Overview

Alzheimer’s disease is the most common form of dementia, accounting for 60-80 percent of dementia cases. Right now, it’s estimated more than five million Americans are living with the disease. Alzheimer’s is a slow, fatal disease of the brain which typically begins by destroying brain cells where memories are formed. The disease is caused by plaques and tangles, abnormal protein fragments that accumulate in the brain, though we don’t exactly understand why.

What Should I Expect As A Caregiver

For caregivers, understanding common behavior changes of someone living with Alzheimer’s is important. A person with Alzheimer’s may need help with planning their day and remembering appointments, or even simple tasks like dressing and bathing. As the disease progresses, a person with Alzheimer’s may become frustrated, anxious or embarrassed by their cognitive decline. A caregiver may need to provide emotional and physical support, as well as encouragement. Individuals with Alzheimer’s may become restless, experience rapid mood swings, or wander. Knowing how to balance a person’s safety and independence becomes more difficult as the disease progresses.

Seven Stages Of Alzheimer's

The following stages help provide a general idea of how the disease will affect certain abilities. The seven-stage framework is based on a system developed by Barry Reisberg, M.D., clinical director of the NYU School of Medicine’s Silberstein Aging and Dementia Research Center.

• No Impairment

  

  There is no sign of memory problems, and an interview with a medical professional does not reveal any signs of dementia.

• Very Mild Cognitive Decline

  

  There may be some awareness of memory lapse—forgetting familiar words or the location of everyday objects. However, no symptoms of dementia are detected by friends, family or co-workers.

• Mild Cognitive Decline

  

  Early-stage Alzheimer’s can be diagnosed in some, but not all individuals. Friends, family and coworkers notice difficulty. Doctors may be able to detect problems in memory or concentration.

  • Noticeable problems coming up with the right word or name.
  • Trouble remembering names when introduced to new people.
  • Having noticeably greater difficulty performing tasks in social or work settings.
  • Forgetting material that one has just read.
  • Losing or misplacing a valuable object.
  • Increasing trouble with planning or organizing.

• Moderate Cognitive Decline

  

  At this stage, a careful interview should reveal clear-cut symptoms in several areas.

  • Forgetfulness of recent events.
  • Impaired ability to perform challenging mental arithmetic—for example, counting backward from 100 by 7s.
  • Greater difficulty performing complex tasks, such as planning dinner for guests, paying bills or managing finances.
  • Forgetfulness about one's own personal history.
  • Becoming moody or withdrawn, especially in socially or mentally challenging situations.

• Moderately Severe Cognitive Decline

  

  Gaps in memory and thinking have become noticeable, and help is needed with day-to-day activities. At this stage, those suffering from Alzheimer’s may:

  • Be unable to recall their own address or telephone number or the high school or college from which they graduated.
  • Become confused about where they are or what day it is.
  • Have trouble with less challenging mental arithmetic; such as counting backward from 40 by subtracting 4s or from 20 by 2s.
  • Need help choosing proper clothing for the season or the occasion.
  • Still remember significant details about themselves and their family.
  • Still require no assistance with eating or using the toilet.

• Severe Cognitive Decline

  

  Memory continues to worsen, personality changes may occur and individuals need extensive help with daily activities. At this stage, those suffering from Alzheimer’s may:

  • Lose awareness of recent experiences as well as of their surroundings.
  • Remember their own name but have difficulty with their personal history.
  • Distinguish familiar and unfamiliar faces but have trouble remembering the name of a spouse or caregiver.
  • Need help dressing properly and may, without supervision, make mistakes such as putting pajamas over daytime clothes or shoes on the wrong feet.
  • Experience major changes in sleep patterns—sleeping during the day and becoming restless at night.
  • Need help handling details of going to the toilet (for example, flushing the toilet, wiping or disposing of tissue properly).
  • Have increasingly frequent trouble controlling their bladder or bowels.
  • Experience major personality and behavioral changes, including suspiciousness and delusions (such as believing that their caregiver is an impostor) or compulsive, repetitive behavior such as hand-wringing or tissue shredding.
  • Tend to wander or become lost.

• Very Severe Cognitive Decline

  

  At the end, individuals lose the ability to respond to their environment, converse with others and control movement. Eating and swallowing become difficult. They will need help with their personal care, including walking and using the toilet. They may also lose the ability to smile, to sit without support and to hold their heads up. Muscles grow rigid.