Alzheimer's disease is a disease that creates anxiety for many families. When it is found that someone close begins to have problems in the field of memory, many people wonder how many stages this disease has, and what the symptoms are in each stage. Understanding the stages of Alzheimer's disease will help us be prepared and care for the patient suitably. This article will take you to understand Alzheimer's disease in detail, from the beginning stage through to the last stage
Before knowing about the stages: coming to understand Alzheimer's disease preliminarily
Before we go deep into each stage of the disease, understanding the foundation of Alzheimer's disease will help you understand the overall picture better, and know why the division into stages is important in planning the care
What is Alzheimer's disease, and why is it important to know the stages of the disease
Alzheimer's disease is a disease arising from the continuous degeneration of the cells of the brain, making the patient have problems in the field of memory, thinking, and behaviour. This disease is classed as the main cause of a state of dementia in older people, having a great effect on the living of daily life. Besides this, cerebrovascular disease is another important cause of a state of dementia, which usually arises alongside Alzheimer's disease
Knowing how many stages Alzheimer's disease has is very important, because each stage has different needs in the care, and it also helps the family plan the care in the long term, be prepared mentally, and choose the method of treatment that suits the state of the patient in each period of time
Stage 1: the beginning stage (Mild Alzheimer's Disease)
The first stage of Alzheimer's disease usually begins gradually, so many families may not observe it or may think that it is a normal matter of degeneration with age. Knowing how to observe the symptoms in the first stage will help make it possible to begin the care sooner
The symptoms that can be observed: forgetting simple things, confusion about time, asking the same questions repeatedly
In the beginning stage, the patient has the problem of forgetting events that have just happened, such as forgetting an appointment, forgetting the name of someone they have just met, or forgetting an object they have just put down. They may be confused about the time, the day, and the month, and usually ask the same questions repeatedly even after receiving the answer. The patient may have a problem finding words, calculating, or planning things that they once did easily
How the patient feels: they may still be aware that their memory is abnormal, which makes them irritated or depressed
Most patients are still aware that their memory has a problem, which gives rise to feelings of irritation, anxiety, or depression. The patient may try to hide the symptoms by avoiding challenging activities, or depending on those close to them more. Some may become suspicious or have a change of personality
The approach to care in this stage: stimulating the memory, arranging the environment so that it is safe
The care should emphasise helping the patient have a good quality of life and keeping the remaining ability for as long as possible. Stimulating the memory with activities, such as looking at old photographs and telling stories of the past, will help slow the degeneration. Arranging the environment so that it is safe and orderly, such as attaching name labels to objects and always placing things used in the same position
Stage 2: the middle stage (Moderate Alzheimer's Disease)
When the disease enters the middle stage, the various symptoms become clearer and affect the living of daily life more. This stage is usually the period when the family begins to feel the challenge in the care and needs help from outside
The symptoms that can be observed: not being able to remember the names of those close, having problems in the field of communication, clearly changed behaviour
In the middle stage, the patient begins not to be able to remember the faces and names of those close to them. They may call their children and grandchildren by the wrong name or not know the people in the family. Communication becomes a difficult matter; the patient cannot find the words to say, speaks unintelligibly, or uses the wrong words. The behaviour changes clearly; they may become aggressive or withdrawn, and have strange behaviour, such as keeping things in strange places and walking back and forth without stopping
How the patient feels: more confused, they may have symptoms of suspicion, they need help in living life
The patient in this stage feels more confused about the things around them, not knowing where they are or what time it is. Some may have symptoms of suspicion, thinking that someone has come to harm them or steal something. The patient begins to need more help in daily life, such as bathing, dressing, eating, or using the bathroom
The approach to care in this stage: using simple communication, caring for the daily routine, being careful about wandering off
The care in this stage must emphasise safety and help in the daily routine. The communication should use short, simple, and clear sentences, avoiding complex words or giving several choices at the same time. Arranging the daily routine systematically will help the patient feel safe. Being careful that they do not wander off is an important matter; it may be necessary to install a system of locking the doors or to use a tracking device
Stage 3: the last stage (Severe Alzheimer's Disease)
The last stage of Alzheimer's disease is the period that is most challenging for the family. The patient must depend on the carer completely and needs palliative care in order to maintain the quality of life that remains
The symptoms that can be observed: not being able to communicate, moving with difficulty, having to depend on the carer completely
In the last stage, the patient cannot communicate with words. They may make a groaning sound or utter sounds that are not words. The ability in movement reduces greatly; they cannot sit, cannot walk, or must lie on the bed all the time. The patient must depend on the carer in everything, from eating food, drinking water, using the bathroom, and changing the position of the body, through to caring for personal cleanliness
How the patient feels: not responding much to the things around them
The patient in this stage usually does not respond to the things around them or responds only slightly. They may not know those close to them and not understand when someone speaks to them, but sometimes they may still have a reaction to touch, to the sound of music, or to receiving gentle care. Receiving love and warm care still has meaning and may help the patient feel at ease
The approach to care in this stage: palliative care, preventing pressure sores and infection
The care in this stage emphasises maintaining comfort and preventing complications: preventing pressure sores by changing the posture of lying regularly, caring for cleanliness in order to prevent infection, and giving food through a tube if it is necessary. Care in the field of the mind is still important; talking gently, playing music they like, massaging lightly, or touching gently may help the patient feel at ease
If it is suspected that someone close has symptoms, what should be done?
If you observe that someone close to you begins to have symptoms that are suspicious, quickly taking them to see a physician is the most important thing. A diagnosis and treatment in the beginning stage will help slow the degeneration of the disease and help the patient have a better quality of life
The observation of the preliminary symptoms
The observation of the preliminary symptoms for screening for Alzheimer's disease should give importance to the change of memory and of the working of the brain. If it is found that there is forgetting of events that have just happened often, a problem in finding the words to say, or confusion about time and place, an expert physician should be consulted
Besides this, a change of personality, a reduction of interest in activities they once liked, or having a problem in planning and in making decisions are also warning signals that should be checked
Frequently asked questions (FAQ)
How long does each stage of Alzheimer's disease take?
The length of time of each stage differs in each person. Generally the beginning stage may take 2-4 years, the middle stage may take 2-10 years, and the last stage may take 1-3 years. But several factors, such as age, health overall, the treatment, and the care, can affect the progress of the disease
Must an Alzheimer's patient pass through all the stages or not?
Not necessarily. Although Alzheimer's disease has a tendency to degenerate continually, some patients may not pass through all the stages, or may be in one stage or another for a long time, depending on various factors, such as the treatment, the care, and the state of the body overall
In summary
Alzheimer's disease has 3 main stages in all, namely the beginning stage, the middle stage, and the last stage. Each stage has different symptoms and needs in the care. Understanding the stages of the disease will help the family be prepared and plan the care suitably
Observing the symptoms in the beginning stage and taking them to see a physician quickly will help slow the degeneration of the disease, while correct care in each stage will help the patient have the best quality of life possible. What is important is the love, the understanding, and the support from the family that will help both the patient and the carer get through this challenging period of time
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