Stages of Alzheimer’s Disease

Alzheimer’s disease is a progressive degenerative disease of the brain that typically advances in stages. These stages are generally referred to as early-, middle-, and late-stage Alzheimer's disease.

Whether you have been diagnosed with Alzheimer's disease or know someone who has, understanding the symptoms and challenges they pose is key for ensuring effective support for patients, caregivers and loved ones.

While there are tools and assessments used to determine Alzheimer’s disease progression, the patient’s ability to function daily will give clues as to the particular stage of the disease they may be in.

Preclinical Alzheimer’s Disease

Alzheimer’s disease can start years or decades before the onset of symptoms. Doctors and researchers call this occurrence “preclinical Alzheimer’s disease” and the condition has no symptoms.

Silent changes in the brain can occur before other Alzheimer’s symptoms are noticed. Doctors might be able to diagnose preclinical Alzheimer’s disease through PET scans, genetic testing and biomarker indicators.

Early-stage Alzheimer's Disease

In the early stage, those diagnosed with Alzheimer’s disease are still able to function independently and perform daily tasks, including driving, working and socializing. However, other people may begin to notice differences in behavior, memory or concentration.

The patient may have trouble:

• Finding the right word or name
• Remembering information they just read or heard
• Losing or misplacing valuable objects
• Performing routine housework, such as cleaning, cooking and yard work
• Handling finances
• Remembering a new person’s name
• Navigating familiar places when driving

Middle-stage Alzheimer's Disease

As symptoms worsen, the impact of Alzheimer’s on someone grappling with the disease becomes more noticeable as they struggle to take care of their own basic needs. Patients begin to require a greater level of care and supervision, as the damage to the brain makes it difficult to express thoughts and perform routine tasks. This is typically the longest stage, sometimes lasting several years.

Patients in the middle stage of Alzheimer's disease may experience symptoms such as:

• Being unable to recall their address or telephone number
• Changes in sleep patterns
• Confusion about where they are or what day it is
• Feeling moody or withdrawn, especially in socially or mentally challenging situations
• Forgetting events or personal history
• Personality and behavioral changes, including suspiciousness, withdrawal, difficulty in engaging with others, delusions or repetitive behavior
• Wandering and becoming lost
• Forgetting how to walk without help, forgetting to chew or swallow food, losing ability to sit up, hold head up and/or smile

Late-stage Alzheimer's Disease

Those in the late stage of Alzheimer’s disease are completely dependent in all aspects of life.

Patients become unable to respond to their environment, communicate and control their movement. Their personalities change significantly and they need extensive help with all aspects of everyday activities, such as grooming, dressing, bathing, eating and using the bathroom. They also lose awareness of their surroundings and physical abilities such as walking, sitting or swallowing.

Patients in the late stage of Alzheimer’s disease may experience the following symptoms:

• Difficulty with short- and long-term memory
• Forgetting their own personal histories, friends and family members
• Inability to comprehend language or written materials
• Inability to express themselves and communicate their needs
• Becoming upset and frustrated easily
• Inability to express emotion
• May become afraid of the water in the bath or shower

The compassionate staff at Banner Alzheimer’s Institute and Banner Sun Health Research Institute recognize this disease has a profound effect on the family and loved ones of someone diagnosed with dementia. We are here to provide you with a variety of support groups to meet you where you are in your journey to better navigate this difficult time.