What to Expect as Alzheimer’s Disease Progresses


Alzheimer’s disease causes a slowly progressive loss of brain function. It is characterized by a gradual deterioration of all the thinking or cognitive faculties caused by the death of nerve cells and the connections between them. Alzheimer’s disease is often accompanied by changes in behavior and personality. Its course is relentless, but the rate of mental decline varies from person to person.

Alzheimer’s disease advances slowly through three stages, progressing from mild forgetfulness to severe dementia. In the first stage (early/mild Alzheimer’s disease), symptoms include impaired memory of recent events, faulty judgment, and poor insight. People may forget important appointments, recent family events, and highly publicized news stories. They may not be aware of their forgetfulness and strongly deny it when told or asked about it. Other symptoms include losing or misplacing possessions, repetition of questions or statements, and minor or occasional disorientation.

In the second stage (middle/moderate Alzheimer’s disease), memory problems grow worse and basic self-care skills begin to decline. Patients have trouble expressing themselves verbally or in writing and very gradually lose the ability to perform everyday activities, such as dressing, bathing, using a knife or fork, or brushing their teeth. They may also suffer from delusions or hallucinations, become lost if they go outside on their own and sometimes do not recognize family members, friends or familiar places, such as their home.

In the third stage (late/severe Alzheimer’s disease), almost all reasoning capacity is lost and physical symptoms develop. Individuals become completely dependent on others for their care. The disorder eventually becomes so debilitating that most patients cannot walk or feed themselves and have impaired ability to swallow. Lung and urinary tract infections are common. Pneumonia is the most common cause of death in Alzheimer’s patients.