THE PROGRESSION OF ALZHEIMER’S DISEASE

Alzheimer’s disease (AD) results in progressive changes to the brain, which affect cognitive function and eventually the ability to perform everyday activities.1

Stages of AD

AD is a slowly progressing, irreversible neurodegenerative brain disease with a long preclinical phase (up to 20
years) and an average clinical duration of 8 to 10 years. The progression of AD is accompanied by changes to the
brain that serve as biomarkers of the disease.1,2

Disease progression typically spans several stages, including preclinical AD, the mild cognitive impairment (MCI) stage of AD, and the dementia stages of AD, which progress from mild to severe.1

The Accelerating Decline of Cognitive Function
in Alzheimer's Disease1,3-5

Click Plus sign inside a circle that when clicked reveals information about a stage in AD progression to learn more about a stage.

X and Y-axis in a hypothetical model that represents the decline in cognitive function
Gray line representing normal cognitive aging in a hypothetical model
Graph representing the decline in cognitive function in a hypothetical model
Legend of the contributing factors of decline in cognitive function in a hypothetical model Plus sign inside a red-filled circle, representing expanding a window for information about the progression of Alzheimer's disease stages Plus sign inside a circle that when clicked reveals information about a stage in AD progression Plus sign inside a circle that when clicked reveals information about a stage in AD progression Plus sign inside a red-filled circle, representing expanding a window for information about the progression of Alzheimer's disease stages Plus sign inside a circle that when clicked reveals information about a stage in AD progression Plus sign inside a red-filled circle, representing expanding a window for information about the progression of Alzheimer's disease stages Plus sign inside a circle that when clicked reveals information about a stage in AD progression Plus sign inside a red-filled circle, representing expanding a window for information about the progression of Alzheimer's disease stages

Normal Cognitive Aging

As people age, cognition gradually declines in a predictable manner. People with early-stage AD (and their families) may mistake the early symptoms for normal aging and put off discussing with their doctor.1

Preclinical AD

Preclinical AD occurs in individuals with evidence of AD pathology who have no clinical symptoms.6

Mild cognitive impairment (MCI)

The MCI stage is the first symptomatic stage of AD, in which there is evidence of AD pathology and impairment in 1 or more cognitive domains but symptoms do not interfere with daily functioning.1,6

Dementia

Mild AD dementia, moderate AD dementia, and severe AD dementia are stages during which cognitive abilities further decline and cause impairment in functional abilities.7

This figure is based on a model.
Adapted from Sperling RA, Aisen PS, Beckett LA, et al. Toward defining the preclinical stages of Alzheimer’s disease: recommendations from the National Institute on Aging–Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement. 2011;7(3):280-292, with permission from John Wiley and Sons.

Normal aging vs Alzheimer’s disease

The differences between normal aging and early-stage AD can be subtle. Individuals in the MCI stage may have difficulty learning new information or their recall may be significantly impaired.1,7

Examples of early-stage AD concerns include8:

  • Consistent forgetfulness about important events
  • Persistent difficulty in maintaining focus
  • Trouble with decision-making
  • Problems planning or understanding instructions
  • Confusion regarding time or place
  • Poor judgment

icon-bookJournal Feature

Learn more about the opportunity to detect Alzheimer’s disease at its earliest recognizable clinical
stage and criteria that can aid in diagnosis.

Read: Petersen RC. Mild cognitive impairment. Continuum (Minneap Minn). 2016;22(2):404-418.

Read: Petersen RC. Mild cognitive impairment. Continuum (Minneap Minn). 2016;22(2):404-418.

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