need the assistance of a carer to provide proper food, manage their financial transactions, and perform other daily tasks. They also show behavioural changes such as anger and suspicion. Those who are not adequately supervised may fall victim to predatory strangers.
Cognitively, the person in this stage can't recall major events or aspects of their current life. Characteristically, the person's remote memory also suffers, as they are not able to recall the schools in which they have studied. Apart from this, they will have difficulty with orientation and calculation. Functionally, this stage is characterised by the onset of difficulties with fundamental daily activities.
Stage 6: Moderately severe dementia
A person in the sixth stage of Alzheimer's disease has noticeable difficulty with memory and thinking, because of which the ability to perform basic daily activities becomes compromised. The sixth stage of Alzheimer's disease has five substages, which are as follows:
Substage 6a: A person in the initial substage of 6a Alzheimer's disease, in addition to losing the ability to choose clothes without assistance, will also require help in putting on their clothes properly. If unsupervised, the individual might wear the clothes backward, have difficulty putting their arm in the correct sleeve, or dress in the wrong sequence.
Substage 6b: Finding it difficult to bathe or wash on their own, such as filling a bath, finding a good water temperature, or using a towel to dry off. Moreover, it is also common for someone in this substage to feel fear or anxiety about bathing.
Substage 6c: Finding it difficult to use the toilet on their own, as they might forget to flush, wipe, or even pull up their underwear afterwards.
Substage 6d: Unable to control their urination, meaning they might not know when to use the toilet or how to go to the bathroom. You may also notice them urinating in their pants.
Substage 6e: This is the most advanced substage of stage 6, where difficulty with faecal incontinence may be experienced, meaning they may not know when they need to poop or how to use the toilet. People in this stage of Alzheimer's disease will need support when using the bathroom.
Stage 7: Very severe cognitive decline, Severe dementia
A person in this stage of Alzheimer's disease loses many of their basic abilities, such as eating, walking, and sitting up. They lose most, if not all, of their independence as thinking, memory, and control over bodily functions all severely decline. There are six substages within stage 7, and understanding these stages will help carers track Alzheimer's disease progression.
Substage 7a: Difficulty in speaking is experienced, and patients eventually become hesitant to speak.
Substage 7b: Increased difficulty with words, as individuals can only say "yes" or "ok," and eventually these will be replaced by vocalisations or soft grunts.
Substage 7c: Finding difficulty walking, climbing stairs, or tilting forward or sideways when standing and ultimately losing the ability to move on their own.
Substage 7d: Difficulty sitting up straight is experienced. However, the individual is typically still able to grimace, chew, grunt, scream, and grasp objects.
Substage 7e: Loses the ability to make facial expressions and struggles to recognise familiar faces. However, they are able to move their eyes, grasp items, chew and swallow food, and vocalise utterances.
Substage 7f: This is the most advanced substage of stage 7 in Alzheimer's disease, where the patient loses the ability to hold up their head and may require feeding tubes to eat. However, they might still be able to make soft grunts or vocalise. Typically, few Alzheimer's disease patients survive to this stage.
Once a person reaches stage 7, Alzheimer's disease is dangerous and fatal, particularly when paired with other health issues.
Nurses Group Homecare UK is the best option if you are seeking a reliable care provider for your loved one in any stage of Alzheimer's disease. We have qualified carers who specialise in assisting those with such conditions. Contact us for additional information.