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Understanding Alzheimer’s: stage by stage

Ask most people what behaviour they typically associate with Alzheimer’s disease and they’ll most likely say memory loss. This is true, and it’s usually the first sign, but this is just one manifestation of a complex disease that has many symptoms which progress slowly over several years.

Of course, Alzheimer’s disease dramatically changes the life of the person suffering from it. But it’s also loved ones – family and friends – whose lives are significantly affected by the progression.

Alzheimer’s destroys cognitive skills and memory, and even basic tasks become impossible. Understanding the phases of the disease and breaking it into early, middle and later stages can be a great help to those navigating the practical and emotional challenges. Doctors can help a patient and their families anticipate what’s to come.

Alzheimer’s symptoms typically appear in the mid-60s age group and symptoms can be divided into three main stages. Note that some symptoms may be confused with other conditions, and may initially be put down to behaviour associated with old age. Becoming familiar with these will give a clearer idea of what to expect and when.

Stage 1: Early symptoms

The usual early symptom of Alzheimer’s disease is memory loss. Typically, the person will lose things, forget about recent conversations, struggle to find an appropriate word, forget the names of places and objects, ask the same questions over and over again, struggle to make decisions, and be nervous to try anything unfamiliar.

There are often signs of mood changes, such as increased anxiety or agitation or periods of confusion.

Stage 2: Mid-stage symptoms

When the person living with Alzheimer’s disease reaches this middle stage, they usually need help with activities of day-to-day living. For example, they may need help with simple tasks such as eating, washing, getting dressed and going to the toilet.

Memory problems will get worse as the disease worsens. People may find it more and more difficult to remember the names of loved ones or even recognise family and friends.

Other symptoms include:

  • Confusion and disorientation;
  • Obsessive or repetitive behaviour;
  • Becoming delusional and distrusting:
  • Problems with speech or language (aphasia);
  • Problems judging distance;
  • Sleep disorders;
  • Changes in mood; and
  • Depression and anxiety.

Stage 3: Later symptoms

When someone is in the later stages of Alzheimer’s (also known as advanced or severe dementia) he or she will be a lot frailer and become completely reliant on someone else for care.

As Alzheimer’s progresses and causes changes to the person’s brain, they may struggle to do many of the things they used to. Even in the later stages, however, they may experience lucid moments. Some of their lost abilities may even temporarily return.

It’s important to know that a loved one’s reactions are likely to be influenced by their environment and how they are feeling. For example, they may react more positively if they are in a familiar environment or one where they feel comfortable.

In this stage, they can also be violent, suspicious of those around them, and extremely demanding.

Signs of this later stage may also include:

  • Significant problems with short- and long-term memory;
  • Incontinence;
  • Extreme weight loss;
  • Problems with eating and swallowing;
  • Difficulty changing position or moving around without help.

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.