You know the stage of Alzheimer's through clinical assessment by doctors, observing increasing memory loss (recent events, names), cognitive issues (finding words, planning), and declining ability to perform daily tasks (bathing, dressing), progressing from mild forgetfulness (early) to needing significant help (moderate) and full-time care (severe), often using tools like the Global Deterioration Scale (GDS) or Functional Assessment Staging (FAST) scale.
STAGE 3: MILD COGNITIVE IMPAIRMENT
For example, a person with mild cognitive impairment (MCl) may noticeably repeat queries. The capacity to perform executive functions also becomes compromised. Commonly, for persons who are still working in complex occupational settings, job performance may decline.
These include problems with memory, thinking, problem-solving or language, and often changes in emotions, perception or behaviour. As dementia progresses, a person will need more help and, at some point, will need a lot of support with daily living.
A doctor may also use a diagnostic framework with five, six, or seven levels. The levels are arranged by the severity of impairment. Progression through these stages usually lasts from 8 to 10 years, but again, it differs from person to person and can stretch out for as long as 20 years.
It is quite common for a person with dementia, especially in the later stages, to spend a lot of their time sleeping – both during the day and night. This can sometimes be distressing for the person's family and friends, as they may worry that something is wrong.
Memory loss affects everyone differently but many people with dementia experience some of the following: forgetting recent conversations or events (sometimes referred to as short-term memory loss) struggling to find the right word in a conversation. forgetting names of people and objects.
Untreated vascular risk factors such as high blood pressure are associated with a faster rate of progression of Alzheimer's disease. Pneumonia is a common cause of death for people with Alzheimer's.
A new study suggests that personality traits like neuroticism and conscientiousness may increase dementia risk. Psychological factors appear to affect dementia likelihood though not underlying brain neuropathology. Protective traits, particularly conscientiousness, seem to grow stronger with age against dementia.
The "2-finger test" for dementia involves an examiner showing a hand gesture (like interlocking index and middle fingers) and asking the patient to copy it, testing motor skills, visual memory, and coordination, as difficulties can signal early cognitive decline, but it's a screening tool, not a definitive diagnosis, prompting further medical evaluation. Other related tests include finger-tapping and finger-to-nose, looking for hesitation or misjudgment in movement.
However, people with Alzheimer's don't need a special class to be able to enjoy memories sparked by music. You could play some recorded music for them or even suggest that they sing along with you. You could also buy a simplified music player designed for people with dementia.
Aggression in the later stage of dementia is often a reaction to personal care. Someone may hit or push away those trying to help them or shout out to be left alone. The person with dementia may have felt scared, threatened or confused. Restlessness is also very common.
Donepezil (Aricept) is approved to treat all stages of the disease. It's taken once a day as a pill. Galantamine is approved to treat mild to moderate Alzheimer's disease. It's taken as an extended-release pill once a day or as a pill or liquid twice a day.
While dementia is a general term, Alzheimer's disease is a specific brain disease. It is marked by symptoms of dementia that gradually get worse over time. Alzheimer's disease first affects the part of the brain associated with learning, so early symptoms often include changes in memory, thinking and reasoning skills.
Life expectancy with Alzheimer's varies significantly, averaging 4 to 10 years after diagnosis, but can range from a few years to 20 years or more, heavily depending on age at diagnosis, overall health, and disease progression, with older diagnoses generally leading to shorter survival. For example, someone diagnosed in their 60s or 70s might live 7-10 years, while someone diagnosed in their 90s might only live about 3 years, with factors like high blood pressure impacting speed.
Warning Signs
Although deciding when it is unsafe to leave someone living with dementia alone oftentimes depends on your unique situation, there are signs indicating that it is no longer safe. Warning signs include: Wandering: Disorientation or confusion often leads to attempts to leave the home.
Most people who have dementia continue to be interested in the same things they were interested in before their diagnosis. The way they express their interests may be different, and they may not be able to remember as much. But they likely think about the same things they did before they were diagnosed.
Middle-stage Alzheimer's (moderate)
Middle-stage Alzheimer's is typically the longest stage and can last for many years. As the disease progresses, the person with Alzheimer's will require a greater level of care. During the middle stage of Alzheimer's, the dementia symptoms are more pronounced.
The greatest known risk factor for Alzheimer's and other dementias is increasing age, but these disorders are not a normal part of aging. While age increases risk, it is not a direct cause of Alzheimer's. Most individuals with the disease are 65 and older.
Smoking, low physical activity, and a poor diet are all lifestyle and environmental influences that have been linked to rapid dementia decline. Physical activity promotes cardiovascular health, which in turn improves brain function. Those who lead a sedentary lifestyle may experience faster cognitive decline.
Seroquel is the brand name for quetiapine, an atypical antipsychotic that is used off-label to treat severe behavioral signs of dementia. It can help with bad symptoms, including agitation, aggressiveness, and hallucinations, that other drugs don't help with.
In the later stages of Alzheimer's disease, the symptoms become increasingly severe and can be distressing for the person with the condition, as well as their carers, friends and family. Hallucinations and delusions may come and go over the course of the illness, but can get worse as the condition progresses.
Remaining at home but with extra support can be a good option for some people with dementia. It allows them to stay in a place that feels familiar and safe to them. It is important to make sure that the person can remain safe and well and get the support they need at home.
Family history. The genes you inherit from your parents can contribute to your risk of developing Alzheimer's disease, although the actual increase in risk is small. But in a few families, Alzheimer's disease is caused by the inheritance of a single gene and the risks of the condition being passed on are much higher.
Recent studies show that in the progression of Alzheimer's disease, semantic memory is affected first. We have seen that even before forgetting their memories of past events, patients show a gradual decline in their general knowledge.