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The Three Stages
of Alzheimer's |
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It is difficult to place a patient with Alzheimer's
disease in a specific stage. However, symptoms seem to
progress in a recognizable pattern and these stages provide
a framework for understanding the disease. It is important
to remember they are not uniform in every patient and
the stages often overlap. |
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First
Stage - 2 to 4 years leading up to and including diagnosis
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Symptoms:
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Recent memory loss begins to affect
job performance.
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What was he or she just told to do?
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Confusion about places - gets lost on
way to work.
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Loses spontaneity, the spark or zest
for life.
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Loses initiative - can't start anything.
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Mood/personality changes - patient becomes
anxious about symptoms, avoids people.
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Poor judgment - makes bad decisions.
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Takes longer with routine chores.
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Trouble handling money, paying bills.
Examples:
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Forgets which bills are paid. Can't
remember phone numbers.
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Loses things; can't remember grocery
list.
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Arrives at wrong time or place, or constantly
rechecks calendar.
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"Mother's not the same - she's
withdrawn, disinterested."
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She spent all day making dinner and
forgot to serve several courses.
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She paid the bills three times over,
or didn't pay for three months.
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Second stage
- 2 to 10 years after diagnosis (longest stage) |
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Symptoms
- Increasing memory loss and confusion.
- Shorter attention span.
- Problems recognizing close friends and/or family.
- Repetitive statements and/or movements.
- Restless, especially in 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.
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Terminal stage
- 1 to 3 years |
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Symptoms:
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Can't recognize family or image of self
in mirror.
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Loses weight even with good diet.
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Little capacity for self care.
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Can't communicate with words.
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May put everything in mouth or touch
everything.
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Can't control bowels, bladder.
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May have seizures, experience difficulty
with swallowing, skin infections.
Examples:
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Looks in mirror and talks to own image.
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Needs help with bathing, dressing, eating
and toileting.
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May groan, scream or make grunting sounds.
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May try to suck on everything.
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Sleeps more.
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Source |
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Care
of Alzheimer's Patients: A Manual for Nursing home Staff,
by Lisa P. Gwyther, ACSW, Member, Committee on Patient
and Family Services, Alzheimer's Association.
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