Alzheimer's Disease: Symptoms, Stages & Treatment Options

How Alzheimer's differs from normal aging

Forgetting a name and remembering it later is normal aging. Alzheimer's is different: information goes in but doesn't come back. The signs most often look like:

• Forgetting often, not occasionally.
• Losing track of time or familiar places.
• Repeating the same questions in a single conversation.
• Forgetting and not remembering — even with prompts.

Brain changes

Two protein abnormalities drive most cases — amyloid plaques between brain cells and tau tangles inside them. Over time, brain cells die and the brain shrinks, especially in regions that control memory and thinking.

How Alzheimer's affects you

• Memory. Difficulty learning new information; forgetting recent events first, older memories later.
• Thinking. Slower decision-making and problem-solving; difficulty with planning and organization.
• Behavior. Changes in mood, anxiety, frustration; loss of motivation; agitation late in the day.
• Communication. Word-finding trouble; following multi-step instructions becomes harder.

Why early detection matters

Alzheimer's cannot be cured yet, but it can be slowed. Early diagnosis keeps you independent longer, lets you plan for the future, and opens access to treatments like Leqembi and Kisunla. Thema Brain Health offers memory testing, brain imaging, and cognitive assessment plans led by neurologist Dr. Lorin Graef.

Early signs & symptoms

• Repeating questions or stories within the same conversation.
• Misplacing items often and being unable to retrace steps.
• Difficulty with familiar tasks (paying bills, following a recipe).
• Confusion about time, place, or recent events.
• Trouble with words, names, or following conversations.
• Changes in mood, motivation, or judgment.
• Withdrawal from work, hobbies, or social activities.

Stages of Alzheimer's disease

Stage 1 — Mild (Early)

• Forgets recent conversations or details.
• Misplaces items, searches for words.
• Needs more time to plan tasks.

Early treatments like Leqembi and Kisunla work best at this stage.

Stage 2 — Moderate (Middle)

• Forgets personal history.
• Loses track of date, season, place.
• Needs help with dressing or bathing.
• Mood and behavior change.

Families benefit from structured support plans and caregiver guidance.

Stage 3 — Severe (Late)

• Needs full support with daily activities.
• Limited speech.
• Sleeps more, may have swallowing difficulty.

Focus shifts to comfort, dignity, and connecting with memory care resources.

Causes & risk factors

Main causes

• Amyloid plaques between brain cells.
• Tau tangles inside brain cells.
• Damage begins years — often decades — before symptoms appear.

Risk factors

• Age — risk roughly doubles every five years after 65.
• Family history and APOE-ε4 status.
• Hypertension and high cholesterol.
• Diabetes and smoking.
• Head injuries.
• Low mental and social activity.

Diagnosis & testing

• Memory and cognitive testing.
• Brain imaging — MRI, CT, sometimes PET.
• Blood tests and lab review.
• Medication review.
• Family input on changes over time.

Our care team

Care is led by Dr. Lorin Graef, a board-certified neurologist with 25+ years of experience treating cognitive disorders. Infusion nurses administer Leqembi and Kisunla. Care coordinators help patients and families navigate testing, treatment, and follow-up.

Treatment options

Symptom management

• Donepezil (Aricept)
• Rivastigmine (Exelon)
• Galantamine
• Memantine (Namenda)

Breakthrough infusions

• Leqembi (lecanemab)— anti-amyloid antibody, slows progression in early Alzheimer's.
• Kisunla (donanemab)— anti-amyloid antibody, FDA-approved for early symptomatic Alzheimer's.

Supportive care

• MIND diet and nutrition coaching.
• Exercise and movement programs.
• Cognitive training and social engagement.
• Structured daily routines.

Living with Alzheimer's

• Daily adaptations. Calendars, labels, voice reminders, consistent layouts.
• Safety. Medication boxes, fall prevention, safe driving decisions, identification.
• Mind & body. Walking, music, hobbies, social time.
• Emotional support. Counseling, support groups, family conversations.

Caregiver support & resources

Caregiver tips

• Keep a consistent routine.
• Use calm, short instructions.
• Redirect gently rather than confront.
• Take breaks — caregiver burnout is real.

Family support

• Hold regular family meetings.
• Use behavior-change tools.
• Connect with Boca Raton support groups.

Prevention strategies

• Move. Walk 20–30 minutes daily.
• Eat. MIND diet — leafy greens, berries, nuts, whole grains, olive oil, fish.
• Engage. Read, do puzzles, take classes.
• Protect. Wear seatbelts and helmets, prevent falls, manage chronic conditions.
• Connect. Stay social — conversations and friendships keep the brain active.

When to see a neurologist

If memory changes interrupt daily life — repeating questions, getting lost, struggling in conversation — it's time to see a neurologist. Early evaluation expands your options.