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What are the symptoms at each stage?

Discovering that you or someone you love has Alzheimer’s disease is very difficult. Dealing with this illness is a difficult path to walk, but the first step on this journey is to fully understand Alzheimer’s disease, and to know how it progresses with each step.

There are seven stages of Alzheimer’s disease, and it’s important to know the distinctive characteristics associated with each condition. The symptoms may vary from person to person, but by knowing what to expect, you can prepare yourself and your home for what is to come.

Stage 1: No impairment

At the earliest stage of Alzheimer’s, no outward signs are present. It is hard to detect Alzheimer’s at this stage, as no memory problems or other symptoms of dementia are evident.

During this stage, the only way to be diagnosed with Alzheimer’s is during a PET scan – a type of imaging test that reveals how the brain is currently working. PET scans, in conjunction with a tracing drug, are able to reveal the presence of the amyloid plaques that cause Alzheimer’s.

If you have a family history of Alzheimer’s, it can be worth talking to your local GP to get tests done. These tests can identify biomarkers that indicate Alzheimer’s risk. Your GP may also discuss memory problems with you, especially if you’re at risk.

Bear in mind that the primary stage of Alzheimer’s can last years or even decades.

Stage 2: Very mild decline

During the second stage of Alzheimer’s, you may find that the person has minor memory problems. This can include losing things around the house or forgetting a word during conversation. However, these are only small differences and are sometimes not fully recognised as early warning signs.

However, as Alzheimer’s typically affects adults over the age of 65, it is common for people at this age to have difficulty remembering things and they will often have forgetfulness problems.

What differentiates stage 2 Alzheimer’s from regular old age is the rate at which the decline is happening. Typically, those in Stage 2 will suffer from a decline in memory function at a much greater rate than those without Alzheimer’s at a similar age.

Unfortunately, these problems are typically not evident during a medical examination and can sometimes not even be apparent to friends, family or co-workers. Often, those in stage two can even pass memory exams designed to test for Alzheimer’s.

Stage 3: Mild decline

Once into the third stage, the symptoms of Alzheimer’s can become a lot clearer. This stage typically lasts around seven years, over which period the symptoms worsen. The symptoms will become more obvious during the first two to four years of the third stage, however, only people close to someone in this stage may notice the signs.

Signs that someone has entered the third stage can include;

•    Remembering the names of new acquaintances
•    Frequent loss of personal possessions, including valuables
•    Decreased concentration
•    Inability to remember what was just read
•    Getting lost whilst travelling familiar routes
•    Finding it hard to remember the right words

During this stage, both memory and cognitive functions are impaired to a degree that they will be detected during tests from doctors and physicians.

Stage 4: Moderate Decline

In stage four, the problems that were evident in the third stage become even more pronounced. Thinking and reasoning become more muddled, and some new issues will arise. These new issues can include;

•    Decreased emotional responses, especially in challenging situations
•    Sudden mood changes
•    Inability to recall personal history
•    Decreasing awareness of recent events

The fourth stage lasts roughly two years, and is the first real stage where a diagnosis of Alzheimer’s is probable. Your GP should be looking for a decline in the areas mentioned in stage three.

Stage 5: Moderately severe decline

Those in stage five will begin to require a lot of support, both emotionally and physically. As people enter this stage, which lasts about a year and a half, they can start forgetting important details. These important details can include major events, the weather conditions, their current address – although they are typically able to remember their own names, as well as the name of loved ones. Those in stage five will still be able to remember some details from their own personal history, especially their childhood and youth.

During stage five, many will need help with their day-to-day activities. They can, however, maintain some functionality. Typically, they will still be able to bathe independently, although they may need help with certain chores – particularly grocery shopping.

Stage 6: Severe decline

Stage six, which lasts around two and a half years, marks the severe decline of memory function. Those in this stage will recognise faces, but often forget names. Sometimes, they will mistake one person for another. Memory becomes a lot worse, especially when discussing current or recent news.

Often, delusions can also set in. These manifest as thoughts of having to go to work, despite not having a job. These feelings can be compounded with feelings of suspiciousness and paranoia as well, and often those in stage six will exhibit personality changes. If this happens, counselling may help combat these behavioral and psychological problems.

There are three distinct characteristics of stage six.

#1 Clothing
In the sixth stage, those suffering from Alzheimer’s will be largely unable to choose their own clothes, and will also require help dressing correctly.

#2 Hygiene
A person with Alzheimer’s in the sixth stage will also need help with their hygiene. Oral hygiene is usually the first to decline. Following this, those in the sixth stage will need help adjusting the water temperature before bathing and eventually, they may need help washing.

#3 Cleanliness
At first, people in the sixth stage of Alzheimer’s will forget to flush. However, as they progress into the stage, they will start to lose control of their bladder and bowels, and will need help with cleanliness.

Stage 7: Very severe decline

The seventh stage is the final stage of Alzheimer’s. In this stage, those suffering with Alzheimer’s begin to lose their ability to respond to the environment or communicate. Movement starts to become more rigid in this stage, and can often be incredibly painful.

In roughly 40 percent of cases, people with Alzheimer’s at this stage will develop contractures – shortening and hardening of the muscles, tendons and other tissues. Because of this, people in this stage will need assistance with all of their daily activities, including bathing and daily chores.

There are six separate phases to the final seventh stage. Each phase lasts about a year and a half.

1st Phase
Speech becomes very limited, often to around six words or less per sentence.

2nd Phase
During the 2nd phase, speech declines even further to a single word per sentence.

3rd Phase
In this phase, movement speed declines rapidly.

4th Phase
Those in the 4th phase become unable to sit up independently.

5th Phase
Facial expressions become harder in the 5th phase, until those in this phase are unable to make any.

6th Phase
The final phase means that people suffering will no longer be able to hold their heads up.

People in this stage need round the clock care, often the kind that can only be provided by a specialised care home or hospital.

If you, or someone you know, suspects that you may have the early warning signs of Alzheimer’s, consult your GP immediately and ask to book in tests.

During the later stages, you may need help adapting your bathroom to make it more accessible. If this is the case, don’t be scared to give us a call – we’re here to help.