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The Alzheimer’s Alphabet – Common Stages of The Disease


Hearing the diagnosis of Alzheimer’s from your doctor can leave you feeling scared, hollow and lost. Whether the diagnosis is or yourself or a loved one, you will most likely be numb; thoughts will be flying through your mind and questions left unanswered. treeheads_framedOne of the most important steps you can take is that very first step of acceptance and with that acceptance will come the need and desire to become knowledgeable.

Below is a listing of the general stages you may experience with Alzheimer’s;  however, keep in mind that every case is different and even the smallest of issues to the body can change the entire direction of the disease. These are not guidelines set in stone and some people may or may not experience these stages. However, it is good to understand what can possibly take place as the Alzheimer’s progresses.[1]

Average life span – typically a person who is diagnosed with Alzheimer’s will live an average of 8 years after diagnosis; however, many have been known to live up to 20 years or more after diagnosis. The average is typically 8 years but each case is different and a number of outside influences can affect this number.

Beginning Stages – in the beginning stages the patient may experience very mild disruptions to their thought processes, occasionally misplacing items and experience slight inconveniences that almost are “expected” as they age. Many will simply apply these short memory losses and misplacing things as a typical sign of aging. Considered to be the earliest stages of Alzheimer’s this can sometimes be a typical sign of aging also.

Changes in Cognizance – this is the stage that is the most noticeable beginning changes in the patient. Cognitive changes include misplacing items and include forgetting common words (for example during a conversation they will stop and explain the word they’re looking for but aren’t able to find the word… “You know that big white thing in the kitchen we keep stuff cold in” and will know when the right word is said or comes to them…“The refrigerator?” “Yeah, that’s it!”). Many times they’ll even chuckle at the fact that words just leave their minds before they get to their mouth. They may also begin to show frustration and confusion when trying to make plans or remember what they were doing if they stop or get interrupted. This stage is often referred to as Early Stage or Mild Alzheimer’s. PT & OT are recognized as an important factor in the patient’s overall health & quality of life at this stage.

Decreasing Cognitive Abilities – at this stage the cognitive changes have progressed to the point that it is very noticeable to those who around the patient regularly. Their past may become confused with the present and they may begin to lose their ability to associate names to faces. Everyday tasks are no longer easy, nor are they taken for granted. Getting confused with simple instructions, such as reading a recipe or simple math tasks, such as balancing a check book or counting by two’s, are now nearly impossible. They may no longer comprehend current events. In some cases the patient may realize these inabilities to perform typical tasks that they may have once done and they may become exceptionally frustrated. While others may not realize the decrease in cognizance themselves but those around them notice easily. It is highly beneficial to look into physical & occupational therapy at this point of the disease, which is referred to as Mid-Early Stage. Physical therapy & occupational therapy can still be beneficial in this stage and will generally help increase their quality of life.

Exacerbating Cognizance Issues – Often referred to as Moderate Mid-Stage Alzheimer’s, at this point the patient shows signs of inability to think and recall properly on a regular basis. This has now become the ‘norm’ as opposed to having more good days than bad. At this point the patient still knows their own name but their history becomes jumbled. They may no longer remember that certain family members are deceased and may even have troubles recalling where they live. Physical and occupational therapy often plays an important part in the patient’s life as it keeps them strong and moving; giving them quality of life and a feeling of purpose. These therapies will make a difference in their everyday existence and may help enhance the patient’s life. Normal actions are no longer taken for granted as loved ones can see times when the person inside has simply disappeared into their own world and a shell of the person they once knew exists. While these moments aren’t always the case, it is more often than not that the patient is no longer able to think in ways that are considered ‘normal’ or regular. At this point many patients become angry and/or even depressed. Families are finding it harder and harder to cope with the increasing debilitating effects of the disease.

Final Stages of Alzheimer’s – These final two stages of Alzheimer’s basically sum up what most people think of when they picture an Alzheimer’s patient. The stage just before the absolute final stage of Alzheimer’s is referred to as the Moderately Severe Mid-Stages of Alzheimer’s. As we know, Alzheimer’s is a progressive disease and by this point the disease has progressed to the point where the patient is severely affected. They can no longer perform typical hygiene and need help with the simplest of tasks including personal hygiene and going to the bathroom. They may experience incontinence because they no longer recognize that they have a need to go to the bathroom. This is one of the hardest points for loved ones also; as the patient will often forget the names of those that are caregivers and family. They generally can still associate a face with the fact that they know this person; however, they cannot put a name to the face. Their sleep patterns are generally affected drastically and many caregivers will rely upon medication to get their loved one the sleep they need. Often, it is by this stage or the stage just above this that caregivers are beginning to understand that this disease is too much for them to handle and will reach out for help to ensure their loved one’s safety. Some patients may become combative, while others severely depressed and withdrawn. At this point many patients become completely delusional and suspicious. They may hear things or become fearful of things that logically give them no reason to fear; however, they no longer have the ability to think logically.  Often, patients at this stage will wander and become lost; sometimes forcing families to make the decision of placing their loved one in a secure environment such as a nursing home or bringing in 24/7 care giving services. Caregivers may work with therapists still during this point of the final stage, as it can help to keep the patient stronger than if they were to simply sit and not move or be given a purpose. This is dependent upon the particular case and patient. Physical Therapy can be helpful during this stage to help keep the patient’s body moving and play some part in tiring their body out, while helping to keep it strong.

Graduated End Stages – This final stage is often referred to as the Severe/Late Stage of Alzheimer’s. The patient may no longer even comprehend their own name, may have no ability to communicate and is completely dependent upon the help of a caregiver to perform everyday daily tasks such as showering, toiletry, teeth brushing, and more. They lose the ability to eat and often will be put on a soft food diet due to choking issues. Many times the patient will appear to be zombie-like and by this point loved ones have faced the fact that their loved one is simply a shell of what they once were. Generally by this point it is a matter of existence and families find this stage to be the hardest stage of all because they can no longer communicate with their loved one. We still suggest trying to stimulate the patient with words and talking to them about the past or discussing the present with them; but, the reality is that this is truly the last stage of the Alzheimer’s.

Alzheimer’s is a progressive disease that destroys a person’s mind bit by bit. It is a complicated disease that can vary by patient. brain_physical_therapyDementia is a symptom of Alzheimer’s; meaning that the mind no longer has the ability to work properly. GO Physical Therapy specializes in working with Alzheimer’s patients and we understand what it takes to give your loved one the best life possible under the circumstances. We have seen patients remain strong and able to perform daily tasks beyond their expectancy to be able to do so. While we can’t promise miracles, we can promise that working with your loved one as they battle Alzheimer’s will help to give them quality of life for as long as possible. We are affiliated with the Long Island Alzheimer’s Foundation who recommends GO Physical Therapy for the therapy needs of Alzheimer’s patients in the Long Island, NY area. Don’t go with just any PT you pull from the phone book. Stick with a physical therapist that has experience and is backed by the Alzheimer’s Association of Long Island for a professional and state of the art knowledge experience that comes to your loved one.


Dedicated To Your Health & Well-being (and safety),



[1] Based on a system developed by Barry Reisberg, M.D., Department of Psychiatry at the New York University Langone Medical Center.


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