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At this point in the decay, the person has severe memory loss and is unable to recognize or even communicate with loved ones.  the person cannot even sit up without assistance, and the systems of the body begin to shut down. There is no cure.

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This disease has run in the women in my mom's family almost without fail for rather a lot of generations. I felt I needed to know what I was doomed to, and let me tell you, it's kind of terrifying.

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The ventricles (remember those?) have now opened up so much that it almost seems there is more to them than what is left of the decayed brain, which has shrunk to only a small portion of what it was before the disease took hold.

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In its earliest stages, Alzheimer’s is undetectable by any means we now have. Researchers are working on ways to detect it at a time when it can be stopped or reversed, but have so far made little progress in the first years. There are no noticeable symptoms this early on, beyond some mild memory loss that can simply be a sign of natural deterioration, rather than a disease such as Alzheimer’s.

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This is the second diagnosable stage, and can be recognized by severe memory loss and inability to live safely at home due to this. The affected may be unable to remember their own contact information or find their way home, and suffer from severe short term memory loss.

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“7 Stages of Alzheimer's.” 6 Steps to Treat Concussions & Prevent CTE Dementia, 14 Feb. 2018.
“Brain Synapses and Neurotransmitters.” Alzheimer's Association, Alzheimer's Association, 2011.
“The Progression of Alzheimer's Disease.” BrightFocus Foundation, 22 June 2017.
“What Does Alzheimer's Do to the Brain?” Alzheimers.net, 17 Oct. 2017.

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The beginning stage affects the areas of the brain in charge of thinking and planning, and those for memory and learning. This is caused initially by a small buildup of a sticky protein called beta-amyloid that forms something called a plaque in the brain. These form between nerve cells in the fatty tissue of the brain and at first cause very little harm.

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According to Alzheimer’s and Dementia Weekly, this is when symptoms such as “Difficulty remembering personal details, recent events; some confusion possible (ie: might put towel in fridge); impaired mathematical ability, financial management (trouble managing a checkbook – for those who did not have trouble managing one before); social withdrawal; moodiness, depression” begin. This is also the first diagnosable stage, and can be caught and slowed with the right medications, although no one has found a way to halt or reverse it yet.

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At this point, the hippocampus is beginning to decay, taking the memory with it at a severe enough level that it causes a person difficulties. The cerebral cortex, which controls thinking and planning, is also taking some damage from the plaques that are steadily growing, now causing cell death and prevention of signals attempting to pass through the brain.

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At this point, according to the Alzheimer's Association things called tangles can be seen growing in the brain. These are twisted proteins called tau that build up in dead and dying cells, and are either the cause or the result of cell death. They grow in places that can harm the brain cells' transport system, causing those systems to lose their integrity and collapse out of shape, meaning that the necessary nutrients cannot reach cells in the brain. This results in even greater levels of cell death.

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These fluid filled areas of the brain are still normal-sized, as the decay has not started in earnest yet, and serve to keep the brain functioning properly in most ways as well as offering protection to it. But not for long...

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In a few years time, I fear that my own mom will begin to show the signs of early Alzheimer’s disease. My grandmother is holding up well so far, but has already found a deterioration in her memory that may indicate the oncoming doom this disease spells for all those who are so unlucky as to have it. She still lives on her own, but her children recently have been discussing the growing need to give her assistance, either by moving her in with one of my mom’s siblings, or by placing her in a nursing home.

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In addition to the hippocampus and cerebral cortex, the sections of the brain in charge of speech (both production of and understanding), Broca's Aphasia; and spatial awareness, posterior parietal lobe, begin to decay noticeably now. This is caused by those same plaques and tangles, which are steadily growing and killing more and more cells in the brain.

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The parts of the brain controlling motor skills, though the last to be effected, are at this point decaying rapidly and fatally. Body control is damaged, and communication with organs begins to fail. The brain is now more empty space and dead cells than live, functioning ones, and the plaques and tangles seem almost as numerous as the cells they kill.

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“Brain Changes.” Alzheimer's Association, www.alz.org/braintour/images/brain_changes.jpg.
"Alzheimer Brain" Alzheimer's Association, https://www.alz.org/braintour/images/alzheimer_brain.jpg.
"Plaques and Tangles." Alzheimer's Association, https://www.alz.org/braintour/images/plaques_tangles.jpg.

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This was the stage at which I lost my great grandmother, who had fought the disease for over two decades and was on numerous medications to prevent it spreading as quickly as it otherwise would. She had lived in a nursing home for most of those two decades, since her husband had died and she found she was unable to live without someone else there to give her aid in everyday tasks. Although she passed from a hip injury whose surgery proved to be fatal, had she lived another few years my family and I would have seen her progressing to the most severe stage. We counted it as a blessing that she, and we, never had to suffer her living like that.

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Most people are given a life expectancy of 8-10 years after diagnosis, so 8 or 10 years before this happens. Some last as long as 20, very few survive longer. The span is increasing as new medications are produced to slow the process, but it is still incurable.