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How Alzheimer's Evolves From Early to Late Stages

Written by Jennifer Wegerer
 about the author
3 minute readLast updated April 10, 2023

Alzheimer’s evolves through several different stages, though symptoms and their severity vary from individual to individual. Learn the common signs and symptoms of the disease that occur throughout its progression.

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The progression of Alzheimer’s

Nearly 7 million Americans are living with Alzheimer’s disease, according to the Alzheimer’s Association. Deaths from Alzheimer’s have increased 145% between 2000 and 2019.
Medical professionals, researchers, and scientists continue striving to learn more about this disease. Fortunately, Alzheimer’s experts have been able to determine three major stages: preclinical, mild to moderate, and severe.
Here’s a breakdown of the symptoms that occur as Alzheimer’s evolves through each of these major stages, according to information from the Alzheimer’s Association and the National Institute on Aging.

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Stage 1: Preclinical Alzheimer’s

Symptoms present: None to very mild cognitive decline
Changes that may occur: Mild memory lapses, such as forgetting everyday words or where things are kept. A medical exam may show no signs of dementia. Studies indicate that brain changes precipitating Alzheimer’s occur during this stage, which may begin as many as 20 years before symptoms become noticeable. Researchers are still working to validate biomarker tests that can detect mild cognitive impairment due to Alzheimer’s before the onset of symptoms.

Stage 2: Mild to Moderate Cognitive Decline

Symptoms present: Noticeable difficulty with memory and concentration that progresses over the course of several years.
Changes that may occur: An aging loved one may have trouble remembering names and words, greater difficulty performing tasks at work or in social settings, increasing problems with planning and organizing. They may also lose or misplace personal items and exhibit personality changes.
At this stage, a doctor’s exam can usually detect clear-cut Alzheimer’s symptoms, such as challenges remembering recent events or performing simple math. Individuals in this stage may also forget their own personal history, make poor judgments with their health or money, and become moody or withdrawn, particularly in social situations.
Throughout this stage, the person’s struggles with memory and language will worsen. They may require a trained caregiver at home or a residential care setting during this stage.

Stage 3: Severe Cognitive Decline

Symptoms present: An overall decline in physical abilities including communicating and performing personal care.
Changes that may occur: A person in the severe stages may lose the ability to speak, walk, and control their bowels.
During severe Alzheimer’s, the brain no longer seems able to tell the body what to do. Individuals become entirely dependent on others for care, including bathing, dressing, eating, and other daily tasks. They may still recognize familiar faces but not know names. They may also experience major personality and behavior changes, including delusions and paranoia.
People in this stage typically require assistance walking and may be unable to sit up or smile. Wringing hands are also common, as are abnormal reflexes and rigid muscles.
Eventually, the person may spend the majority of time in bed as Alzheimer’s continues to progress.

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The rate of Alzheimer’s progression

Each case of Alzheimer’s is different. On average, people age 65 and over survive four to eight years after an Alzheimer’s diagnosis. However, some live for as many as 20 years. The bulk of that time (around 40%) will be spent in the most severe Alzheimer’s stage.
Researchers continue to try to unravel Alzheimer’s stages. Great strides have been made in early detection and treatments that can slow the disease’s progress. Some of these treatments have the potential to extend earlier Alzheimer’s stages when symptoms are less severe.


Meet the Author
Jennifer Wegerer

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