As part of the large family of neurocognitive disorders, Alzheimer's disease unfortunately affects many seniors. To better understand this condition and thus better support our elderly loved ones who are affected by it, let's take a look at the seven stages of Alzheimer's disease.
Based on symptoms and the person's level of independence, these different stages provide a better understanding of how dementia progresses over time. A good understanding of these stages makes it possible to adapt services and care in real time, ensuring the well-being and safety of seniors affected by this disease.
The 7 stages of Alzheimer's disease according to the Reisberg scale
Also known as the "global deterioration scale," the Reisberg scale is intended as a reference for classifying the progression of Alzheimer's disease based on the severity of cognitive symptoms, as well as the limitations experienced by the individual in their daily life.
To this day, this system is used by healthcare professionals and caregivers to better understand the impact of the disease, at a specific point in time, on the activities and independence of a person with Alzheimer's.
Stage 1: No symptoms
At this stage, there are no particular problems to report. If in doubt, for example if your elderly relative is experiencing minor memory lapses, it is best to have the diagnosis confirmed by a healthcare professional. It is important to remember that changes attributable to normal aging must always be distinguished from actual Alzheimer's disease.
Stage 2: Very mild cognitive impairment
This is when the first symptoms of Alzheimer's appear. Although mild, the onset of cognitive impairment is noticeable at this stage. This most often manifests itself in memory loss and forgetting small details of everyday life. If one of your loved ones is suffering from stage 2 Alzheimer's, be aware that they may forget where they have put everyday objects, confuse names, or struggle to find the right words.
Stage 3: Alzheimer's disease with mild cognitive symptoms
Still considered part of the "pre-dementia" phase, it is at this stage that the disease generally begins to show the first noticeable signs. Concentration problems, difficulty with orientation, and limitations in performing more complex tasks are some examples of classic symptoms in a Stage 3 Alzheimer's diagnosis. It is also at this point in the progression of the disease that neuropsychological tests become more easily measurable during assessments by healthcare professionals. Fortunately, in most cases, independence in everyday life remains intact at this stage of the disease, allowing the person to continue to carry out most of their activities.
If one of your elderly loved ones has stage 3 (or higher) Alzheimer's disease, be aware that he or she may be in denial about their situation. In such cases, support from family and friends can make a big difference. If you are a caregiver or regularly interact with an elderly person with Alzheimer's, don't hesitate to take advantage of the resources available to you, both for your own well-being and that of your loved one.
Stage 4: Cognitive impairment with moderate deficit
According to several experts, this stage marks the onset of the dementia phase often associated with Alzheimer's disease. The most common symptoms may include:
- difficulty performing complex tasks;
- problem with planning and organization;
- more frequent forgetfulness, especially regarding recent events;
- limited ability to solve calculations or manage finances.
Although the progression of the disease varies from person to person, stage 4 Alzheimer's marks, for some, the onset of the first symptoms that can affect a person's behavior. As physical and cognitive symptoms progress, mood disorders such as anxiety, depression, and anxiety may develop. In order to help these individuals, strategies can be put in place to better manage these strong emotions.
Stage 5: Moderate to severe cognitive symptoms
At this intermediate stage of Alzheimer's disease, several significant symptoms tend to appear. Memory loss generally becomes more frequent and performing simple everyday tasks becomes more difficult. Typical examples include difficulty choosing one's own clothes, counting/calculating, or finding one's way around.
It is therefore at stage 5 of Alzheimer's that the person's loss of independence becomes more significant. In order to maintain maximum independence for seniors and allow them to continue enjoying the comforts of home, home care becomes essential.
Stage 6: Severe cognitive impairment with behavioral disorders
Defined by significant cognitive impairment and dementia that is often considered severe, stage 6 Alzheimer's disease represents another turning point in the progression of this neurodegenerative disorder. In addition to worsening memory loss, particularly with regard to recent events, personality and behavioral disorders may appear in some people with the disease.
- Frequent forgetfulness and confusion, especially with regard to short-term memory;
- Daily assistance required for hygiene care (toileting, bathing, etc.);
- Possible onset of incontinence problems;
- Behavioral disorders and mood changes (agitation, hallucinations, anxiety, delusions, etc.);
- Difficulty remembering names and relationships (even though the person may still be able to recognize certain familiar faces).
Stage 6 Alzheimer's therefore requires constant presence and supervision. For their own safety and well-being, it is recommended that elderly loved ones not be left alone in such circumstances.
In order to help seniors themselves, as well as their families and caregivers, professional home care services can be a valuable resource.
Stage 7: Alzheimer's disease with severe impairment and major limitations
Marking the most advanced stage of Alzheimer's disease, stage 7 involves severe cognitive impairment and significant limitations in most areas of daily life. In addition to the significant memory problems characteristic of Alzheimer's, physical symptoms may intensify:
- coordination problems causing difficulty sitting or walking;
- more limited facial expressions/smiles;
- interaction plus difficile avec l’entourage ;
- swallowing disorders (difficulty eating and drinking);
- assistance required during meals and basic care (hygiene, washing, etc.);
- more hunched posture, even when seated;
- muscle stiffness, etc.
The duration of stage 7 Alzheimer's varies from person to person and can depend on a number of factors. In all cases, however, the person affected must receive continuous care and assistance in order to maintain the best possible quality of life under the circumstances.
Alzheimer's and aggression: how to respond?
Among the many symptoms of Alzheimer's disease, aggression is often one of the most concerning for the loved ones of those affected. Although the aggressive phase does not affect everyone, and certainly not in the same way from one situation to another, it is an aspect of the disease that can be difficult to know how to respond to.
If an elderly loved one with Alzheimer's disease displays verbal aggression or agitated behavior, here are some tips to follow:
- do your best to stay calm;
- try to reassure your loved one;
- ensure that the person's immediate environment is safe;
- avoid physical contact;
- investigate the cause of aggressive behavior in order to understand its origin and limit the risk of recurrence;
- If the situation seems dangerous, leave the premises and ask for help.
Are you concerned about your loved one's aggressive behavior due to Alzheimer's disease? Would you like to find support? The Alzheimer Society of Canada is here to guide you to the right resources available in your area. If you are facing this situation, don't hesitate to take advantage of the various support options available to you!
Remember that you are not alone, and that surrounding yourself with the right people shows how much you care about the well-being of your loved one, as well as your own health and precious life balance.
Solutions: home care or transition to a nursing home?
Although we all want Alzheimer's symptoms to progress as slowly as possible, the search for solutions should begin as soon as the disease appears. This preventive approach aims to maintain the person's independence, well-being, and safety.
Home care for seniors with Alzheimer's disease
Home care services are a tailor-made solution that allows seniors to remain in the comfort of their own homes for as long as possible. Despite the onset of certain symptoms, staying at home is an advantageous and realistic option in the early stages of Alzheimer's disease.
With personalized support services and quality care from professional caregivers, seniors in the early stages of this cognitive disorder can maintain maximum independence at home while living in an environment that ensures their well-being.
Residence for Alzheimer's and other cognitive disorders
Specially designed for seniors with Alzheimer's disease (or similar neurocognitive disorders), these residences offer an adapted environment and a range of services that effectively meet the specific needs of residents. Qualified staff and specialized care allow seniors to enjoy a safe living environment, providing comfort for those affected by the disease and some relief for family and loved ones.
Of course, each case is different. And the typical symptoms of each of the seven stages of Alzheimer's disease can sometimes overlap. When it comes time to choose between home care and moving to a nursing home, the person's wishes and specific individual needs are factors that must be taken into account in this important decision.