7 Stages of Alzheimer’s Disease

By Carol Bradley Bursack, AgingCare.com

It’s instinctive to want a map. Where’s the next turn? What’s the next step? It’s a human thought pattern. We at least think we want to know what happens next.

The Caregivers’ Guide to Alzheimer’s

After we find out that a loved one has Alzheimer’s disease (or any other disease) it’s only natural to research it. What can we expect and when can we expect it?

The National Alzheimer’s Association has developed a very useful tool, or “staging system,” to use as a frame of reference when coping with Alzheimer’s disease. The organization, however, will be the first to tell you that people are not programmed to follow these stages in a direct line. No matter how much we’d like to “know” what stage someone is in, we can’t. One day, our loved one may seem like he or she is in stage five, and the next day the disease may seem more like stage four or six. With that in mind, we’ll look at the stages as presented by the National Alzheimer’s Association, so we at least have a shot at some order.

Read more:
When a Loved One with Alzheimer’s Doesn’t Recognize You
10 Warning Signs of Alzheimer’s and Dementia
How To Tell Family That Mom or Dad has Alzheimer’s Disease

The 7 Stages of Alzheimer’s Disease originally appeared on AgingCare.com.

Stage 1: No impairment (normal function)

There is some thought in the medical community that Alzheimer’s disease may start years, if not decades, before we have even a clue that anything is wrong with ourselves or our loved ones. Not much we can do here until there is more known. Genetic research and much more sophisticated technology will no doubt make this an important and focused area of study as we march into the future. But, for now, most of us will never know (would we even want to?) if we are in stage one of Alzheimer’s disease.

How to Tell If You Have Early-Stage Dementia

Stage 2: Very mild cognitive decline (may be normal age-related changes or earliest signs of Alzheimer’s disease).

At this time you or your loved one may have a sneaking suspicion that something sinister is on the horizon. A little more forgetfulness, but it could be natural aging. A little more irritability when that forgetfulness occurs, but isn’t that normal? Hmm, maybe we should chat with a doctor. Still, we aren’t likely to get satisfaction (such as a definite yes or no). Most likely, we will hear something to the effect that it’s just normal aging, and maybe we should do more crossword puzzles or take a class. Oh yeah, and eat more chocolate. Chocolate has antioxidants in it that are good for the brain. That I can do.

Stage 3: Mild cognitive decline

This is a tricky point. The Alzheimer’s Association says that early-stage Alzheimer’s disease can be diagnose in “some, but not all,” individuals with the symptoms recognizable to family and others close to the person having problems. These symptoms include problems with words and names, decreased ability to remember names of newly introduced people (oops, that one scares me — I forget new names all the time), unusual performance issues at work or in social settings, retaining little of material that has been recently read, losing or misplacing something of value to the person and/or a decline in the ability to plan and organize.

Read more:
When a Senior Can’t Remember the Story, Let Them Make It Up
A Kids-Eye View of Alzheimer’s
“My Mom Has Dementia and Is Telling Lies About Me”

The 7 Stages of Alzheimer’s Disease originally appeared on AgingCare.com.

Stage 4: Moderate cognitive decline (Mild or early-stage Alzheimer’s disease)

The Alzheimer’s Association says that by now there are clear-cut indications that a careful medical examination can detect. There would be an obvious decrease in knowledge of recent events — personal and community and/or world. There would a decrease in the performance of the standard test where they ask someone to count backward from 75 by 7s, which scares me to death. I’d have to use my fingers to figure that out. Please, please, all of you doctors out there, make sure that you know in advance if the person you are evaluating is a math-challenged English major.

Will I inherit Alzheimer’s disease if my parent has it?

Stage 5:  Moderately severe cognitive decline (Moderate or mid-stage Alzheimer’s disease)

Okay, this is where things get pretty obvious and serious. This is when the going gets rough for the caregiver and the frustration gets huge for most Alzheimer’s patients. This is where a great deal of the agitation occurs. People are aware that they aren’t functioning normally, and it understandably makes them angry. They often take it out on the person or people they feel safest with – their spouse and/or their adult children. Those that are their caregivers.

People in this stage are often unable to recall their current address or phone number. They may not remember where they graduated from school, can become confused not only about the date (not too hard to do) but the season, as well. They have trouble with easier arithmetic such as counting backward from 20 by 2s. They often need help choosing appropriate clothing for the occasion or even for the season.

