First Stage – 2 to 4 years leading up to and including diagnosis
- Recent memory loss begins to affect job performance.
- Confusion about places – gets lost on way to work.
- Loses initiative – can’t start anything.
- Mood/personality changes – patient becomes anxious about symptoms, avoids people.
- Poor judgment – makes bad decisions.
- Takes longer with routine chores.
- Trouble handling money, paying bills.
- Can’t remember what she was just told to do.
- Forgets which bills are paid – can’t remember phone numbers.
- Loses things – can’t remember grocery list.
- Arrives at wrong time or place, or constantly rechecks calendar.
- “Mother’s not the same – she’s withdrawn, disinterested.”
- She spent all day making dinner and forgot to serve several courses.
- She paid the bills three times over, or didn’t pay for three months.
Second Stage – 2 to 10 years after diagnosis (longest stage)
- Increasing memory loss and confusion.
- Shorter attention span.
- Problems recognizing close friends and/or family.
- Repetitive statements and/or movements.
- Restless, especially in late afternoon and at night.
- Occasional muscle twitches or jerking.
- Perceptual motor problems. Difficulty organizing thoughts, thinking logically.
- Can’t find right words – makes up stories to fill in blanks.
- Problems with reading, writing and numbers.
- May be suspicious, irritable, fidgety, teary or silly.
- Loss of impulse control – sloppy, won’t bathe or afraid to bathe, has trouble dressing.
- May see or hear things that are not there.
- Needs full-time supervision.
- Can’t remember visits immediately after you leave.
- Repetitive movements or statements.
- Sleeps often – awakens frequently at night and may get up and wander.
- Perceptual motor problems – difficulty getting into a chair, setting the table for a meal.
- Can’t find the right words.
- Problems with reading, numbers – can’t follow written signs, write name, add or subtract.
- Suspicious – may accuse spouse of hiding things, infidelity; may act childish.
- Loss of impulse control – sloppier table manners; may undress at inappropriate times or in the wrong place.
- Huge appetite for junk food and other people’s food; forgets when last meal was eaten, then gradually loses interest in food.
Terminal Stage – 1 to 3 years
- Can’t recognize family or image of self in mirror.
- Loses weight even with good diet.
- Little capacity for self-care.
- Can’t communicate with words.
- May put everything in mouth or touch everything.
- Can’t control bowels, bladder.
- May have seizures, experience difficulty swallowing, skin infections.
- Looks in mirror and talks to own image.
- Needs help with bathing, dressing, eating and toileting.
- May groan, scream or make grunting sounds.
- May try to suck on everything.
- Sleeps more.