Table 2. Stages of AD Stage Description
Clinical Presentation
Stage 1 No evident dementia
• No identifiable dementia; person is mentally healthy
Stage 2 Subjective memory loss and age- related forgetfulness
• Can last 15 years in healthy people • May have difficulty remembering where they have placed things • May not be able to recall names as they have in the past • Subjective cognitive decline • Memory issues may be noticed by loved ones or coworkers • May repeat statements • Patient should visit a physician to understand root cause of MCI • Lifestyle changes can be made to reduce stress, improve diet, and increase physical exercise • Diagnosis by a trained professional can be made with great accuracy • Person may sense a loss of independence • Person may become forgetful with finances, bill paying, organizing the home • Poor time management • Person may inadvertently engage in unsafe behavior (e.g., leave door unlocked or forget to shut off oven) • Patient may be aware but lack understanding • Job performance may be impaired • Concentration may be impacted • High levels of anxiety • Evident decline in activities of daily living • May start to wear the same clothing, be resistant to changing • Needs daily assistance with life management, including finances • Cannot recall daily occurrences, cannot comprehend concepts such as the weather or their current address • Memory is erratic from moment to moment • May exhibit a lack of control, agitation, and aggression • Person will be unable to dress themselves properly • Person will require full-time oversight and assistance for activities of daily living • Bathing issues present—person may not discern water temperature and personal hygiene will be impaired, including toileting and brushing teeth; ultimately person becomes incontinent • Person will exhibit radical changes in emotions and express frustration with inability to communicate • People with AD who have been in good physical health and do not have cooccurring illnesses may be able to maintain some abilities longer • Limited to no mobility • Ultimately, rigid and unable to move • More vulnerable to normal aging diseases that can impact mortality • Person may be in denial or embarrassed • Person may isolate and avoid socialization • Person is unintelligible; speaks very few words • Physical decline is imminent due to lack of self-care
Stage 3 Mild cognitive impairment (MCI)
Stage 4 Moderate cognitive decline; mild dementia
Stage 5 Moderately severe cognitive decline; moderate dementia
Stage 6 Severe cognitive decline; moderately severe dementia
Stage 7 Very severe cognitive decline; severe dementia
Note: Adapted from Alzheimer’s Association (2022) Early detection of AD may impact the stage development of the disease. It may permit time for potential pharmacological interventions, clinical trials, and environmental and lifestyle adjustments. Additionally, proactive approaches may allow time to plan and identify healthcare providers that are engaging in progressive approaches toward the disease.
Self-Assessment Quiz Question #3 Understanding the aspects of clinical stage 4 can help with: a. Potentially minimizing the loss of social connections and isolation. b. Limiting potentially unsafe behavior. c. Both a and b. d. Retraining.
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Book Code: PCIL1525
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