How Can You Recognize the Stages of Alzheimer’s?

It’s instinctive to want a map. Where’s the next turn? What’s the next step? It’s a human thought pattern. We at least think we want to know what happens next.

After we find out that a loved one has Alzheimer’s disease (or any other disease) it’s only natural to research it. What can we expect and when can we expect it?

The National Alzheimer’s Association has developed a very useful tool, or “staging system,” to use as a frame of reference when coping with Alzheimer’s disease. The organization, however, will be the first to tell you that people are not programmed to follow these stages in a direct line. No matter how much we’d like to “know” what stage someone is in, we can’t. One day, our loved one may seem like he or she is in stage five, and the next day the disease may seem more like stage four or six. With that in mind, we’ll look at the stages as presented by the National Alzheimer’s Association, so we at least have a shot at some order.

Stage 1: No impairment (normal function)

There is some thought in the medical community that Alzheimer’s disease may start years, if not decades, before we have even a clue that anything is wrong with ourselves or our loved ones. Not much we can do here until there is more known. Genetic research and much more sophisticated technology will no doubt make this an important and focused area of study as we march into the future. But, for now, most of us will never know (would we even want to?) if we are in stage one of Alzheimer’s disease.

Stage 2: Very mild cognitive decline (may be normal age-related changes or earliest signs of Alzheimer’s disease).

At this time you or your loved one may have a sneaking suspicion that something sinister is on the horizon. A little more forgetfulness, but it could be natural aging. A little more irritability when that forgetfulness occurs, but isn’t that normal? Hmm, maybe we should chat with a doctor. Still, we aren’t likely to get satisfaction (such as a definite yes or no). Most likely, we will hear something to the effect that it’s just normal aging, and maybe we should do more crossword puzzles or take a class. Oh yeah, and eat more chocolate. Chocolate has antioxidants in it that are good for the brain. That I can do.

Stage 3: Mild cognitive decline

This is a tricky point. The Alzheimer’s Association says that early-stage Alzheimer’s disease can be diagnose in “some, but not all,” individuals with the symptoms recognizable to family and others close to the person having problems. These symptoms include problems with words and names, decreased ability to remember names of newly introduced people (oops, that one scares me – I forget new names all the time), unusual performance issues at work or in social settings, retaining little of material that has been recently read, losing or misplacing something of value to the person and/or a decline in the ability to plan and organize.

We can chat with a doctor, and even request the cognitive tests at this point, but is this conclusive? This is still a point where a diagnosis could be a tough call. Yet, personally, I would suggest that if someone is very concerned, he or she should see a team of physicians uniquely qualified to diagnose dementia – and the often subtle differences between dementias – because this a point where some medications can help maintain better  brain function longer into the disease. If we brush off worries too long, and then go for help, we may have lost valuable time. Still, this isn’t a time to panic. Just get in, have a good general physical and perhaps see a qualified neuropsychologist that has experience with diagnosing dementia. Schedule any and all of the tests suggested by this expert. Follow through with all appointments. And then, get a grip. There is likely still room for doubt.

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