Alzheimer’s is a neurodegenerative disease that progresses in stages. To date, 4 stages have been identified: the mild stage, the moderate stage, the advanced stage and end of life. Understanding these stages helps to better anticipate the needs of the person affected — and those of their family.
What are the 4 stages of the disease’s progression?
The mild (or early) stage
It refers to people presenting mild deficits: memory loss, difficulty communicating, changes in mood and behaviour. At this stage, the help needed remains limited: people can understand the changes taking place, talk about them with those around them, and sometimes wish to take part in planning their future care.
The moderate stage
Memory and cognitive faculties continue to deteriorate, even if many people retain a certain awareness of their condition. Help becomes necessary for many everyday tasks — doing the shopping, the housework, getting dressed, washing — marking a substantial increase in the care required.
The advanced (or severe) stage
The person becomes unable to communicate verbally or to take care of themselves. Care is needed around the clock, aimed at preserving the best possible quality of life.
End of life
Cognitive and physical decline deepens, with continuous care required. How quickly this decline progresses varies from person to person. Care then focuses on comfort, taking into account the person’s physical needs, but also their emotional and spiritual ones.
What is the impact on the family?
Alzheimer’s disease often disrupts family life, upending the balance of roles: children sometimes become the parents of their parents, and grandchildren, kept away in an attempt to “protect” them, sometimes end up drifting away from their grandparents — consequences that benefit neither the loved ones nor the person who is ill. Families need to rethink how they organise themselves and encourage exchange between generations to preserve these bonds, just as staying physically active remains beneficial to carers as much as to the people they care for.
Are there encouraging avenues of research?
In late March 2016, Cambridge researchers published a study suggesting that stimulating the brain with blue light could reactivate memories the disease renders inaccessible, rather than destroying them. This theory, based on a study in mice, had yet to be confirmed in humans, since no such device existed yet for people. Since then, research has advanced chiefly on another front: two treatments targeting amyloid plaque, lecanemab (2023) and then donanemab (2024), have received authorisation in the United States to slow cognitive decline in the early stages. Biomarker blood tests, available since 2024, now make diagnosis easier too.
