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Alzheimer’s Disease and its progression are described by doctors and medical researchers through stages, and symptoms that can occur in each stage. Alzheimer patients are categorized by their level of cognitive and functional impairment – mild, moderate, severe, and profound. This outline describes the stages and possible symptoms:

Mild

  • Forgetfulness

  • Difficulty with complex math problems, such as balancing the checkbook, doing taxes

  • Inability to plan and execute a complex series of actions, such as that required to prepare a three-course meal

  • Inability to stick to a complex schedule, such as that required by certain prescriptions, 2 tablets 3 times a day

  • Confusion or disorientation about time, date or place, wandering toward a specific goal, such as a friend’s house that, results in getting lost

Moderate

  • More pronounced memory problems that may interfere with normal daily activities

  • Difficulty with simple food preparation, such as brewing a cup of tea or coffee

  • Inability to perform routine household chores and yard work

  • Decline in personal hygiene, possibly requiring reminders or assistance to use the bathroom, shave, fasten clothing correctly, and choose appropriate clothing

  • Increased wandering behavior that’s not goal-directed, getting lost

  • Agitation, pacing, increased irritability more likely

  • Confusion that often becomes worse in evening

The following symptoms can occur in both the moderate and severe stages, and may become more noticeable as the patient enters the severe stage.

  • Increased irritability and agitation, verbal and physical aggression

  • Symptoms of psychosis, including delusions, paranoia, and hallucinations

Severe

  • Need for extensive assistance with personal care, including eating, hygiene, grooming and toileting

  • Increased irritability and agitation, verbal and physical aggression

  • Symptoms of psychosis, including delusions, paranoia, and hallucinations

  • Unsteadiness and reduced ability to walk

  • Incontinence

  • Disorientation

Profound

  • Complete lack of awareness of surroundings

  • Total dependence on caregivers for feeding, hygiene, and everything else

When AD patients reach what’s known as the terminal stage of the disease, they may become bedridden and will certainly require around-the-clock care. At this stage, many Alzheimer’s patients succumb to opportunistic infections, such as pneumonia.

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