The Stages of Alzheimer's: What to Expect
What to expect as Alzheimer's progresses
One vexing thing about Alzheimer's, especially in the beginning, is how its effects differ from person to person. The person you're caring for might not experience every symptom or behavioral change, and the disease's timetable can vary. A particular Alzheimer's stage may last years longer for one person than for another, and symptoms can be experienced at earlier or later stages than described below. Because Alzheimer's is a progressive disease, however, it always starts with mild symptoms and gradually worsens as it continues.
Mild (Early-Stage) Alzheimer's Disease
During this first Alzheimer's stage, someone with the disease is likely to continue his or her usual activities, with Alzheimer's-related changes being written off as "getting older," "stress," being "tired," or "simple mistakes."
Memory: Memory lapses are typically the first sign, often years ahead of later symptoms. At this stage, it's common to forget things more often or have trouble remembering details about even familiar topics. Of special difficulty will be recalling recent events and people met later in life, as well as learning and retaining new information. That's why asking repetitive questions is a hallmark of the disease, as is writing notes to oneself about things like where the car is parked. It's common, too, to repeat comments and stories within minutes without realizing it. (Long-term memory, such as childhood recollections, may remain fairly detailed.)
Communication and social skills: Someone with Alzheimer's may have trouble finding the right word. Often people in this early Alzheimer's stage are aware that something is amiss, though they may not be sure what's wrong. They therefore shy from situations where they feel put on the spot or vulnerable to embarrassing mistakes, such as social outings, time with friends, or even telephone conversations.
Everyday life: At this stage, they're easily confused and distracted. They may find it hard to keep track of the time and miss appointments or favorite TV programs. Abstract thinking and making sound judgments become more difficult. They may lose the initiative to partake in activities that were once pleasurable (hobbies, a job) or routine (cooking, writing checks). They may misplace objects regularly or store them in unusual places, then forget where they put them.
Personality: Somone at this stage may seem to be acting unlike his or her old self. They may become irritable or angry when disease symptoms are disruptive or embarrassing. Mood swings are common and usually stem from frustration.
Other: You'll notice "good" days where the person you're concerned about seems unchanged and "bad" days when he or she is having trouble coping, especially in situations that are new, unusual, or otherwise stressful. At this stage, it's common to get lost, leave a stove burner on, lock one's self out of the car or house, or experience other such incidents.