STAGES

The following stages are based on my experience with my mom, not all AD persons have the same ones. Below you will also find "The Global Deterioration Scale for the Assessment of Primary Degenerative Dementia by the American Journal of Psychiatry, 1982, 139:1136-1139.

Stage 1: onset approx. late 1988
Slight forgetfulness, mood swings, paranoid behavior(she thought people were coming into her apt. and stealing things from her),confusion, time of day/date began to get disoriented. These all started as slight and progressed.

Stage 2: onset approx. mid 1992
She began to forget entire years for periods of time, repeating the same question or response every couple of minutes, hallucinations(seeing things that weren't there), forgetfulness began to get very bad(Did she eat? did she take her meds? did she get the mail? did she call/why?)

Stage 3: onset approx. early 1994
Time of day/date got very bad(night became day/day became night. She could be brought out of this with explaination), confusion increased, hallucinations more often, aggitation at everything, severe mood changes, increased forgetfulness. See My Personal Journey

Stage 4: onset May 1995
Loss of bowel and bladder control, unable to walk, unable to feed self, no recognition of family or familiar faces, no concept of time/date/year, no current memory, combative, aggitated at all times. This stage continued through September of 1995 and were very severe.

September 1995
Able to recognize family and familiar faces(can't always place the name), non-combative, not always agitated, able to walk unaided, able to feed herself, little current memory, still confused and forgetful, able to toilet self still has accidents. This continues through today. All of the stages are combined and the severity of each condition varies, dependent on sleep, hunger, meds. schedule

I hope that this helps you. I do not know what brought her out of the severe stage of early 1995. Perhaps proper diet. She was doing meals for herself until then and God only knows what she may or may not of been eating. She moved in with me May 1995.

Global Deterioration Scale for assessment of Primary Degenerative Dementia
Level 1 - Clinical characteristics: No cognitive decline or memory deficits.
Level 2 - Clinical characteristics: "Forgetfulness Stage" Very mild cognitive decline. Subjective complaints of memory deficits such as losing familiar objects, forgetting names of persons formerly known well,. Some word finding noted. No obvious objective evidence on clinical interview or in social/employment situations. Appropriate concern regarding symptoms.
Level 3 - "Early Confusional Stage" Mild cognitive decline. Multiple deficits noted: getting lost while traveling to unfamiliar location; decreased performance in demanding work settings; word and name finding deficits become noticeable; poor retention of reading materials; forgets names of new acquaintances, loses valued items and has a concentration deficit. Denial with mild to moderate anxiety accompanies symptoms.
Level 4 - "Late Confusional Stage" Moderate cognitive decline. Clear-cut deficits in following areas: decreased recall of current and recent events; some memory deficits in personal history; decreased ability to handle finances, travel and complex tasks. Is still oriented to time and person, recognizes familiar persons and faces, can travel to familiar places. Denial is dominant defense mechanism. Flattening of affect and withdrawal from challenging situations.
Level 5 - "Early Dementia Stage" Moderately severe cognitive decline. Patient requires some assistance to function, cannot recall major relevant aspects of their lives (home address, where they went to school or names of family members such as grandchildren), may be disoriented to time and place; can usually remember their own name, their spouse and their children. Unable to count backwards from 40 by 4's or 20 by 2's. Can toilet, feed and dress self but requires assistance with choosing proper clothes to wear due to judgment impairment.
Level 6 - "Middle Dementia Stage" Severe cognitive decline. May forget name of spouse upon whom they are now quite dependent. Largely unaware of all recent events and experience but retain sketchy knowledge of their past life. Requires assistance with activities of daily living and eventually develops urinary and fecal incontinence. They know their own name and frequently are able to distinguish familiar from unfamiliar persons. Personality and emotional changes occur and could include delusional behavior, obsessive behaviors, anxiety symptoms, agitation and previously absent aggression. Cognitive abulia and loss of will may occur due to inability to carry a thought long enough to decide a course of action or to recognize cause and effect.
Level 7 - "Late Dementia and Failure to Thrive Stage" Very severe cognitive decline. All verbal abilities are lost. Incontinent, requires maximum assistance toileting and feeding. Loss of basic psychomotor skills beginning with ambulation, sitting and head control. Generalized and cortical neurologic signs are frequently present but patient is unable to attend to or follow commands.
Adapted from Reisberg, B., Ferris, S.H., Leon, J.J. and Crook, t. .The Global Deterioration Scale for the Assessment of Primary Degenerative Dementia by the American Journal of Psychiatry, 1982, 139:1136-1139.