Course

The course of Alzheimer's disease varies individually. The disease develops insidiously and worsens gradually over 10-15 years. The lifespan for younger patients with Alzheimer's disease is an average of 8-10 years after the diagnosis has been made. The course may, however, span 20 years. In rare instances, the course of the disease may be very quick and span a few years.

Dementia diseases are divided into three degrees or stages: mild, moderate and severe. Read Degrees of Dementia. The stages and changes that the person goes through are described below.

Common Changes during Mild Dementia

In the mild phase of the disease, memory disorders are obvious. It begins to be difficult to do calculations. Language begins to fail; it can be particularly hard to find nouns. In the beginning, the difficulty in word finding can cause the person to rephrase sentences so the noun is replaced by a verb, for example: "My wife says that there is something wrong with my mem..., that I don't remember things very well anymore."

During this phase, some people with dementia can develop problems with operating equipment. Appliances they never had problems using before suddenly become "tricky", for example the dishwasher, the washing machine, the lawnmower and the TV remote control. In the kitchen, the person often puts the dishes away in new places as it is hard to remember the last place. Later on, people develop problems finding their way in new surroundings.

Despite these changes, the person with dementia can continue to participate in making decisions on legal and financial matters, and it is important to discuss this within the family if something needs to be settled.

Common Changes during Moderate Dementia

During the moderate phase, people develop problems planning and doing the shopping and cooking. Later on it becomes hard to pick out clothes that are appropriate for the weather and the occasion.

This is also the time to determine whether it is responsible to drive.

Behavioural symptoms may begin to appear. More help is needed when activities of daily living begin to deteriorate.

Common Changes during Severe Dementia

During the severe phase of Alzheimer's disease, there is increasing need for help in activities of daily living. Help is needed for bathing and dressing. Problems may arise with hygiene and toileting. A person may lose both bladder and bowel control during this very late stage.

The psychological symptoms become more common. Finally, language skills disappear. The ability to walk or sit in a chair then disappears, and in the end the person becomes bedridden.

It is important that you do not expect more of the person with dementia than a child in a comparable age of development. The emotional reactions can be the same in many ways.

The moderate stage of dementia is also the time people tend to wander, and the ability to manoeuvre through traffic safely can disappear.

During the severe stages of the disease, the person with dementia may have a difficult time sitting down, getting up, walking, etc. and may not recognize what a chair or a toilet is for.