Stages of Alzheimer’s Disease

The seven stages of Alzheimer’s disease are also characterized as early onset Alzheimer’s or early stage, moderate of mid stage Alzheimer’s, and severe or late stage Alzheimer’s.

The sign of Alzheimer’s present differently in different individuals. A person can exhibit different behaviors and physical changes in the numbered different stages at one time. I think it is easier to identify a person in early, mid or late stage Alzheimer’s than to worry about being concerned about trying to be specific and trying to identify what numbered stage an individual may be presently functioning.

Alzheimer disease stages for some individuals are just not that clear cut. Some individuals will progress very slowly and show signs of behaviors or physical indications of the next level intermittently. Or an individual may experience several good days in a row you are sure that they are improving. It is the cruel nature of this illness that gives us those glimmers of hope and moments of the seeing the person we once knew and loved.

Still others will have rapid periods of deterioration and may even skip several of the numbered stages all together.

So, as you read this information, please understand, with this disease, there is nothing cut and dry. These stages are a reference guide, to prepare you for what may lie ahead for you as you provide care for the aging senior with Alzheimer’s. Use this information as a tool to plan for the future.

For future reference, I will refer to the different stages as early onset Alzheimer’s or early stage, mid stage Alzheimer’s or end stage Alzheimer’s.

The framework for the stages of Alzheimers is based on a system developed by Barry Reisberg, M.D., Clinical Director of the New York University School of Medicine’s Silberstein Aging and Dementia Research Center.

Seven stages of Alzheimer’s

No impairment. A person functions on a normal level.

Individuals experience no memory problems and none are evident to a health care professional during a medical interview.

Stages of Alzheimers 2

Very mild cognitive decline (may be normal age-related changes or earliest signs of Alzheimer's disease) See how a brain fitness program may be employed.

Individuals may feel as if they have memory loss and lapses, especially in forgetting familiar words or names or the location of keys, eyeglasses or other everyday objects. But these problems are not evident during a medical examination or apparent to friends, family or co-workers.

Stages of Alzheimers 3

This is time to begin putting home safety measures into place as you notice Mild cognitive decline This is time to begin putting home safety measures into place as you will notice mild cognitive decline.

Early-stage Alzheimer's can be diagnosed in some, but not all, individuals with these symptoms

Friends, family or co-workers begin to notice deficiencies. Problems with memory or concentration may be measurable in clinical testing or discernible during a detailed medical interview.

Common difficulties include:

Word- or name-finding problems noticeable to family or close associates
Decreased ability to remember names when introduced to new people
performance issues in social or work settings noticeable to family, friends or co-workers
Reading a passage and retaining little material
Losing or misplacing a valuable object
Decline in ability to plan or organize

Stages of Alzheimers 4

Moderate cognitive decline (Mild or early-stage Alzheimer's disease)

At this stage, a careful medical interview detects clear-cut deficiencies in the following areas

Decreased knowledge of recent occasions or current events
Impaired ability to perform challenging mental arithmetic-for example, to count backward from 75 by 7s
Decreased capacity to perform complex tasks, such as planning dinner for guests, paying bills and managing finances
Reduced memory of personal history
The affected individual may seem subdued and withdrawn, especially in socially or mentally challenging situations

May appear depressed

Stages of Alzheimers 5

Moderately severe cognitive decline (Moderate or mid-stage Alzheimer's disease)

Major gaps in memory and deficits in cognitive function emerge. Some assistance with day-to-day activities becomes essential.

At this stage, individuals may
Be unable during a medical interview to recall such important details as their current address, their telephone number or the name of the college or high school from which they graduated
Become confused about where they are or about the date, day of the week or season
Have trouble with less challenging mental arithmetic; for example, counting backward from 40 by 4s or from 20 by 2s
Need help choosing proper clothing for the season or the occasion
Usually retain substantial knowledge about themselves and know their own name and the names of their spouse or children
Usually require no assistance with eating or using the toilet

Stages of Alzheimers 6

Severe cognitive decline (Moderately severe or mid-stage Alzheimer's disease)

Memory difficulties continue to worsen, significant personality changes may emerge and affected individuals need extensive help with customary daily activities.

At this stage, individuals may

Lose most awareness of recent experiences and events as well as of their surroundings
Recollect their personal history imperfectly, although they generally recall their own name
Occasionally forget the name of their spouse or primary caregiver but generally can distinguish familiar from unfamiliar faces
Need help getting dressed properly; without supervision, may make such errors as putting pajamas over daytime clothes or shoes on wrong feet
Experience disruption of their normal sleep/waking cycle
Need help with handling details of toileting (flushing toilet, wiping and disposing of tissue properly)
Have increasing episodes of urinary or fecal incontinence

Experience significant personality changes and behavioral symptoms, including suspiciousness and delusions (for example, believing that their caregiver is an impostor); hallucinations (seeing or hearing things that are not really there); or compulsive, repetitive behaviors such as hand-wringing or tissue shredding
Tend to wander and become lost

Stages of Alzheimers 7

Very severe cognitive decline (Severe or late-stage Alzheimer's disease)

This is the final stage of the disease when individuals lose the ability to respond to their environment, the ability to speak and, ultimately, the ability to control movement.

Frequently individuals lose their capacity for recognizable speech, although words or phrases may occasionally be uttered.

Individuals need help with eating and toileting. Generally there is incontinence of both bowel and bladder.
Individuals lose the ability to walk without assistance, then the ability to sit without support, the ability to smile, and the ability to hold their head up. Reflexes become abnormal and muscles grow rigid. Swallowing is impaired




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