Stages of Alzheimer’s Disease

Posted on August 13, 2018

Assessing the stage of Alzheimer’s helps anticipate disabilities and plan accordingly for care. Physicians who treat Alzheimer’s stage the disease based on the way the condition typically progresses. However, symptoms of Alzheimer’s can vary by the type of Alzheimer’s and between individuals. A person with Alzheimer’s will not necessarily experience all or even most symptoms and may not experience them at the same stage in which others experience them. Alzheimer’s is a progressive disease, which means that symptoms worsen gradually over time, new symptoms appear, and disability accumulates.

Experts use different systems to assess Alzheimer’s. Alzheimer’s can be said to have three, five, or seven stages. Ask your physician which system they use to better understand your loved one’s staging.

Three-stage system

  • Early or mild stage:

Symptoms are mild, and some people are still independent. The person or their family or friends may notice problems with memory or concentration.

  • Middle or moderate stage:

Usually the longest stage. The person with Alzheimer’s requires more care. They may forget basic information such as familiar phone numbers or addresses. Behavior, personality, and sleep patterns may change. They may wander or get lost.

  • Late or severe stage: The person will gradually lose the ability to communicate and control movements. They will lose awareness of their surroundings and require constant care. Personality changes will increase.

Five-stage system

  • Preclinical Alzheimer's disease: There are no symptoms. The only way of detecting preclinical Alzheimer’s in some people is with a genetic test that shows specific genetic markers. This stage is mostly referred to in research.

  • Mild cognitive impairment (MCI): Mild memory loss, trouble with sequencing steps or planning time needed for tasks.

  • Mild dementia: Friends and family notice memory loss, lapses in judgement, difficulties with communication, and personality changes.

  • Moderate dementia: Confusion deepens, and assistance is needed for some daily tasks. Some people become aggressive or agitated.

  • Severe dementia: The person can no longer hold conversations. Assistance is needed for all tasks. Physical abilities such as walking, holding up the head, and bowel and bladder control are lost.

Seven-stage system

The system may be further broken down – for instance, 6a, 6b, and so forth – to describe incremental changes.

  • Stage 1: No symptoms are detectable.
  • Stage 2: Mild memory problems that may be seen as part of normal aging.
  • Stage 3: Friends and family begin to notice memory loss and a very mild decline of cognitive function.
  • Stage 4: Symptoms are apparent. People have trouble with simple math, cannot manage their finances, and lose short-term memory.
  • Stage 5: People begin to need help with daily activities but can still usually bathe themselves and use the bathroom independently. Memory loss and confusion increase, but they can still remember some details, usually about their youth and childhood.
  • Stage 6: Constant supervision is required. Many people require professional care at this point. People may wander off. Loss of bowel and bladder control is common.
  • Stage 7: In the final stage of Alzheimer’s, death is near. People can no longer communicate and do not respond to their environments. Every activity of life requires assistance. Control over movements is lost, and they may no longer be able to swallow.

Resources

External resources

myALZteam resources

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