How Quickly Does Alzheimer’s Progress?

According to the Alzheimer’s Association, someone develops Alzheimer’s disease every 65 seconds and more than 5.7 million Americans have the disease. As people live longer, these numbers continue to increase as evidenced by the fact that between 2000 and 2015, deaths resulting from Alzheimer’s increased by 123%. It’s the sixth leading cause of death in the United States and the only top 10 cause of death that cannot be prevented, cured or even slowed.

With statistics such as these, is it any wonder that so many people are looking for answers? In this blog post, we hope to provide you with a few answers, mainly about the disease’s progression.

Alzheimer’s disease evolves through various stages; however, its effects can vary from person to person. This means that the disease progresses differently with different people. On average, individuals who are 65 years of age and older typically survive three to 11 years after receiving an Alzheimer’s diagnosis. Having said that, some people live much longer – as many as 20 years longer.

Alzheimer’s disease typically develops slowly, gradually worsening over several years. Over time, it will affect almost every area of the brain. Memory, language, personality, judgment, thinking, problem-solving and movement can all be impacted by Alzheimer’s disease.

As we examine the progression of Alzheimer’s disease, we will carefully look at the five stages an individual with Alzheimer’s passes through. These stages can help you understand what might happen, but each person’s experience with the disease will be different. The stages, described below, are only rough generalizations but can give you an idea of what to expect as you or someone you are caring for passes through them. Knowing what to expect will be helpful to anyone making this difficult journey.

General Overview of Alzheimer Disease Stages

For those who are diagnosed with Alzheimer’s disease, symptoms typically manifest when a person reaches their 70s, but for those who develop early-onset Alzheimer’s disease (approximately five percent of all cases), symptoms can develop as early as a person’s 30s.

When it comes to Alzheimer’s disease, life expectancy can range from a few years to as many as 20. It really depends on the overall health of the individual and the severity of their symptoms. There is one factor, however, that has a major impact on life expectancy – the age when symptoms appear. Those diagnosed at the age of 65 have a life expectancy of 8.3 years, whereas, someone at the age of 90 has a shorter life expectancy of 3.4 years.

In the typical progression of Alzheimer’s disease, the mild or early stages last approximately two to four years. The moderate or middle stages lasts anywhere from two to 10 years. And the severe or late stages typically last one to three years. Doing the math, you see that there is a wide range of years in which the disease can progress – between five to 17 years for the typical progression of Alzheimer’s disease.

Alzheimer’s disease is the most common cause of dementia. In its early stages, Alzheimer’s disease may interfere with some day-to-day activities. As it progresses into the later stages, however, an individual with Alzheimer’s disease will be completely dependent on others to accomplish even the most basic tasks.

Although treatment and interventions can slow the disease’s progression, with no cure, it’s important to know what to expect during each stage of the disease. Let’s look at them now.

Stage 1: Preclinical Alzheimer’s Disease

Alzheimer’s disease begins long before any symptoms become apparent. An individual who is at the preclinical stage of Alzheimer’s disease is fully independent and may not even be aware they have the disease. They may not experience any symptoms and if they do, they will be very mild and considered to be normal everyday occurrences, especially for an older adult, such as minor memory lapses – forgetting words or where things are kept, things we all forget from time to time. Even a medical examination may indicate no presence of dementia.

This stage is called preclinical because it’s usually identified only in a research setting. Research laboratories now have new imaging technologies able to identify the common amyloid-beta protein deposits in the brain – a hallmark indicator of Alzheimer’s disease.

Symptoms won’t be apparent to you or to those around you yet. This stage can last for many years, possibly even decades, before you notice any symptoms at all.

Stage 2: Mild Cognitive Impairment (MCI) Due to Alzheimer’s Disease

Although “senior moments” are common occurrences for most older adults, an individual with MCI will experience them at a slightly higher rate. MCI will cause an individual to forget things like familiar words, where they placed something or a family member’s name. They may have difficulty accurately judging the sequence, number of steps or the time required to complete a task. It becomes more difficult for them to make sound decisions.

Memory troubles are still mild enough that they may not be apparent to the individual’s family and friends. Additionally, symptoms at this stage typically don’t cause problems at work or in relationships.

Not everyone who has MCI has Alzheimer’s disease. Based on a review of symptoms, a medical professional can diagnose MCI. The same procedures used to diagnose preclinical Alzheimer’s disease (in a research setting) can be used to determine if the MCI is caused by Alzheimer’s disease or something else.

Stage 3: Mild Dementia Due to Alzheimer’s Disease

The symptoms of Alzheimer’s disease during this stage are still mild; however, close friends and family may begin to notice signs and symptoms of the disease. Work quality will begin to suffer, and the individual is likely to experience problems when trying to learn something new. Although stage three lasts for approximately seven years, symptoms will become more apparent over a span of two to four years. It’s during stage three that Alzheimer’s disease is most often diagnosed, as it becomes apparent to family and medical professionals that the individual is having significant trouble with memory and thinking, so much so, that it impacts day-to-day activities.

In stage three, an individual may require counseling. They may have mild to moderate denial, depression and anxiety. As this stage progresses and their symptoms worsen, they may require caregiving assistance in their home or in a senior care community.

