Alzheimer’s Disease: A Journey in Time

When Did He Get Alzheimer’s Disease? A Continuous Journey

We probably all know that we can’t date the start of Alzheimer’s Disease. Instead, we notice changes over time.

  • Hal’s memory is not working well. He is asking the same question several times in a row or he drives to the neighborhood supermarket, but doesn’t remember what he went there to buy.
  • Susana, a sweet and passive woman for most of her life, seems grumpy and snaps at her family members.
  • Bella has bruises on her body, but doesn’t remember falling.

Alzheimer’s Disease develops gradually. In fact, it may begin to develop long before the symptoms are noticed by the patient or people around him.

We won’t know when the disease started, but it is helpful to know how the disease develops over time.

Most descriptions of Alzheimer’s Disease include three stages, starting with noticeable symptoms. The following list includes two additional stages . . . stages before symptoms interfere with daily living.

Before noticeable symptoms:

  1. Prior to Symptoms: The brain may undergo changes for many years, but there are no noticeable, significant symptoms of the disease.
  2. Mild Cognitive Impairment (MCI): People who have MCI experience some memory and thinking changes but are capable of independently carrying out daily activities. About 38% of people with MCI go on to develop Alzheimer’s Disease.

After noticeable symptoms:

  1. Early (or Mild) Stage Alzheimer’s Disease: People with an Alzheimer’s Disease diagnosis experience changes in memory, language and personality that make some tasks difficult for them. The changes are noticeable and interfere to some extent with carrying out activities of daily living.
  2. Middle (or Moderate) Stage Alzheimer’s Disease: In this stage, the person with a diagnosis needs significant amounts of help with activities of daily living, but can communicate some and carry out some activities without help.
  3. Late (or Severe) Stage Alzheimer’s Disease: Typically, in this stage, the person with a diagnosis needs help with all activities of daily living. Communication and memory are severely restricted.

Alzheimer’s Disease is a progressive disease. It is often described as a “continuum,” which reminds us of a smooth, steady progression of changes. However, this is not always the case.

  • The changes caused by Alzheimer’s Disease and the timing of those changes vary from person to person.
  • The disease does not always progress in a continuous, smooth path. There are times when some changes seem to be noticed “suddenly” or “acutely.”
  • A person’s ability to remember, communicate, and engage in activities may be stronger some days than other days.


For more about the progress of Alzheimer’s Disease, you might see the Alzheimer’s Association’s Stages of Alzheimer’s.

What is a Dementia?

What is a Dementia? Are there many types of dementias? Are they treatable?

As we get older, we wonder and sometimes worry about “having dementia.” What is it and what are the chances?

Dementia is a general term – and umbrella term – for many diseases that affect the brain, or “cognition.”

Cognition involves memory, thinking, problem solving, decision making, communication and/or personality.

Dementias are diseases that affect cognition and, as a result, affect an individual’s ability care for himself or herself, work, do hobbies, and socialize.

Reversible Dementias

It is not unusual for people to become disoriented and forgetful as a result of a medical condition When diagnosed and treated promptly, the dementia may be reversible. Examples of conditions that may be reversible are

  • Dehydration
  • Nutrients insufficiency
  • New medication or interaction of medications
  • Alcohol consumption
  • Depression
  • Infections
  • Thyroid disorders
  • Tumors

Irreversible Dementias

Dementias that are progressive or chronic, and for which there are no known treatments at this time, are associated with diseases such as

  • Alzheimer’s Disease (about 60% of all dementia cases)
  • Vascular Dementia
  • Dementia with Lewy Bodies
  • Frontotemporal Dementia
  • Creutzfeldt-Jakob Disease
  • Alcohol-related brain damage, including Korsakoff’s Syndrome)
  • HIV-associated neurocognitive disorder


For a brief description of chronic dementias, see the Alzheimer’s Society website at Chronic Dementias. A list and brief overview of reversible dementias can be found at Reversible Dementias.