Difference between three Alzheimer disease stages

Dementia is a syndrome characterized by disturbance of multiple brain functions, including memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement. Consciousness is not clouded. The impairments of cognitive function are commonly accompanied, and occasionally preceded, by deterioration in emotional control, social behaviour, or motivation.
Alzheimer disease is the most common form of dementia and possibly contributes to 6070% of cases. Other types of dementias include vascular dementia, dementia with Lewy bodies, and a group of diseases that contribute to frontotemporal dementia. The boundaries between subtypes are indistinct and mixed forms often co-exist.


Dementia can affect a person in different ways, and progression of the disease depends upon the impact of the disease itself and the person’s personality and state of health. Alzheimer can be divided in three Alzheimer disease stages:  early stage – first year or two  middle stage – second to fourth or fifth years  late stage – fifth year and after.

These periods are given as an approximate guideline and not all persons with dementia will display the same symptoms.


Early stage

The early stage is often overlooked. Relatives and friends (and sometimes professionals as well) see it as "old age", just a normal part of ageing process. Because the onset of the disease is gradual, it is difficult to be sure exactly when it begins.  Become forgetful, especially regarding things that just happened  May have some difficulty with communication, such as difficulty in finding words  Become lost in familiar places  Lose track of the time, including time of day, month, year, season  Have difficulty making decisions and handling personal finances   Have difficulty carrying out complex household tasks  Mood and behaviour:  may become less active and motivated and lose interest in activities and hobbies  may show mood changes, including depression or anxiety   may react unusually angrily or aggressively on occasion.



Middle stage



As the disease progresses limitations become clearer and more restricting.  Become very forgetful, especially of recent events and people's names  Have difficulty comprehending time, date, place and events; may become lost at home as well as in the community  Have increasing difficulty with communication (speech and comprehension)   Need help with personal care (i.e. toileting, washing, dressing)  Unable to successfully prepare food, cook, clean or shop  Unable to live alone safely without considerable support  Behaviour changes may include wandering, repeated questioning, calling out, clinging, disturbed sleeping, hallucinations (seeing or hearing things which are not there)   May display inappropriate behaviour in the home or in the community (e.g. disinhibition, aggression).



Late stage


The last stage is one of nearly total dependence and inactivity. Memory disturbances are very serious and the physical side of the disease becomes more obvious.  Usually unaware of time and place  Have difficulty understanding what is happening around them  Unable to recognize relatives, friends and familiar objects   Unable to eat without assistance, may have difficulty in swallowing  Increasing need for assisted self-care (bathing and toileting)  May have bladder and bowel incontinence  Change in mobility, may be unable to walk or be confined to a wheelchair or bed  Behaviour changes, may escalate and include aggression towards carer, nonverbal agitation ( kicking, hitting, screaming or moaning)   Unable to find his or her way around in the home.