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Alzheimer's Disease: Symptoms, Stages, and Why Early Planning Matters

 

5-min read

Updated on 2026-2-27

Author: AIA Content Editorial Team

Alzheimer’s disease - mild cognitive impairment - alzheimer's symptoms
Do you recall the highly acclaimed movie Coco from a few years ago? In the movie, an elderly grandmother's memory gradually fades as she forgets moments from her past. It is only when she hears a long-forgotten song that memories of her father briefly return, moving the audience to tears.
 
The thought of bringing back forgotten memories feels both beautiful and heartbreaking. While such moments may happen on screen, in real life, Alzheimer's disease follows an unpredictable and irreversible course. Once memories are lost to the disease, they cannot simply be brought back.
 
Understanding what Alzheimer's disease is, recognizing early Alzheimer's symptoms, and identifying conditions such as mild cognitive impairment (MCI) are all essential for early planning—not only for patients, but also for caregivers and families who must prepare for the long-term medical, emotional, and financial challenges ahead.

What Is Alzheimer's Disease? Causes, Definition, and Impact on Daily Life

Alzheimer's disease (AD) is defined as a progressive, neurodegenerative disease and is the most common cause of dementia. It gradually affects memory, thinking, learning, and a person's ability to organise daily life.  According to the Hong Kong Elderly Mental Health Survey (2019–2023)1 , 9.7% of people aged 60 or above had dementia after adjusting for age and gender. The prevalence rises sharply with age, reaching nearly 50% among those aged 85 and above.
 
Over the past 20 years, registered deaths related to cognitive impairment in Hong Kong have increased nearly fivefold, from 276 cases in 2004 to 1,364 cases in 2024, making it the seventh leading cause of death in the city, accounting for nearly one-tenth of the elderly population1.
 
The brain, which has an extremely complex structure, also experiences ageing. Due to the degeneration of nerve cells, Alzheimer's patients experience a faster rate of brain cell death compared to others, affecting not only memory but also language, comprehension, judgment, learning abilities, social behaviours 2, and can even lead to personality changes, delusions, or hallucinations 3.

Alzheimer's Symptoms vs Normal Age-Related Changes: How to Tell the Difference

Memory loss that disrupts daily life may be a symptom of Alzheimer's or other dementia. It is crucial to schedule an appointment with a doctor if you notice one or more warning signs. Identifying the difference between typical ageing and the symptoms of Alzheimer's is the first step toward early detection.
Signs of Alzheimer's and Dementia Typical Age-Related Changes
Memory loss that disrupts daily life (e.g., forgetting recently learned information, repeatedly asking the same questions, relying heavily on memory aids or family members)
Sometimes forgetting names or appointments, but remembering them later.
Challenges in planning or solving problems (e.g., trouble following a familiar recipe, difficulty keeping track of monthly bills)
 Making occasional errors when managing finances or household bills.
Difficulty completing familiar tasks (e.g., trouble driving to a familiar location, organizing a grocery list, or remembering game rules)
 Occasionally needing help to use microwave settings or to record a TV show.
Confusion with time or place (e.g., losing track of dates/seasons, forgetting where they are or how they got there) Getting confused about the day of the week but figuring it out later.
Poor or decreased judgment (e.g., making poor choices with money, paying less attention to grooming or cleanliness) Making a bad decision or mistake once in a while, like neglecting to change the oil in the car.
Misplacing things and losing the ability to retrace steps (May accuse others of stealing as the disease progresses) Losing things from time to time and retracing steps to find them.

Mild Cognitive Impairment (MCI): Early Warning Signs Before Alzheimer's Disease

Mild cognitive impairment (MCI) is a condition where people experience a greater decline in memory or other thinking skills than is typical for their age. MCI symptoms are generally not severe enough to significantly impair a person's ability to function at work or in social settings, meaning they can usually carry out their normal daily activities.

Risk of Progression from Mild Cognitive Impairment to Alzheimer's Disease

People with MCI have a higher risk of developing dementia. When MCI primarily affects memory, the condition is more likely to progress to dementia due to Alzheimer's disease. According to the National Institutes of Health, roughly 10% to 20% of people age 65 or older with MCI are estimated to develop dementia within a one-year period4.

