Alzheimer’s disease damages nerve cells in the brain called neurons that help you think, learn, and remember information, among other functions. Experts believe the damage is largely caused by a buildup of two proteins in the brain: beta-amyloid and tau.

Beta-amyloid clumps together in the spaces between neurons, creating amyloid plaques that disrupt cell function. Tau accumulates into tangles within neurons, blocking communication between cells. The cells eventually die off, causing permanent changes in the brain that erode memory and other thinking and reasoning abilities.

Early-Stage Alzheimer’s

Some of the earliest changes in the brain may begin up to 20 years before an Alzheimer’s diagnosis. The first symptoms tend to be related to memory. At this stage, “People may not be completely independent, but they can do a lot of activities on their own,” says Charles Bernick, MD, MPH, a neurologist at the Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas.

Middle-Stage Alzheimer’s

Individuals at the moderate stage of Alzheimer’s typically need assistance on all of their daily tasks, says Dr. Bernick. This stage tends to last the longest and brings more noticeable symptoms that necessitate a greater level of care.

Late-Stage Alzheimer’s

As the disease progresses to the late stage, the brain — and, as a result, the body — continues to lose its ability to function. With severe Alzheimer’s, which may last one to five years, “People need assistance with bathing, dressing, eating, and [using the toilet],” says Bernick.

“People who have two different diseases also tend to have a more rapid progression of Alzheimer’s,” says Heather Whitson, MD, director of the Duke Aging Center in Durham, North Carolina. For example, in people with a blood vessel disease or another brain disease (such as Lewy body dementia), Alzheimer’s tends to progress faster than in those without other conditions.

• Use memory aids, such as alarm clocks, calendars, dry-erase boards, medication reminder boxes, and sticky notes.
• Expand your care team as new challenges arise, such as working with a mental health provider to support anxiety, depression, and other mood or personality changes.
• Implement assistive devices and tools, such as a cane or walker, a grab bar, and nonslip rugs, to help with mobility and prevent falls.
• Take up “brain-healthy” activities that may protect cognitive function and help you relax, such as doing puzzles and word games, reading, and going for walks.
• Line up trusted care partners who can help with tasks such as driving, grocery shopping, making appointments, and paying bills.
• Talk to your neurologist about how your care needs may change as Alzheimer’s advances and how and when to integrate a part- or full-time caregiver into your routine. They may connect you with a social worker who can help you create a plan.

This assessment is designed to determine how much of an impact Alzheimer’s is having on your daily functioning and quality of life. The results aren’t intended to diagnose which stage you may be in, but they can help guide a conversation with your healthcare provider about how your support needs may have changed.

Take the assessment on your own if you feel up to it, or ask a loved one to help you complete it.

Medications

Medications known as anti-amyloid treatments can be prescribed in the earliest stage of the condition, says Bernick, and help slow the progression of the disease. These medications clear beta-amyloid buildup in the brain, ultimately protecting neurons from further damage.

• Cholinesterase inhibitors target chemicals in the brain that carry messages between nerve cells, helping lessen symptoms such as memory loss and language problems.
• Glutamate regulators work on glutamine, a chemical messenger that helps the brain process information, which can improve memory, language, attention span, and more.

Other medications, some prescribed off label, are available to treat the behavioral and psychological symptoms of Alzheimer’s, such as agitation, depression, and insomnia. In general, though, “We want to make sure we’re not giving people too many medications — especially medicines that can affect cognition,” says Dr. Whitson, who suggests taking medication at the lowest possible dose that makes symptoms tolerable.

Complementary Therapies

• Cognitive behavioral therapy to help with sadness or anxiety
• Cognitive rehabilitation, tailored to your specific needs and disease stage, to maintain skills and better manage symptoms
• Creative therapies, such as music therapy, to keep your brain active and express yourself and your emotions
• Getting enough sleep to help keep symptoms at bay and promote overall health
• A Mediterranean diet to help lower inflammation and slow cognitive decline
• Mindfulness exercises to improve mood and manage anxiety
• Safely staying active to promote brain health and overall well-being

You’ll also want to ensure you can see and hear as well as possible. “People do better if they have hearing aids if they need them or the right glasses or contacts for vision problems,” says Whitson.

Receiving an Alzheimer’s diagnosis can cause fear and uncertainty, among other challenging emotions, but knowing what to expect and putting a comprehensive treatment plan in place may help slow the disease process and improve your quality of life.

Your neurologist is a great starting point for discussing how care needs change as Alzheimer’s advances. Because cognitive and physical abilities can decline over time, planning ahead helps ensure your safety and comfort while reducing stress and overwhelm for both you and your family.

Consider putting the following steps in place early:

• Connect with a social worker. Your care team can introduce you to professional resources, local support programs, and community organizations.
• Identify care partners. Talk openly with family members, trusted friends, or potential aides about who can assist with daily tasks, transportation, and medical decision-making when the time comes.
• Put legal and financial documents in place. Ensure power of attorney, healthcare proxies, and advance directives are established while you can actively participate in those decisions.

You aren’t alone in managing Alzheimer’s as it advances. Implementing and staying on top of a treatment plan, keeping in close contact with your care team, and leaning on your support system can help you live the happiest, most independent life possible with the condition.