Alzheimer’s Disease Progression Three Part Article Series
Part II: Middle-Stage Symptoms
Alzheimer’s disease (AD) causes a gradual decline in memory, thinking, and reasoning skills. Symptoms depend on the stage of the disease. In this three-part article series, we discuss early-stage symptoms, middle-stage symptoms, and late-stage symptoms exhibited by individuals diagnosed with AD.
In Part II of this article series, we are discussing symptoms commonly associated with middle-stage AD, which is typically the longest stage and may last for many years. During middle-stage AD, a person’s symptoms become more noticeable. However, unlike the early stages of AD, individuals are usually unaware of their cognitive decline even though it has worsened.
Cognitive decline often ranges from moderate to severe and although symptoms vary, many people in this stage may no longer be able to function completely independently. Usually, individuals can complete daily care tasks with help from a caregiver, such as getting dressed and eating. As the disease progresses, the caregiver will need to be attentive to changing needs. For example, at first, laying out clothing may be enough to imply that it is time to get dressed. Eventually, extra guidance may be needed by laying out one piece at a time in the order they need to be put on.
An understanding and patient caregiver is necessary due to the challenges that accompany the symptoms experienced by individuals diagnosed with AD. Common middle-stage AD symptoms are listed below.
Loss of Long-Term Memories. During middle-stage AD, memory loss progresses into forgetting long-term memories. For example, it is common to forget personal life events like weddings and funerals, family members, and friends. Memories of how to perform a task such as riding a bike or driving can also be affected.
Decreased Personal Hygiene. Another consequence of continued cognitive decline is that individuals may forget how to complete seemingly easy tasks such as showering or brushing their hair. Or they may remember how to do these tasks but forget to do them. This is one of the reasons a person in the middle stages of AD may require caretaking.
Developing Sundowning Behaviors. Exhibiting certain behaviors at nighttime is very common in the middle stage of AD. Common behaviors include restlessness, wandering, and confusion. This can result in potentially dangerous situations due to their unpredictable nature. Read more about sundowning syndrome here.
Personality Changes. During middle-stage AD, someone diagnosed with AD may experience delusions, believe things that are false, or become suspicious of others, even their own caregivers. It is also possible to develop depression or compulsive behaviors such as pacing or tissue shredding. These personality changes are often accompanied by changes in social interactions, some examples are given below.
Changes in Social Interactions. A common symptom of middle-stage AD is a change in how an individual interacts with others. For example, individuals with AD may isolate themselves during family gatherings they once loved and/or appear moody or unfriendly by refusing to engage in conversations. On the other hand, they may act out of character and say or do things that are viewed as inappropriate or rude by others.
Increased Confusion. Becoming confused about the date or not recognizing a recently visited place may happen more often for someone in the middle stage of AD. This may happen even if it is a family place they have been to many times, like a relative’s home. Confusion and disorientation often increase as short-term and long-term memory loss worsen.
Changes in Appetite. In middle-stage AD, people often experience weight loss due to a decreased appetite, refusing to eat, or forgetting to eat. Also, physical limitations such as toothaches can limit the ability to eat, and personality changes may affect the desire to eat.
AD affects each person in different ways, so everyone will experience symptoms differently and progress through the stages differently. The examples provided in this article should only be used as a guide for a better understanding of middle-stage symptoms of AD.
To explore early-stage symptoms of Alzheimer’s disease, please read Part I of this article series, Alzheimer’s Disease Progression Three Part Series, Part I: Early-Stage Symptoms.
To explore late-stage symptoms of Alzheimer’s disease, please read Part III of this article series, Alzheimer’s Disease Progression Three Part Series, Part III: Late-Stage Symptoms.