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November is National Alzheimer’s Disease and Family Caregivers Month

President Ronald Reagan designated November as National Alzheimer’s Disease Awareness Month in 1983. At the time, fewer than 2 million Americans had Alzheimer’s; today, the number of people with the disease has soared to nearly 5.4 million.

Alzheimer's is a type of dementia that causes problems with memory, thinking and behavior. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks.

Alzheimer's is not a normal part of aging. The greatest known risk factor is increasing age, and the majority of people with Alzheimer's are 65 and older. But Alzheimer's is not just a disease of old age. Approximately 200,000 Americans under the age of 65 have younger-onset Alzheimer’s disease (also known as early-onset Alzheimer’s).

Overview of disease progression

The stages below provide an overall idea of how abilities change once symptoms appear and should only be used as a general guide. It may be difficult to place a person with Alzheimer's in a specific stage as stages may overlap.

Early stages

In the early stage of Alzheimer's, a person may function independently. He or she may still drive, work and be part of social activities. Despite this, the person may feel as if he or she is having memory lapses, such as forgetting familiar words or the location of everyday objects.

Friends, family or others close to the individual begin to notice difficulties. During a detailed medical interview, doctors may be able to detect problems in memory or concentration. Common difficulties include:

  • Problems coming up with the right word or name

  • Trouble remembering names when introduced to new people

  • Challenges performing tasks in social or work settings.

  • Forgetting material that one has just read

  • Losing or misplacing a valuable object

  • Increasing trouble with planning or organizing

Middle stages

Moderate Alzheimer's is typically the longest stage and can last for many years. As the disease progresses, the person with Alzheimer's will require a greater level of care.

You may notice the person with Alzheimer's confusing words, getting frustrated or angry, or acting in unexpected ways, such as refusing to bathe. Damage to nerve cells in the brain can make it difficult to express thoughts and perform routine tasks.

At this point, symptoms will be noticeable to others and may include:

  • Forgetfulness of events or about one's own personal history

  • Feeling moody or withdrawn, especially in socially or mentally challenging situations

  • Being unable to recall their own address or telephone number or the high school or college from which they graduated

  • Confusion about where they are or what day it is

  • The need for help choosing proper clothing for the season or the occasion

  • Trouble controlling bladder and bowels in some individuals

  • Changes in sleep patterns, such as sleeping during the day and becoming restless at night

  • An increased risk of wandering and becoming lost

  • Personality and behavioral changes, including suspiciousness and delusions or compulsive, repetitive behavior like hand-wringing or tissue shredding

Late Stage

In the final stage of this disease, individuals lose the ability to respond to their environment, to carry on a conversation and, eventually, to control movement. They may still say words or phrases, but communicating pain becomes difficult. As memory and cognitive skills continue to worsen, significant personality changes may take place and individuals need extensive help with daily activities.

At this stage, individuals may:

  • Need round-the-clock assistance with daily activities and personal care

  • Lose awareness of recent experiences as well as of their surroundings

  • Experience changes in physical abilities, including the ability to walk, sit and, eventually, swallow

  • Have increasing difficulty communicating

  • Become vulnerable to infections, especially pneumonia


Alzheimer's has no current cure, but treatments for symptoms are available and research continues. Although current Alzheimer's treatments cannot stop Alzheimer's from progressing, they can temporarily slow the worsening of dementia symptoms and improve quality of life for those with Alzheimer's and their caregivers. Today, there is a worldwide effort under way to find better ways to treat the disease, delay its onset, and prevent it from developing.

Caregiver information

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