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Alzheimer's Association, New York City Chapter

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Stages of Alzheimer's
 
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First Stage - 2 to 4 years leading up to and including diagnosis

Symptoms:

  • Recent memory loss begins to affect job performance.
  • Confusion about places - can't start anything.
  • Mood/personality changes - patient becomes anxious about symptoms, avoids people.
  • Poor judgment - makes bad decisions.
  • Takes longer with routine chores.
  • Trouble handling money, paying bills.

Examples:

  • Can't remember what she was just told to do.
  • 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  • "Mother's not the same - she's withdrawn, disinterested."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.

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Second Stage - 2 to 10 years after diagnosis (longest stage)

Symptoms:

  • Increasing memory loss and confusion.
  • Shorter attention span.
  • Problems recognizing close friends and/or family.
  • Repetitive statements and/or movements.
  • Restless, especially in the 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, has trouble dressing.
  • May see or hear things that are not there.
  • Needs full-time supervision.

Examples:

  • 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 for a meal.
    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 interest in food.

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Terminal Stage - 1 to 3 years

Symptoms:

  • 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, bladder.
  • May have seizures, experience difficulty swallowing, skin infections.

Examples:

  • Looks in mirror and talks to own image.
  • Needs help with bathing, dressing, eating and toileting.
  • May groan, scream or make grunting sounds.
  • May try to suck on everything.
  • Sleeps more.

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