From left to right: Dr. Joslynn Faustino, Research Project Coordinator, Memory and Aging Program at Butler Hospital; Dr. Hwamee Oh, Director of Imaging Research, Memory and Aging Program at Butler Hospital; Dr. Stephen Salloway, Martin M. Zucker Professor of Psychiatry and Human Behavior and professor of Neurology at the Warren Alpert Medical School of Brown University and director, Neurology and Memory and Aging Program at Butler Hospital; Dr. John Sedivy, Hermon C. Bumpus Professor of Biology and Professor of Medical Science at Brown University and director, Brown University Center on the Biology of Aging; Dr. Rami Kantor, Professor of Medicine in the Division of Infectious Diseases, Brown University and Director HIV Resistance Laboratory, Miriam Hospital; and Lynne Larson, Director of Foundation Relations, Brown University.

If you or a loved one has recently been diagnosed with Alzheimer’s disease, you are likely experiencing many different emotions including shock, fear, sadness, and worry. Knowing what to expect and how to plan ahead can provide a sense of control and important peace of mind. Alzheimer’s disease has three stages: early (mild), middle (moderate), and late (severe). Here is what to expect and what to do during each of them.

Early Stage (Mild) Alzheimer’s

A person in the early stage of Alzheimer’s may:

  • Find it hard to remember things
  • Be repetitive
  • Get lost in familiar places
  • Lose things or put them in odd places
  • Have trouble handling money and paying bills
  • Forget to take medication
  • Take longer than normal to finish daily tasks

During early-stage Alzheimer’s, a person can generally do most things independently and can interact socially. He or she may have difficulty performing some tasks, such as driving, managing medications, continuing with work or paying bills. Symptoms may only be noticeable to the individual affected and those that are closest to them.

Receiving a diagnosis in the earliest stage allows for better planning and management during the course of the disease.

Recent studies have shown that lifestyle changes may help maintain the best quality of life for as long as possible. These lifestyle changes include incorporating regular exercise, a Mediterranean-style diet and plenty of social and intellectual stimulation into daily life.

[Related: Activ8 Your Brain – The 8 Pillars of Brain Health]

There are currently FDA approved medications that can help to temporarily stabilize memory and thinking ability, however, they do not slow or change the disease process overall. There are, however, many ongoing research studies investigating ways to slow or halt the progression of Alzheimer’s disease. These advances may make new disease-modifying medications available in the not too distant future.

Becoming involved in a research study or clinical trial is an option to consider during this early stage. Your participation in research can help to change the outlook of the disease for others in the future, and perhaps even the progression of the disease for yourself.

[Related: Alzheimer’s Research and Clinical Trials at the Memory and Aging Program]

It’s also important to begin planning for the future.

You’ll want to plan ahead to ensure your loved ones have the information and tools they need to care for you and to carry out your wishes relating to your healthcare, financial and legal matters. This can provide immeasurable peace of mind and comfort to the person affected by the disease as well as his or her loved ones, both in the present and as the disease progresses.

[Related: Planning for the Future After an Alzheimer’s Diagnosis]


Middle Stage (Moderate) Alzheimer’s

Those in the middle stage of Alzheimer’s exhibit:

  • Increased memory loss and confusion
  • Difficulty recognizing acquaintances
  • Forgetting names of some friends or family members
  • Difficulty learning new things and coping with new situations
  • Trouble completing tasks with multiple steps
  • Changes in behavior or mood
  • Forgetting the names of common items
  • Wandering

In the middle stage of Alzheimer’s, symptoms will become more pronounced. The individual affected will have difficulty performing some tasks, and generally should not drive, pay bills, or work independently.  Though memory loss will have progressed, he or she may still remember significant details about their life and loved ones. As this stage advances, the individual may require a higher level of care.

During this stage, it’s important for loved ones and caregivers to seek education about the behavior changes they can expect and strategies for coping with them. It’s also important that caregivers seek support for themselves in order to avoid caregiver burnout. Seeking out education and support will help to provide the best quality of life for the person affected by Alzheimer’s, as well as for his or her caregivers and loved ones.

[Related: Alzheimer’s Association – Middle Stage Caregiving]


Late Stage (Severe) Alzheimer’s

In the late stage, people may:

  • Lose the ability to communicate
  • Sleep more
  • Lose weight
  • Have trouble swallowing
  • Struggle with incontinence

The last stage of Alzheimer’s disease is the most difficult, but in most cases it is also the briefest portion of the disease’s progression. During this time, around-the-clock care is usually required. This is when prior planning and communication during the earlier stages of the disease about the wishes of the person affected can be useful, and can greatly ease stress for caregivers.

It is important to remember that although conventional communication is often greatly reduced during this stage, caregivers and loved ones may still be able to connect with the person affected.  They can show their caring and love through communication of the senses, such as through touch, music, or looking at old photos together. As in the middle stage of the disease, seeking out support is crucial to ensuring the best quality of life for both the person affected by the disease, as well as for caregivers and loved ones.

[Related: Alzheimer’s Association – Late-Stage Caregiving]



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