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Departments |
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What
Are The "Stages" Of
Alzheimer's Disease?
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My father recently told me
that my grandmother, his mother, is in the 5th stage of
Alzheimer's. I'm not clear what this means, and I don't
think my father is, either. Can you explain?
There is a medical model for dementias of the Alzheimer's
type, the Reisberg Global Deterioration Scale, that divides
the process into seven stages. These stages are far from
absolute, and you shouldn't rely on them. But they will give
you some idea of how the doctor probably thinks your
grandmother is progressing, and what you should be planning
for in the future.
Stage 1: No Cognitive Decline
The patient has no complaints of memory loss. No memory
deficits are evident.
Stage 2: Very Mild Cognitive
Decline
The patient is beginning to notice some memory problems, but
continues to function at home and at work. There are still
no measurable symptoms. Memory complaints usually involve
"losing" familiar objects such as keys, glasses, pens, and
forgetting familiar names.
Stage 3: Mild Cognitive Decline
Memory deficits are now becoming obvious to friends,
co-workers and family. Problems with word and name-finding
may be evident. The patient may have become lost. The
patient has difficulty remembering information recently read
or heard. The patient may be withdrawing or becoming anxious
in social situations and may be having noticeable difficulty
at work. Coping strategies such as list-making may begin. At
this stage clinical testing will reveal deficits.
Stage 4: Moderate Cognitive Decline
Family members and intimates will identify that there are
memory deficits. The patient will be noticeably less able to
concentrate. Recollection of personal history may be
impaired. Current and recent events are not remembered
reliably. The patient often withdraws from challenges,
becoming defensive and denying any disability.
Stage 5: Moderately Severe Cognitive Decline (Early
Dementia)
The patient cannot reliably recall significant facts
pertaining to his own life, such as telephone numbers,
addresses, some family members' names. There may be some
disorientation about time or place. Eating and toileting are
usually still accomplished independently, but complex tasks
such as choosing clothing or bathing require assistance.
Preparing meals becomes problematic. The patient can no
longer live without some assistance.
Stage 6: Severe Cognitive Decline
(Middle Dementia)
The patient may not remember the spouse's name and recent
events are forgotten. Assistance is required with many
activities of daily living, and incontinence may begin.
Often the "rhythm" of daily life becomes disturbed,
resulting in insomnia and night wandering. The patient may
begin misreading items in the environment such as
reflections in mirrors. Obsessive and repetitive behavior
may occur. Anxiety and agitation are common. The patient can
no longer carry through with activities. Close supervision
becomes necessary.
Stage 7: Very Severe Cognitive
Decline (Late Dementia)
Verbal abilities disappear, and the patient requires full
assistance with toileting and eating. The ability to walk
disappears. The patient becomes chair confined, and
eventually bed-bound. The body appears to be "forgetting"
how to function.
Remember that these stages are just very general
descriptions. Everyone will progress differently. Your
grandmother may move back and forth between stages.
Depending on the day, and even the hour, she may appear to
be better or worse. These are just general guidelines to
help you anticipate what may come next.
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