Managing Mild Cognitive Impairment: Monitoring and Early Intervention

Management: A diagnosis of MCI offers a valuable opportunity to adopt healthier lifestyle habits and closely monitor changes in memory and thinking. It is important to see a doctor or specialist every six to twelve months to track any changes in memory and thinking skills over time.

Stages of Alzheimer's Disease: Early, Middle, and Late-Stage Progression

As Alzheimer's disease progresses, patients gradually lose independence, and caregivers often find their own lives changing alongside them. Caregivers can provide and adjust appropriate care based on the patient's stage:
Dementia Progress3

Symptom Early Stage (1st - 3rd year) Mid Stage (3rd - 8th year) Late Stage (8th - 10th year)
Deal with complicated matters unassisted, such as managing bank accounts
Return home from a familiar location
State the approximate date and time
Feel what's happening around
Express one's thought
Self-care in daily routine
Bowel control
Able to do
Need promots or guidance
Need assistance
Unable to do
As seen in the table above, as Alzheimer's disease progresses, patients become more dependent on others for care. Currently, Alzheimer's disease can only be managed with medication and training to slow down the progression of the disease and functional decline. Furthermore, the medical care costs for Alzheimer's patients are even higher than those for cancer and heart disease. Without early preparation or emergency support, it will be very challenging for both patients and caregivers.

Alzheimer's Disease Prevention and Risk Management: What You Can Do Early

Although Alzheimer's disease cannot be completely prevented, lifestyle changes that support heart health may also help lower the risk of dementia.

1. Exercise Regularly to Reduce Alzheimer's Risk

Physical exercise increases blood flow and oxygen to the brain, which may improve brain cell health and is important in managing the disease.

2. Diet and Nutrition for Brain Health and Dementia Risk Reduction

Eating a diet rich in fresh produce, healthy oils, and foods low in saturated fat, such as a Mediterranean diet, is linked to a lower risk of Alzheimer's disease and better cognitive function.

3. Heart Health Management and Alzheimer's Disease Risk

 Work with a healthcare professional to manage conditions like high blood pressure, high cholesterol (especially high LDL levels in middle age), and type 2 diabetes, as these are also risk factors for dementia.

4. Mental and Social Engagement for Cognitive Health

Staying engaged mentally and socially through activities like reading, dancing, playing games, or volunteering can lower the risk of Alzheimer's disease.

5. Sleep, Hearing, and Vision Health in Alzheimer's Prevention

Poor sleep patterns, untreated hearing loss, and untreated vision loss are linked to an increased risk of Alzheimer's disease. Appropriate use of hearing aids may help reduce the risk of cognitive decline and dementia.
 
Alzheimer's disease is a long and challenging journey—one that becomes more demanding as time goes on. The patient's lifestyle changes and functional decline can also negatively affect the caregivers' emotions. While we cannot stop the brain from forgetting, we must learn to cherish the present and proactively consider appropriate protection planning for both our families and ourselves.

Alzheimer's Disease FAQ

No. While some memory changes are common with ageing, Alzheimer's disease is not a normal part of growing older. It is a medical condition that causes progressive memory loss and cognitive decline, eventually affecting a person's ability to live independently.

Currently, there is no cure for Alzheimer's disease. However, certain lifestyle choices—such as regular exercise, a balanced diet, good heart health, mental stimulation, and quality sleep—may help reduce the risk or slow cognitive decline.

Alzheimer's disease is unpredictable and progressive. Early planning allows patients and families to prepare for future medical care, caregiving needs, emotional challenges, and financial arrangements, helping reduce stress and uncertainty as the condition advances.
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1. Centre for Health Protection(2025),  Non-Communicable Diseases Watch https://www.chp.gov.hk/files/pdf/ncd_watch_aug_2025_en.pdf 　 
2. Hong Kong Adventist Hospital. (n.d.). Cognitive impairment and dementia. https://www.hkah.org.hk/en/conditions-and-treatments/dementia hkah.org.hk
3. Jockey Club Centre for Positive Ageing. (n.d.). What is dementia? https://www.jccpa.org.hk/en/about-dementia/what-is-dementia/

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