In stage three, individuals may experience:

Memory loss

The individual may begin to have an especially hard time recalling recently learned information and may repeatedly ask the same question.

Getting lost or misplacing items

They may experience increased problems navigating their surroundings, even in familiar places. They may lose or misplace items, even items that are valuable.

Difficulty with problem-solving, making sound judgments and performing complex tasks

Individuals may find things like balancing the checkbook or planning a family event to be overwhelming. They often have lapses in judgment.

Problems organizing and expressing thoughts

It becomes increasingly more difficult to clearly express ideas or to find the right words to describe objects.

Personality changes

Individuals may become moody, withdrawn or subdued, particularly in social situations. They may demonstrate uncharacteristic anger or irritability. Having less motivation to complete tasks is common.

Stage 4: Moderate Dementia Due to Alzheimer’s Disease

It’s at this stage, which lasts about two years, that Alzheimer’s disease is much more diagnosable. Symptoms experienced in stage three become much more pronounced. The individual becomes increasingly more forgetful and confused, requiring assistance with self-care and activities of daily living (ADLs). Mood changes are much more obvious. They also frequently experience a decreased emotional response, especially in challenging situations.

Individuals with moderate dementia may:

  • Require increasing assistance with ADLs. This may include activities such as bathing, grooming and toileting. They may need assistance choosing the appropriate clothing. They may lose control of their bladder and bowels.
  • Experience greater memory loss, forgetting details of their personal life such as where they attended school or their current address or phone number. They begin to repeat favorite anecdotes and make up stories in an attempt to fill in the gaps of lost memories.
  • Experience profound changes in behavior and personality. They may develop unfounded suspicions – for example, they believe their spouse is having an affair or that others are stealing or hiding their possessions. They may experience visual and auditory hallucinations. Many experience “sundowning” – growing restless or agitated later in the day. Some exhibit outbursts of physically aggressive behavior.
  • Demonstrate deepening confusion and increasingly poor judgment. They may begin to confuse close friends and family members for each other. They may mistake strangers for family members. They begin to lose touch with reality – where they are, the day of the week or what season it is. They may begin to wander, searching for something that is familiar.

All the difficulties they begin to face as they move into moderate dementia make it unsafe for them to continue to live on their own. For their own safety and that of others, they eventually require constant supervision. Counseling can be helpful for them and those that care for them as they progress through stage four.

Stage 5: Severe Dementia Due to Alzheimer’s Disease

In the final stage of Alzheimer’s, mental functions continue to decline and the individual experiences difficulties with movement and physical abilities. They require assistance with most tasks. Many begin to sleep through most of the day and wander at night, although some individuals seem to require very little sleep. As the disease progresses, the individual will spend the majority of their time in bed.

Individuals in this last stage of Alzheimer’s generally:

  • Require assistance with most activities including eating, dressing, grooming, bathing and toileting
  • Experience a loss of coherent speech. They come to the point where they can no longer carry on a conversation that makes sense. Eventually, they may not speak at all or may occasionally utter a word or phrase.
  • Undergo an increasing decline in physical abilities. They become unable to walk without assistance, then to being unable to sit or hold up their head without support. Muscles can become rigid causing pain when moved. Many individuals with Alzheimer’s form contractures (a shortening and hardening of muscles, tendons and other tissues.) They develop infantile reflexes such as sucking and laying in a fetal position. They become totally incontinent and eventually lose the ability to swallow.

They may experience more personality and behavior changes including:

  • Anxiety
  • Depression
  • Frustration
  • A need to fidget
  • Fear being alone
  • Paranoia
  • Suspicions
  • Shame
  • Delusions
  • Hallucinations

The Rate of Progression Through Alzheimer’s Disease Stages

The rate at which an individual passes through each of these stages varies widely. Although some people live much longer, an individual with Alzheimer’s disease typically lives between three to 11 years after diagnosis. Due to impaired swallowing which allows food and drink to enter the lungs, an ensuing infection leading to pneumonia is the most common cause of death. Other causes include other infections, falls, malnutrition and dehydration.

Preventing Alzheimer’s Disease

Although there is no known cure, research suggests that a healthy lifestyle may reduce the chance of developing many age-related dementias including Alzheimer’s disease. By making sure to exercise regularly, eat a healthy diet and take part in activities that stimulate the brain, individuals can make huge strides in the prevention of Alzheimer’s disease. Amazingly enough, as many as 50% of all cases of Alzheimer’s disease may be due to lifestyle choices; therefore, making educated decisions is certainly worth the effort. Not only will better choices help prevent Alzheimer’s, but they’ll also provide many additional benefits.

If your spouse or family member is already facing Alzheimer’s disease, Homestead at Hamilton is here to provide the best possible care and environment for those with memory support needs. In our ValeoTM memory care neighborhood, we offer compassionate care and a variety of options for engaging the mind, body and spirit to help residents connect with others and experience a wide range of stimulating programs and events. At our memory care community — located in Hamilton Township, New Jersey — they’ll enjoy access to multiple dining options, convenient services and elegant amenities. To schedule a visit, please contact us today.


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