What Are the Late Stage Symptoms of Alzheimer's Disease?

Reviewed by: HU Medical Review Board | Last reviewed: June 2019 | Last updated: August 2021

Alzheimer’s disease is a progressive brain disease. This means it gets worse over time as the brain gets more and more affected, causing worsening symptoms. The progression of the disease is typically broken down into three main stages: early-stage (mild), mid-stage (moderate), and late-stage (severe) Alzheimer’s disease. Knowing the symptoms of each stage is helpful in order to be aware of how the disease is progressing, and take steps to get the appropriate treatments and make the necessary adaptations or plans to ensure well-being.

What is later stage Alzheimer’s

Later stages of Alzheimer’s disease can be thought of here as the late-middle stage of Alzheimer’s and late-stage Alzheimer’s. Stages can overlap, which can make it tricky at times to ascertain which stage a person might be in. The middle stage of Alzheimer’s tends to be the longest stage and can last years – although it might change over those years, as well.1 The rate of progression can vary among individuals, so even if one person’s disease progressed very rapidly, that doesn’t necessarily mean a different person’s will, as well. Some symptoms might be more prevalent in some people than others, and symptoms might not present the same way either. As symptoms are experienced, have honest conversations about those symptoms to loved ones, caregivers, and the doctor. There are treatments available that might help minimize these symptoms, and patients might get helpful information about lifestyle modifications or adjustments that they can make to help ease everyday tasks and improve quality of life.

Symptoms of later stage Alzheimer’s

Symptoms of later stage Alzheimer’s can vary greatly, and over time, the symptoms increase in severity and frequency, requiring a more intensive level of care. In middle-stage, or moderate Alzheimer’s, a person may have trouble performing basic tasks, but can still remember parts of their lives, especially the distant past. As the person’s disease progresses, however, this declines, and in late-stage Alzheimer’s disease, extensive help is needed. At this point, moving to a nursing facility may be an option to increase the individual’s safety and provide round the clock medical attention.

Behavior symptoms of later stages can include1,2:

Other symptoms of later stages include1,2:

  • Trouble with language (speaking, writing, reading)
  • Inability to learn new things
  • Trouble recognizing family and friends
  • Shortened attention span
  • Inability to communicate
  • Loss of bladder or bowel control

In late-stage Alzheimer’s disease, an individual loses the ability to have a conversation and interact with others, and intensive, extensive help is needed with everyday activities. Walking, talking, moving, swallowing, and sitting may all become difficult.

Later stage Alzheimer's treatments

The behavioral symptoms of Alzheimer’s can be distressing, for both the person with Alzheimer's and their loved ones. Although most behavioral symptoms are due to the progression of the disease and subsequent brain cell loss, certain aspects of the environment can exacerbate behavior symptoms, like noise or clutter, as well as other medical conditions.3 While these treatments won’t stop symptoms or halt the progression of Alzheimer’s disease, they can help minimize symptoms for a period of time.

Non-drug approaches are generally preferred as first-line treatment for behavioral symptoms with Alzheimer’s disease. This can include reducing over-stimulation in the environment, creating a calm space, following a routine, and having supportive caregivers. Medication that can help with behavioral symptoms includes antidepressants, anti-anxiety medications, and antipsychotics.3 Antipsychotics and anti-anxiety medications should be used with extreme care for those with Alzheimer’s, and it’s important to talk with the doctor about the risks and benefits of each medication. Patients might have to try different kinds of medications if one doesn’t work, so don't give up if the first one wasn’t a good fit.

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