not have additional cognitive decline. In other cases, such as when a medication inadvertently causes cognitive changes, MCI is mistakenly diagnosed and cognitive changes can be reversed. Identifying which individuals with MCI are more likely to develop dementia is a major goal of current research. Dementia Due to Alzheimer’s Disease Dementia due to Alzheimer’s disease, or Alzheimer’s dementia, is characterized by noticeable memory, language, thinking or behavioral symptoms that impair a person’s ability to function in daily life, combined with biomarker evidence of Alzheimer’s-related brain changes. As Alzheimer’s progresses, individuals commonly experience multiple types of symptoms that change with time. These symptoms reflect the degree of damage to neurons in different parts of the brain. The pace at which symptoms of dementia advance from mild to moderate to severe differs from person to person. Mild Alzheimer’s Dementia In the mild stage of Alzheimer’s dementia, most people are able to function independently in many areas but are likely to require assistance with some activities to maximize independence and remain safe. Handling money and paying bills may be especially challenging, and they may need more time to complete common daily tasks. They may still be able to drive, work and participate in their favorite activities. Moderate Alzheimer’s Dementia In the moderate stage of Alzheimer’s dementia, which is often the longest stage, individuals experience more problems with memory and language, are more likely to become confused, and find it harder to complete multistep tasks such as bathing and dressing. They may become incontinent at times, and they may start having personality and behavioral changes, including suspiciousness and agitation. They may also begin to have problems recognizing loved ones. Severe Alzheimer’s Dementia In the severe stage of Alzheimer’s dementia, individuals’ ability to communicate verbally is greatly diminished, and they are likely to require around-the-clock care. Because of damage to areas of the brain involved in movement, individuals become bed-bound. Being bed-bound makes them vulnerable to physical complications including blood clots, skin infections and sepsis, which triggers body-wide inflammation that can result in organ failure. Damage to areas of the brain that control swallowing makes it difficult to eat and drink. This can result in individuals swallowing food into the trachea (windpipe) instead of the esophagus (food pipe). Because of this, food particles may be deposited in the lungs and cause lung infection. This type of infection is called aspiration pneumonia, and it is a contributing cause of death among many individuals with Alzheimer’s (see Mortality and Morbidity section, page 29). Overview 11 Signs of Alzheimer’s Dementia Typical Age-Related Changes Memory loss that disrupts daily life: One of the most common signs of Alzheimer’s dementia, especially in the early stage, is forgetting recently learned information. Others include asking the same questions over and over, and increasingly needing to rely on memory aids (for example, reminder notes or electronic devices) or family members for things that used to be handled on one’s own. Sometimes forgetting names or appointments, but remembering them later. Challenges in planning or solving problems: Some people experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before. Making occasional errors when managing finances or household bills. Difficulty completing familiar tasks: People with Alzheimer’s often find it hard to complete daily tasks. Sometimes, people have trouble driving to a familiar location, organizing a grocery list or remembering the rules of a favorite game. Occasionally needing help to use microwave settings or record a television show. Confusion with time or place: People living with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they forget where they are or how they got there. Getting confused about the day of the week but figuring it out later. Trouble understanding visual images and spatial relationships: For some people, having vision problems is a sign of Alzheimer’s. They may also have problems judging distance and determining color and contrast, causing issues with driving. Vision changes related to cataracts. New problems with words in speaking or writing: People living with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have trouble naming a familiar object or use the wrong name (e.g., calling a watch a “hand clock”). Sometimes having trouble finding the right word. Misplacing things and losing the ability to retrace steps: People living with Alzheimer’s may put things in unusual places. They may lose things and be unable to go back over their steps to find them. They may accuse others of stealing, especially as the disease progresses. Misplacing things from time to time and retracing steps