Alzheimer's disease is the most prevalent form of dementia, accounting for 60-80% of cases. It involves the build up of amyloid plaques and tau tangles in the brain, which disrupt cell communication and lead to neuron death. This primarily affects areas responsible for memory and cognition, spreading gradually throughout the brain.

Early Stage (Mild Alzheimer's):
In the early stage, individuals often maintain independence in daily activities like driving or working, but subtle cognitive changes emerge. Common symptoms include memory lapses, such as forgetting recently learned information, struggling to find the right words during conversations, or misplacing items more frequently than usual. For instance, someone might forget a familiar name when meeting new people or have trouble recalling what they just read in a book.  In one real-life case, a woman named Jacquelyn, diagnosed at 57 with early-onset Alzheimer's, began repeatedly asking her daughter about everyday details like meal plans, even after just discussing them minutes earlier, leading to frustration but no major disruptions yet.  Other signs include increased difficulty with planning or organizing, like managing finances or following a recipe, and minor challenges in social or work settings.  These symptoms may not be obvious to outsiders but can be noticed by close family or through diagnostic tools like cognitive tests.  At this stage, the brain changes are beginning but haven't caused widespread damage yet.  Mood changes, such as mild frustration from these lapses, might occur, but personality remains largely intact. It's easy to mistake these for normal aging, but if they interfere with daily life, it's a red flag.  Another example comes from a retiree who started losing track of appointments, like missing a doctor's visit but later vaguely recalling it, prompting his family to notice the pattern.

Actions to Take in the Early Stage:

Early intervention is key to maximizing quality of life. First, seek a professional diagnosis through a doctor who can conduct neuropsychological tests, brain scans (like MRI or PET to detect plaques), and lab work to confirm Alzheimer's and rule out other causes.  Once diagnosed, focus on empowerment: the individual should participate in legal and financial planning, such as creating advance directives, power of attorney, and living wills, while they can still make informed decisions.  Lifestyle changes are vital - adopt a heart-healthy diet (e.g., Mediterranean style with fruits, vegetables, and omega-3s), engage in regular physical exercise (at least 150 minutes weekly), and stimulate the brain with activities like puzzles or learning new skills to build cognitive reserve.

Medications like cholinesterase inhibitors (e.g., donepezil) may be prescribed to boost brain chemicals for better memory and judgment.  Join support groups through organizations like the Alzheimer's Association for education and emotional support.  Caregivers should learn about the disease to provide subtle assistance without undermining independence, such as using reminders or calendars.  Overall, this stage is about maintaining autonomy and planning ahead to reduce future stress.

Moderate Stage (Middle Alzheimer's):
As the disease advances, symptoms become more pronounced, lasting several years and requiring increased assistance. Memory issues deepen, with forgetfulness of personal history or recent events—someone might not recall their address, phone number, or the school they attended.  Confusion about time and place is common, leading to disorientation, such as not knowing the date or where they are.  Behavioural changes emerge, including mood swings, withdrawal in challenging situations, or unfounded suspicions (e.g., accusing others of theft).  In a documented case, a man in the middle stage became convinced his wife was hiding his belongings, leading to arguments and him searching the house obsessively at odd hours.  Sleep patterns disrupt, with daytime sleeping and night time restlessness, increasing the risk of wandering.  Physical symptoms like bladder or bowel control problems may start, and routine tasks become harder, such as choosing appropriate clothing or managing hygiene without prompts.

Personality shifts can be distressing, like compulsive behaviours (e.g., repetitive hand-wringing) or delusions.  These stem from nerve cell damage affecting judgment and emotional regulation, making social interactions strained.

Actions to Take in the Moderate Stage:
Care needs intensify, so involve a multi disciplinary team including doctors, occupational therapists, and social workers.  Continue medications, possibly adding memantine to regulate brain chemicals and slow symptom progression.  Therapies like occupational therapy can teach adaptive strategies for daily tasks, such as simplifying routines or using labelled drawers.  Environmental modifications are essential: reduce clutter to minimize confusion, install safety features like grab bars or wander-prevention locks, and use monitoring devices for safety.

Caregivers should prioritise respite care or adult day centres to prevent burnout, allowing breaks while ensuring the individual receives structured activities.  Encourage engagement in simplified hobbies, like listening to music or gardening, to maintain purpose.  Address behavioural symptoms with non-drug approaches first, such as validating feelings to reduce agitation, and use antidepressants if depression arises.  Regular check-ups monitor for complications like infections.  This stage emphasises balancing support with dignity, adapting to the person's abilities to foster independence where possible.

Severe Stage (Late Alzheimer's):
In the final stage, profound cognitive and physical decline occurs, with individuals needing round-the-clock care.  Communication falters—they may utter words but struggle to express needs or pain.  Awareness of surroundings diminishes, leading to loss of recent memory and recognition of loved ones.  Physical abilities erode: walking becomes unsteady, then sitting and swallowing difficult, increasing risks of aspiration pneumonia or infections. In one poignant account, a patient in late-stage Alzheimer's refused food due to swallowing issues, resulting in rapid weight loss and dehydration that required tube feeding.  Personality changes peak, with possible apathy or agitation, and basic self-care is impossible.

Brain damage is extensive, affecting motor control and vital functions, often leading to bed-bound states and vulnerability to health issues. Caregivers often report loved ones becoming non-verbal, responding only to touch or music.

Actions to Take in the Severe Stage:
Shift focus to comfort and dignity through palliative or hospice care, which provides pain management, emotional support, and end-of-life planning.  Ensure 24/7 supervision, possibly in a specialised facility if home care is overwhelming.  Nutritional support, like soft foods or feeding assistance, prevents malnutrition.  Therapies such as music or gentle touch can offer comfort even if verbal response is limited.

Caregivers need robust support - join groups, seek counselling for grief, and use community resources.  Monitor for infections vigilantly, as they are common causes of death.  Legal plans from earlier stages ease decisions now.  Hospice benefits families by emphasizing quality over curative efforts, helping navigate emotional challenges.