There are many things the medical community understands about Alzheimer's disease and many things it doesn't yet know. For example, it's not clear why some people with Alzheimer's disease experience faster decline than others. Early Alzheimer's diagnosis and treatment may help to slow progression of Alzheimer's symptoms.

Using the Functional Assessment Staging (FAST) scale developed by Dr. Barry Reisberg, director of the New York University School of Medicine's Silberstein Aging and Dementia Research Center, doctors are able to make a determination about which stage of the disease a person is suffering from, based on the Alzheimer's symptoms being experienced. The FAST scale divides the progression of Alzheimer's disease into areas of functional loss, such as degrees of forgetfulness, agitation and behavior and deficits in intellect and reasoning, as well as the ability to perform daily activities. By understanding the various areas, Alzheimer's caregivers can better meet the needs of the person suffering from Alzheimer's.¹⁹

Alzheimer's Disease: Progressing through Three Stages

In people with Alzheimer's disease, changes in the brain may begin 10 to 20 years before any visible signs or symptoms appear. Some regions of the brain may begin to shrink, resulting in memory loss, the first visible sign of Alzheimer's disease.

Over time, Alzheimer's disease progresses through three main stages: mild, moderate, and severe. Because it is not easy to look inside a living brain to see the damage Alzheimer's disease causes, these stages are characterized by a collection of signs and symptoms and behaviors the people with Alzheimer's disease experience.

Mild Alzheimer's Disease

People with mild symptoms of Alzheimer's disease often seem healthy, but they are actually having trouble making sense of the world around them. It often takes time for an observer to realize that something is wrong because the initial symptoms are often confused with changes that take place in normal aging. Symptoms and early signs of Alzheimer's disease may include:

• Difficulty learning and remembering new information
• Difficulty managing finances, planning meals, taking medication on schedule
• Depression symptoms (sadness, decreased interest in usual activities, loss of energy)
• Still able to do most activities such as driving a car
• Gets lost going to familiar places

Moderate Alzheimer's Disease

In moderate Alzheimer's disease, the damaging processes occurring in the brain worsen and spread to other areas that control language, reasoning, sensory processing, and thought. In this stage, symptoms and signs of Alzheimer's disease become more pronounced and behavioral problems may become more obvious. Signs and symptoms of moderate Alzheimer's disease may include:

• Forgetting old facts
  • Continually repeats stories and/or asks the same questions over and over
  • Makes up stories to fill gaps
• Difficulty performing tasks
  • Following written notes
  • Using the shower and toilet
• Agitation, behavioral symptoms common
  • Restlessness, repetitive movements
  • Wandering
  • Paranoia, delusions, hallucinations
• Deficits in intellect and reasoning
• Lack of concern for appearance, hygiene, and sleep become more noticeable

Severe Alzheimer's Disease

In the advanced stage of Alzheimer's disease, damage to the brain's nerve cells is widespread. At this point, full–time care is typically required. For friends, family, and Alzheimer's caregivers, this can be the most difficult stage. People with severe Alzheimer's disease may have difficulty walking, and they often suffer complications from other illnesses, such as pneumonia. Signs of severe Alzheimer's disease may include:

• May groan, scream, mumble, or speak gibberish
• Behavioral symptoms common
  • Refuses to eat
  • Inappropriately cries out
• Failure to recognize family or faces
• Difficulty with all essential activities of daily living

People with moderate to severe Alzheimer's disease may benefit from treatment with Namenda^® (memantine HCl)*, the first and only Alzheimer's medication approved to treat moderate to severe Alzheimer's disease. Namenda works in an entirely different way than currently available medications, and offers an important advance in the treatment of Alzheimer's disease.

With this information on the various stages of Alzheimer's disease – and the symptoms associated with them – you are in a better position to discuss Alzheimer's treatment options with the doctor.⁹