A common system for describing the different
phases or stages of Alzheimer’s disease was developed by Dr. Barry Reisberg of
New York University.
There are seven stages of Alzheimer’s disease
but the precise number of stages is arbitrary. Each patient experiences the
disease differently.
Stage 1: No Impairment
There is no memory problem or other symptoms
of dementia evident. It is important to remember that the brain pathology of
Alzheimer’s disease can typically begin 10-15 years before any signs of the
illness are evident.
Stage 2: Very Mild Decline
The patient may notice minor memory problems
or misplace things around the house. The memory loss may not be distinguished
from normal age related memory loss. The disease may not be noticed by
physicians or family members.
Stage 3: Mild Decline
The family members may begin to notice memory
and cognitive problems. Performance on memory and cognitive tests are definitely
affected. Physicians will detect impaired cognitive function. Patients will
have difficulty in finding the right word during conversations and remembering
names of new acquaintances. They may also frequently lose personal possessions.
Stage 4: Moderate Decline
There will be clear cut symptoms of
Alzheimer’s disease. Patients will have difficulty with simple arithmetic,
managing finance and paying bills. They will suffer from short term memory impairment
and forget details about their life histories.
Stage 5: Moderately Severe Decline
Patients begin to need help with many daily
activities. They may experience significant confusion, difficulty dressing
appropriately and cannot recall simple details such as their own phone number.
They can still bathe and toilet independently. They still know their family
members and some details about their childhood and youth.
Stage 6: Severe Decline
Patients need constant supervision and
frequently require professional care. They may suffer confusion, major
personality changes and potential behavior problems. They also need assistance
with all activities of daily living such as dressing, toileting and bathing.
They cannot recognize faces except closest friends and relatives nor remember
most details of personal history. They may have loss of bowel and bladder
control. They may wander too.
Stage 7: Very Severe Decline
This is the final stage of Alzheimer’s
disease and patients are nearing death. They lose ability to respond to their
environment or communicate. They may still be able to utter words and phrases
but have no insight into their condition. They need assistance with all
activities of daily living. They may lose the ability to walk and swallow.
Some experts use a simple three-phase
model (early, moderate and end). The simple three-phase model according
to the Alzheimer's Association is as follows:
In “early” or “mild” Alzheimer's, a
person may still be able to drive, work and interact socially. The patient may
forget where something is placed. There may be difficulty remembering names
shortly after being introduced to someone new and material just read. There may
be challenges in planning, organizing, and thinking of the correct name or
word.
Moderate Alzheimer's disease can last
many years. The patient may become more irritable, behave in unusual ways or
mix up language. Becoming moody or withdrawn in social situations can be
common. During this stage, the patient is likely to wander and unable to recall
personal details including phone numbers and home address. Complex daily
activities such as banking, driving, cooking will usually be significantly
impaired, though many basic activities such as dressing, bathing and toileting,
may still be possible.
Severe Alzheimer's necessitates
full-time care as the patient is unable to participate in meaningful conversation,
or complete any activities of daily without significant assistance. Personality
changes are obvious. The patient forgets both recent and past experiences and
is especially vulnerable to infections.
