The Progression of Alzheimer’s disease

The Progression of Alzheimer’s disease

Alzheimer’s disease is a progressive illness that affects every person differently. This means that the structure and chemistry of the brain become increasingly damaged over time. It can however, be helpful to think of the way the condition progresses as a series of stages. This blog post outlines the characteristics of early, middle and late stages of Alzheimer’s disease.

Looking at Alzheimer’s disease as a series of three stages is a useful way of understanding the changes that occur over time. But it important to realise that these three stages only provide a rough guide to the course of the disease, this is because: 

  • Some symptoms may appear earlier or later than indicated, or not at all.
  • The three stages may overlap each other.
  • Some symptoms, such as walking, may appear at one stage and then vanish, while others such as memory loss will worsen over time.

Physical make-up, emotional resilience, medication and other factors affects how one person will experience the Alzheimer’s disease. 

Early Stage

Alzheimer’s disease usually begins gradually with very minor changes in the person’s abilities or behaviour. Some signs are often mistaken for stress or bereavement, or, in order people, to the normal process of ageing.

Loss of memory for recent events is a common early sign. Someone with Alzheimer’s disease may:

  • Forget about recent conversations and events
  • Repeat themselves
  • Become slower at grasping new ideas
  • Becoming confused
  • Unwilling to adapt to change
  • Lose interest in other people or activities
  • Show poor judgement towards decisions

Middle Stage

As the disease progresses, the changes will become more apparent. The person will require further support to help them manage their everyday living which may include reminding them to eat, wash, dress and use the toilet. They are likely to become increasingly forgetful, particularly with names, and they may repeat the same stories and questions due to a decline in their memory. The person may begin failing to recognise people or confuse them with others.

At this stage, people start to become easily upset, angry or aggressive due to frustration and lack of confidence. Other symptoms may include: 

  • Becoming confused on where they are
  • Becoming muddled about time and getting up at night because they are mixing up the night and day
  • Putting themselves or others at risk through forgetfulness, for example by not lighting the gas on the cooker
  • Starting to behave in ways that may seem unusual
  • Beginning to hallucinate

Late Stage 

At the final stage, the person with Alzheimer’s will need even more help and support as they gradually become totally dependent on others for nursing care. Loss of memory may become very pronounced, with the person unable to recognise familiar objects or people closest to them, although there may be sudden flashes of recognition.

The person may also become increasingly frail. They may start to shuffle or walk unsteadily, eventually becoming confined to a bed or wheelchair. Other symptoms may include: 

  • Difficulty in eating and sometimes swallowing
  • Considerable weight loss – although some people eat too much and put on weight
  • Incontinence – losing control of their bladder and sometimes their bowels
  • Gradual loss of speech although they may repeat a few words or cries out from time to time.

The person may become restless and sometimes seeming to be searching for something or someone. They may become easily distressed or aggressive – especially if they feel threatened in some way. Those caring for the person should try to not take this personally, as the person is not being aggressive deliberately.

Although the person may seem to have little understanding of speech and may not recognise those around them, they may still respond to affection and to being talked to a calming voice. They may also enjoy scents, music or stroking a pet.

On average, people with Alzheimer’s disease live for eight to ten years after their symptoms begin. Life expectancy does, however, vary considerably depending on how old the person is and whether they were diagnosed early on or later in the disease.

For more information about the three stages of Alzheimer’s disease please visit the Alzheimer’s Society website at