Alzheimer’s disease is a brain disorder named after German physician Alois Alzheimer who first described it in 1906.  Alzheimer’s disease is a progressive and fatal brain disease that causes memory loss and problems with thinking and behavior that affect work, lifelong hobbies, and social life.  Today it is the seventh leading cause of death in the United States.

Dementia is a general term for memory loss and other intellectual disabilities.  Alzheimer’s disease accounts for 50-70 percent of dementia cases.  Other types of dementia include vascular, mixed, Lewy bodies, and frontotemporal.  Currently there is no cure for Alzheimer’s disease.  Treatment for symptoms includes medical and non-medical strategies.

1. Stage 1: No impairment and normal functioning.
2. Stage 2: Very mild cognitive decline (may be normal age-related changes or earliest signs of Alzheimer’s disease). 
3. Stage 3: Mild cognitive decline (can be diagnosed in some but not all).
   1. Family, friends, co-workers begin to notice deficiencies with memory or concentration including word or name finding to family or close associates, decreased ability to remember names of new people when introduced, performance issues in social, work settings, reading a passage and remembering material, losing or misplacing objects, decline in ability to plan or organize.
   2. Stage 4: Moderate cognitive decline (mild or early stage Alzheimer’s).  In this stage a thorough medical review detects clear-cut deficiencies in the following areas:
      1. Decreased knowledge of recent occasions or events.
      2. Impaired ability to perform challenging mental arithmetic (i.e. counting backward from 75 by 7s.)
      3. Decreased capacity to perform complex tasks, such as planning dinner for guests, paying bills and managing finances.
      4. Reduced memory of personal history.
      5. The person seems subdued and withdrawn, especially in socially and mentally challenging situations.
      6. Stage 5: Moderate severe cognitive decline (moderate or mid-stage Alzheimer’s).
         1. Major gaps in memory and deficits in cognitive function.
         2. Unable to recall important facts such as current address, telephone number, name of high school or college the person attended.
         3. Confusion with date, day of the week, or season.
         4. Have trouble with less challenging arithmetic, for example counting backward from 40 by 4s or from 20 by 2s. 
         5. Need help choosing proper clothing for the season or occasion.
         6. Usually retain information about their name and spouse’s name or children.
         7. Usually require no assistance with eating or using the toilet.
         8. Stage 6: Severe cognitive decline (moderately severe or mid-stage Alzheimer’s disease). 
            1. Memory difficulties continue to worsen, significant personality changes may emerge and affected individuals need extensive help with customary daily activities.
            2. Lost most awareness of recent experiences and events as well as of their surroundings.
            3. Recollect their personal history incorrectly, although they generally recall their own name.
            4. Occasionally forget the name of their spouse, but generally can distinguish familiar and unfamiliar faces.
            5. Need help getting dressed properly; without supervision, may make such errors as putting pajamas over daytime clothes or shoes on wrong feet.
            6. Experience disruptions of their normal sleep/waking cycle.
            7. Need help with handling details of toileting (flushing toilet, wiping and disposing of tissue properly).
            8. Have increasing episodes of urinary or fecal incontinence.
            9. Experience significant personality changes and behavioral symptoms, including suspiciousness and delusions (i.e. believing their caregiver is an impostor); hallucinations (i.e. seeing or hearing things that are not really there); or compulsive, repetitive behaviors such as hand-wringing or tissue shredding.
            10. Tend to wander or become lost.
            11. Stage 7: Very severe cognitive decline (Severe or late-stage Alzheimer’s).
                1. This is the final stage of the disease.
                2. Lost ability to respond to the environment, the ability to speak, and the ability to control movement.
                3. Frequently lose capacity for recognizable speech. 
                4. Need help with eating and toileting and there is general incontinence of urine.
                5. Lose the ability to walk without assistance, then the ability to sit without support, the ability to smile, and the ability to hold their head up.  Reflexes become abnormal and muscles grow rigid.  Swallowing is impaired.