Alzheimer’s is a chronic disease that progresses over the course of many years. It typically begins after the age of 65. Alzheimer’s that starts at a younger age will usually progress faster than if it had developed later on.
Alzheimer’s disease has three stages, each of which has its own characteristic symptoms. But the changes that happen, and how fast they happen, can vary from person to person. Some symptoms may appear earlier, and others may not occur at all.
Early-stage Alzheimer's
In early-stage (mild) Alzheimer’s, people have a bit more trouble managing their lives on their own, but they can usually still lead independent lives. It's often difficult to tell the difference between early-stage symptoms and normal forgetfulness due to aging. There is no clear cut-off point between the normal problems associated with aging and mild Alzheimer's. But forgetfulness, absentmindedness and trouble concentrating mean that more complex everyday tasks are difficult to perform.
People who have early-stage Alzheimer’s will almost always need help with business and financial matters or official appointments. Driving and taking medication regularly are two other critical areas.
Behavior and mood can already change in early-stage Alzheimer’s. The limitations resulting from the disease can cause fear, stress, anger, or even feelings of shame: It can be embarrassing to forget things and lose your orientation. And it takes a lot of strength to find strategies to deal with these problems.
A person’s inner drive and interest in hobbies or other activities may fade. Some people feel down or irritable, or they may have intense mood swings. These mood swings – making people suddenly burst into tears for no apparent reason, for example – are often puzzling as well as draining for other family members.
Middle-stage Alzheimer's
People with middle-stage (moderate) Alzheimer’s usually have to give up living independently. They can still eat, drink and wash themselves, and perhaps do simple tasks around the home or garden, but may have to be reminded and asked to do so. Cooking, shopping, keeping their home clean, and going out on a walk are only possible with the help of others.
They are more likely to get lost, not find their way back home, leave the stove on and endanger themselves or others. Patterns of behavior such as frantic pacing, seemingly meaningless rummaging through drawers and fiddling with clothing become more frequent. Fits of rage, distrust and aggressive behavior are also consequences of problems associated with Alzheimer’s that affect the person’s perception and limit their abilities.
People’s daily sleep-wake cycle is often affected. It becomes more difficult for them to express things in words and understand what other people say. They also confuse the past with the present. For instance, they may falsely believe that their parents are still alive and are expecting them to come back home.
Late-stage Alzheimer's
In late-stage (severe) Alzheimer’s, people need constant help from others. Speech and language problems may start making conversation barely possible. They now even need help to accomplish simple everyday activities, and to eat and drink.
People who have late-stage Alzheimer’s are often restless, hallucinate or confuse the past with the present. They no longer recognize people who they used to know very well. The control of bodily functions and the ability to coordinate movement may also be lost.
On average, people with Alzheimer’s die about six years after being diagnosed. But many people also live with the disease a good deal longer.