Page 8 - Healthy Brain Initiative, State and Local Public Health Partnerships to Address Dementia: The 2018-2023 Road Map

Figure 1. Life Course Perspective on Alzheimer’s and Other Dementias

Healthy Cognitive Pre-symptomatic Mild Cognitive
Functioning Impairment Dementia

Dementia occurs along a continuum. While most older adults have healthy cognitive functioning, some will
experience pre-symptomatic changes in the brain that may eventually lead to cognitive impairment or dementia.
In dementia, symptoms become noticeable and the disruption to cognition and everyday life can range from mild
to severe.

The symptoms of Alzheimer’s and other dementias daily living such as managing medications, dressing,
worsen over time, although the rate at which the and bathing. In the final or severe stage of this
disease progresses varies. In the early stage of disease, as more neurons involved in cognitive and
Alzheimer’s dementia, for example, a person may physical functioning are damaged or destroyed, people
function independently, still drive, work, and be part of lose the ability to respond to their environment, have a
social activities. Despite this, the person may feel as if conversation and, eventually, control movement. They
he or she is having memory lapses, such as forgetting may become bed-bound and require around-the-clock
familiar words or the location of everyday objects. care. On average, a person with Alzheimer’s lives four
The moderate stage of Alzheimer’s dementia is for to eight years after diagnosis, but can live as long as

some the longest stage and can last for many years. 20 years, depending on other factors. •
During the moderate stage, people may have greater
difficulty performing tasks such as paying bills, but they
may still remember significant details about their life.
As this stage evolves, people may have more trouble
communicating and experience mood or behavior
changes. They may also have trouble with activities of

2 Healthy Brain Initiative State and Local Public Health Partnerships to Address Dementia: The 2018–2023 Road Map