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Alzheimer’s Disease: Stages of Progression

Excerpted from Duke Alzheimer’s Disease and Related Disorders Association Family Support Network Newsletter of January, 1982.

First Stage: Behavior
  1. Subtle, not identified as a disease
  2. Family denies or excuses behavior
  3. Forgetfulness/memory impairment
  4. Increasing inability to handle routine tasks
  5. Lack of spontaneity
  6. Lessening of initiative
  7. Disorientation of time and places
  8. Depression and terror

Second Stage: An event occurs that forces family to acknowledge existence of problem and seek medical help.

  1. Wandering and repetition in speech
  2. Increasing disorientation
  3. Increasing forgetfulness
  4. Agitation and restlessness, especially at night
  5. Developing inability to attach meaning to sensory perceptions
  6. Inability to think abstractly
  7. Muscle twitching may develop
  8. Convulsive seizures may develop
  9. Repetitive actions

Third Stage: May last for years or months.  Patient needs total personal care.  Patient may no longer be able to speak.

  1. Total disorientation
  2. Complete dependence
  3. Developing inability to recognize self in a mirror or other people
  4. Speech impairment or muteness
  5. Develop a need to put everything in their mouths
  6. Develop a necessity to touch everything in sight
  7. Becoming emaciated
  8. Complete loss of control of all body functions

When it is time for hospice care, contact Covenant Hospice at
1-800-541-3072 (Florida)
1-877-244-7379 (Alabama)
or online at