Understanding stages of Alzheimer’s disease can help those experiencing it
Alzheimer’s disease can be very daunting, but understanding the stages can help both patients and their loved ones through the journey.
“Doctors have come up with various descriptions of clinical stages of Alzheimer’s,” said Christopher Janson, MD, with the Clinical Neuroscience Institute. “In fact, there are an infinite number of stages of Alzheimer’s disease because every passing day means that more brain cells are lost, and our ability to think is proportional to the number of functioning brain cells.”
Rather than think of the disease in stages, Dr. Janson said it is more useful to think of it in terms of progression. This helps people to better understand their place in the spectrum, from normal to severe cognitive impairment.
“There are a handful of clinical stages that we use as part of the diagnosis,” said Janson, who practices with Premier Physician Network. “I like to tell patients that the basic breakdown is threefold: normal (age-appropriate) cognition, mild cognitive impairment (MCI), or dementia. Beyond that, there are subcategories describing the severity of dementia, whether mild, moderate or severe.”
There are several rating scales that have been developed to help health care providers assign patients for clinical studies. Dr. Janson, for instance, uses the Clinical Dementia Rating Scale, which is a five-point scale used to characterize six domains of cognitive and functional performance applicable to Alzheimer’s disease and dementia. These includes memory, orientation, judgment and problem solving, community affairs, home and hobbies and personal care.
The symptoms of Alzheimer’s disease occur gradually over a period of time, typically years. The time from diagnosis to late, or terminal, stages of the disease can range from a few years to 15 years or longer. Symptoms are cumulative and at first may not seem concerning, Dr. Janson said.
“The most common early sign of Alzheimer’s disease is persistent memory loss,” he said. “Family members of people with early stages of dementia may notice increasingly frequent lapses in their loved one’s concentration and memory, especially with declarative memory or memory of specific facts.”
Over time, patients often experience declines in their levels of attention and concentration and develop problems with visual-spatial tasks that cause them to be lost or disoriented in familiar places.
As the disease progresses, people lose interest in all former hobbies and interests and both their language and reasoning are severely affected. They also become unable to care for themselves and eventually are incontinent, non-verbal and require fulltime nursing care.