Read more:
A Caregiver’s Story: Getting Into a Dementia Patient’s Head
Dreams and Past Events: What is Reality for People With Dementia?
Things People With Dementia Say: Common Phrases and How to Reply

The 7 Stages of Alzheimer’s Disease originally appeared on AgingCare.com.

Stage 6:  Severe cognitive decline (Moderately severe or mid-stage Alzheimer’s disease)

This stage is where really significant personality changes can emerge. That sweet person you used to know suddenly is combative, volatile and possibly violent at times. The Alzheimer’s Association says that at this stage, people lose “most awareness of recent experiences…as well as their surroundings.”

People in this stage can be very inventive, when trying to outwit the caregiver. They are also prone to wandering, so keeping them safe can be a challenge. They’ve been known to find ways to unlock several locks on doors and to enable a supposedly disabled car. They are not dumb, folks. This isn’t about intelligence.

When Alzheimer’s Steals Their Personality

Stage 7:  Very severe cognitive decline (Severe or late-stage Alzheimer’s disease)

This phase, before death, is the sad time when speech is often unrecognizable, there is general incontinence, eating is difficult (or food refused – in any form) and swallowing can be impaired. They usually need assistance and support walking and even sitting.

This stage was one that I found particularly hard for caregivers to tolerate, in that many become frantic when the Alzheimer’s patient wouldn’t eat. We, as healthy humans, get hungry. We think they must be starving. However, as the body prepares to die, it often does not want food. The organs are shutting down.

Read more:
The Curiosity Challenge: 8 Ways to Construct Cognitive Reserve
Facing Hallucinations, Delusions and Paranoia in a Positive Way
How to Discuss an Alzheimer’s Diagnosis

The 7 Stages of Alzheimer’s Disease originally appeared on AgingCare.com.



Jeramie D
Jeramie D1 months ago

Thank you

Ann B.
Ann B5 years ago

Thanks for the information - I needed this.

Jane Warren
Jane Warren5 years ago

thnx for this

Lynn D.
Lynn D5 years ago

I don't care for putting 'labels" on people and really believe that we can help best by just accepting people as they are, where they are, when they're there! The whole world would be in better shape if we followed this idea! Thanks for all the help though!

Lynn Squance
Lynn S5 years ago


and I am preparing the best I can for that. It is all the disease. When she gets frustrated, which happens less and less now, I remind her it is all the disease and there is nothing we can do except laugh at the world.

I am determined that she will have as much happiness as she can so we do things like go out for dinner and hang anybody that has a problem with the way she eats. One thing now, the staff love her and she loves them --- she always wants to give hugs etc. But it is still hard to see her die a little bit each and every day.

Lynn Squance
Lynn S5 years ago

My mother will be 84 in 10 weeks and she has had Alzheimer's/dementia for the past 5 years (since diagnosis) but really for longer. When she was diagnosed, I put her in assisted living and she thrived in that environment, but this past March, I had to move her to a full care dementia unit because she could no longer bathe or dress herself. One of the things that really helped her was the regular routine. But now that is no longer helpful. My mother is essentially a 2 year old in an 84 year old body. Physically she is pretty good and I insist that the staff at the centre "kick her butt" if she doesn't want to do exercises.
She is unable to bathe or dress, brush her teeth, or toilet herself, she has started eating with her fingers as even using a spoon is too difficult to grasp.

Shan D said "...it was her body that had died - my *real* grandmother had died months before...." and I agree. Watching a loved one with Alzheimer's/dementia is like watching a person die a little bit every day. There will be good days where there is some clarity, but as the disease progresses they are fewer and fewer. My mother still knows me and her face lights up whenever she sees me which is once or twice a week. We have outings --- usually to doctor or dentist or a massage and then for supper. We have one place we go so they know what is happening and are so supportive if she spills something or eats with her fingers. But I know that the time will come when she doesn't know me and I

Winn Adams
Winn A5 years ago

Thanks for the article.

Carol C.
Carol Cox5 years ago

it IS horrible and I hope a cure is found soon... both my Mom and my mother-in-law have it... they are old and the doctors here aren't very up-to-date with treatment.... from the article, they are mid.stage...thanks for an interesting and informative article..

KS Goh
KS Goh5 years ago

Thanks for the article.

Susy L.
Susy L.6 years ago

My dad had Alzheimer's and it's a horrible disease...