Alzheimer's disease progresses gradually, and early stages can be subtle. While mild Alzheimer's may begin with the need for extra reminders or help with complex tasks, moderate Alzheimer's brings more visible changes, requiring hands-on support for daily routines, safety, and decision-making. Severe stage may require intensive support. Recognizing these shifts early allows for timely treatment, personalized care, and meaningful quality of life, even as independence declines.

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Mild Alzheimer's Disease

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‍The transition from Mild Cognitive Impairment (MCI) to mild Alzheimer’s occurs when cognitive and behavioral symptoms have progressed to the point when the individual is no longer able to maintain overall independence. Patients at this stage, without help from others, would likely be jeopardizing their own safety and well-being.

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Symptoms may include needing frequent supervision with
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• Managing financial affairs
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• Managing medications
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• Remembering to schedule and keep appointments
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• Operating appliances
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• Learning new apps on a smartphone
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• Driving may become concerning, potentially warranting a formal evaluation.

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However, patients generally maintain independence with basic activities of daily living, like dressing, showering, grooming and eating regularly.

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Treatment approaches
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• Cholinesterase inhibitor medications, which boost an important brain chemical (acetylcholine) and can help delay further decline in cognition and function.
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• Potential consideration of anti-amyloid antibody therapies that may slow progression.
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• Medications for related symptoms like insomnia or agitation when needed.
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• Supportive strategies to maintain safety, well-being, and overall health.

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Getting help early allows time to plan, adapt routines, and preserve autonomy wherever possible.

Neura Health’s memory specialists are ready to help you or a loved one with early-stage Alzheimer's, and offer video appointments within just one week, on average.  These short wait times mean more opportunities for early intervention.  Book a video visit today!

Moderate Alzheimer's Disease
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At this stage, cognitive symptoms typically include:
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• Severe memory impairment
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• Significant difficulty with concentration and attention
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• Inability to independently plan or initiate activities
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• Need assistance with one or more basic activities of daily living, such as requiring reminders to shower or help selecting appropriate clothing.
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• More complex tasks like cooking, shopping, and following daily routines become impossible without directed assistance.

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Treatment approaches
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• Continuing cholinesterase inhibitor medications when well-tolerated.
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• Possibly adding memantine, which when combined with a cholinesterase inhibitor, may help stabilize cognitive performance and reduce decline in basic activities of daily living for a year or more.
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• Patients at this stage are no longer candidates to start anti-amyloid antibody therapy, which has been tested only in and approved only for patients with MCI or mild AD.
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• More focused attention to safety concerns while still emphasizing quality of life.
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• Medications to control agitation (which may have previously been managed only through coaching and lifestyle modifications).

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Severe Alzheimer's Disease

When Alzheimer's progresses to this advanced phase, families face significant challenges that require both emotional resilience and practical knowledge. Your loved one may no longer initiate conversation and might respond only to simple instructions or familiar voices.

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This stage brings profound cognitive impairment, and 24/7 care becomes necessary.

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Symptoms typically include
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• Difficulty expressing needs
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• Trouble recognizing loved ones
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• Loss of mobility and balance
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• Swallowing difficulties
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• Increased sleep needs
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• Incontinence

Management options

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At this stage, care partners and providers often shift to a palliative care approach, focusing on:

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• Physical comfort (positioning, skin care, nutrition)
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• Emotional reassurance and soothing routines
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• Minimizing distress or agitation
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• Preserving dignity through gentle, respectful care
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• Supporting the emotional and spiritual needs of both the patient and their loved ones.

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Learn more about the other memory disorders we treat at Neura Health.
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Neura Health’s memory specialists are ready to help you or a loved one with Alzheimer's disease, and offer video appointments within just one week, on average.  These short wait times mean more opportunities for early intervention.  Book a video visit today!

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