People with Alzheimer’s live an average of 8 years after diagnosis, but may survive anywhere from 3 to 20 years.

There are a variety of schemes to classfiy the stages of Dementia. These may be useful in understanding what sort of changes to expect as the disease progresses. It is important to remember they are not uniform in every patient and the stages often overlap.

First Stage – 2 to 4 years leading up to and including diagnosis. Stage of where the patient has some difficulties and may require some help but usually able to function pretty well with a bit of help.

Symptoms

• Recent memory loss begins to affect job performance
• Forgetting what he/she was just told to do
• Confusion about places – gets lost driving
• Loses spontaneity, the spark or zest for life
• Loses initiative – can’t start anything
• Mood/personality changes – patient becomes anxious about symptoms, avoids people
• Poor judgement – makes bad decisions
• Takes longer with routine chores
• Trouble handling money, paying bills

Examples

• Forgets which bills are paid
• Can’t remember phone numbers
• Loses things
• Can’t remember grocery list
• Arrives at wrong time or place – constantly rechecks calendar
• “Mother’s not the same – she is withdrawn, disinterested”
• “She spent all day making dinner and forgot to serve several courses”
• “She paid the bills 3 times over” or “She didn’t pay the bills for 3 months”

Second Stage – 2 to 10 years after diagnosis. Stage of considerable problems where assistnce is generally needed, but not totally dependent for care.

Symptoms

• Increasing memory loss and confusion
• Shorter attention span
• Problems recognizing close friends and/or family members
• Repetitive statements and/or movements
• Restless, especially in the late afternoon and at night
• Occasional muscle twitches or jerking
• Perceptual motor problems
• Difficulty organizing thoughts, thinking logically
• Can’t find right words – makes up stories to fill in blanks
• Problems with reading, writing and numbers
• May be suspicious, irritable, fidgety, teary, or silly
• Loss of impulse control – sloppy – won’t bathe or afraid to bathe – trouble dressing
• Gains and then loses weight
• May see or hear things that are not there
• Needs full time supervision

Examples

• Can’t remember visits immediately after you leave
• Repetitive movements or statements
• Sleeps often – awakens frequently at night and may get up and wander
• Perceptual motor problems – difficulty getting into a chair, setting the table for a meal
• Can’t find the right words
• Problems with reading, numbers – can’t follow written signs, write name, add, or subtract
• Suspicious – may accuse spouse of hiding things, infidelity, may act childish
• Loss of impulse control – sloppier table manners – may undress at inappropriate times or in the wrong place
• Huge appetite for junk food and other people’s food – forgets when last meal was eaten, then gradually loses interest in food

Terminal Stage – 1 to 3 years. Stage of total dependency.

Symptoms

• Can’t recognize family or image of self in mirror
• Loses weight even with a good diet
• Little capacity for self care
• Can’t communicate with words
• May put everything in mouth or touch everything
• Can’t control bowels, bladder
• May experience difficulty with swallowing, skin infections or have seizures

Examples

• Looks in mirror and talks to own image
• Needs help with bathing, dressing, eating, and toileting
• May groan, scream, or make grunting sounds
• May try to suck on everything
• Sleeps more