Stages of Symptom Progression in Alzheimer's Disease
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.
1. First stage - 2 to 4 years leading up to and including diagnosis.
-Recent memory loss begins to affect job performance.
-What was he or she just told to do?
-Confusion about places
- gets lost on way to work.
-Loses initiative -can't start anything.
-Loses spontaneity, the spark or zest for life.
- patient becomes anxious about symptoms, avoids people.
-Poor judgment - makes bad decisions.
-Takes longer with routine chores
-Trouble handling money, paying bills.
-Forgets which bills are paid. Can't remember phone numbers.
-Loses things; can't remember grocery list.
-Arrives at wrong time or place, or constantly rechecks calendar.
-"Mother's not the same - she's withdrawn, disinterested".
-She spent all day making dinner and forgot to serve several courses.
-She paid the bills three times over, or didn't pay for three months.
2. Second Stage - 2 to 10 years after diagnosis [longest stage]
-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.
-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.
-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 all interest in food.
3. Terminal Stage - 1 to 3 years.
-Can't recognize family or image of self in mirror.
-Loses weight even with good diet.
-Little capacity for self care.
-Can't communicate with words.
-May put everything in mouth or touch everything.
-Can't control bowels or bladder.
-May have seizures, experience difficultly with swallowing, skin infections.
-Looks in mirror and talks to own image.
-Needs help with bathing, dressing, eating, and toileting.
-May groan, scream or make grunting sounds.
(c) copyright 1994
Greater San Antonio Chapter
Alzheimer's Outreach http://alzheimers.zarcrom.com
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