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Alzheimer's stages and symptoms

October 09, 2000

Alzheimer's stages and symptoms



Despite the fact they sometimes overlap and are not uniform in every patient, the stages to which Alzheimer's symptoms progress provide a framework for understanding the disease, according to the Alzheimer's Association.

The first stage of Alzheimer's usually lasts from 2 to 4 years, leading up to and including diagnosis.

Symptoms are:

  • Recent memory loss, which begins to affect job performance.
  • Confusion about places, such as getting lost on the way to work.
  • Loss of spontaneity, the spark or zest for life.
  • Loss of initiative.
  • Mood/personality changes.
  • Poor judgment.
  • Slower performance time on routine chores.
  • Trouble handling money, paying bills.


The second stage of Alzheimer's usually lasts from 2 to 10 years after diagnosis.

Symptoms are:

  • Increasing memory loss and confusion.
  • Shorter attention span.
  • Problems recognizing close friends and/or family.
  • Repetitive statements and/or movements.
  • Restlessness, especially in late afternoon and at night.
  • Wandering.
  • Occasional muscle twitches or jerking.
  • Perceptual motor problems, such as difficulty setting a table.
  • Difficulty organizing thoughts, thinking logically.
  • Difficulty finding the right words and making up stories to fill in blanks.
  • Problems with reading, writing and numbers.
  • Suspicion, irritability and fidgeting.
  • Loss of impulse control, such as undressing at inappropriate times.
  • Fear of bathing or trouble dressing.
  • Sporadic weight gain and loss.
  • Hallucinations.


The terminal stage of Alzheimer's usually lasts from 1 to 3 years.

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Symptoms are:

  • Inability to recognize family members or self-image in mirror.
  • Weight loss even with good diet.Little capacity for self care.
  • Inability to communicate with words.
  • Tendency to put everything in mouth or touch everything.
  • Inability to control bowels, bladder.
  • Seizures, difficulty with swallowing, skin infections.


Ultimately, Alzheimer's disease renders the patient bedfast and in need of 24-hour care, said Barbara Pilgram, executive director of the Alzheimer's Association of Western Maryland.

The patient can't communicate hunger, thirst or pain, and forgets how to walk and how to swallow, she said.

"More and more, it's being recognized as a terminal disease," Pilgram said.

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