7 Stages of Alzheimer's Disease

You can help support your loved one with Alzheimer's by learning more about how the condition unfolds.

The stages don't always fall into neat boxes, and the symptoms might vary -- but they can be a guide and help you plan for your friend or relative's care.

Stage 1: Normal Outward Behavior

When your loved one is in this early phase, they won't have any symptoms that you can spot. Only a PET scan, an imaging test that shows how the brain is working, can reveal whether they have got Alzheimer's.

As they move into the next 6 stages, your friend or relative with Alzheimer's will see more and more changes in their thinking and reasoning.

Stage 2: Very Mild Changes

You still might not notice anything amiss in your loved one's behavior, but they may be picking up on small differences, things that even a doctor doesn't catch. This could include forgetting a word or misplacing objects.

At this stage, subtle symptoms of Alzheimer's don't interfere with their ability to work or live independently.

Keep in mind that these symptoms might not be Alzheimer's at all, but simply normal changes from aging.

Stage 3: Mild Decline

It's at this point that you start to notice changes in your loved one's thinking and reasoning, such as:

  • Forgets something they just read
  • Asks the same question over and over
  • Has more and more trouble making plans or organizing
  • Can't remember names when meeting new people

You can help by being your loved one's "memory" for them, making sure they pay bills and get to appointments on time. You can also suggest they ease stress by retiring from work and putting their legal and financial affairs in order.

Stage 4: Moderate Decline

During this period, the problems in thinking and reasoning that you noticed in stage 3 get more obvious, and new issues appear. Your friend or family member might:

  • Forget details about themselves
  • Have trouble putting the right date and amount on a check
  • Forget what month or season it is
  • Have trouble cooking meals or even ordering from a menu

You can help with everyday chores and their safety. Make sure they don't driving anymore, and that someone isn't trying to take advantage of them financially.

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Stage 5: Moderately Severe Decline

Your loved one might start to lose track of where they are and what time it is. They might have trouble remembering their address, phone number, or where they went to school. They could get confused about what kind of clothes to wear for the day or season.

You can help by laying out their clothing in the morning. It can help them dress by themselves and keep a sense of independence.

If they repeats the same question, answer with an even, reassuring voice. They might be asking the question less to get an answer and more to just know you're there.

Even if your loved one can't remember facts and details, they might still be able to tell a story. Invite them to use their imagination at those times.

Stage 6: Severe Decline

As Alzheimer's progresses, your loved one might recognize faces but forget names. They might also mistake a person for someone else, for instance, think their wife as their mother. Delusions might a set in, such as thinking they need to go to work even though they no longer have a job.

You might need to help them go to the bathroom.

It might be hard to talk, but you can still connect with them through the senses. Many people with Alzheimer's love hearing music, being read to, or looking over old photos.

Stage 7: Very Severe Decline

Many basic abilities in a person with Alzheimer's, such as eating, walking, and sitting up, fade during this period. You can stay involved by feeding your loved one with soft, easy-to-swallow food, helping them use a spoon, and making sure they drink. This is important, as many people at this stage can no longer tell when they're thirsty.

WebMD Medical Reference Reviewed by Neil Lava, MD on May 05, 2019

Sources

SOURCES:

Alzheimer's Association: "Early-Stage Caregiving, "Late-Stage Caregiving," "Middle-Stage Caregiving, "Seven Stages of Alzheimer's."

Fisher Center for Alzheimer's Research Foundation: "Clinical Stages of Alzheimer's."

Fritsch, T. The Gerontologist, March 18, 2009.

Johns Hopkins Medicine: "Stages of Alzheimer's Disease."

Lloyd, J. Dementia, Dec. 29, 2014.

Daniel L. Murman, MD, director, behavioral and geriatric neurology program, professor of neurological sciences, University of Nebraska Medical Center, Omaha.

National Institute on Aging: "Understanding How AD Changes People-Challenges and Coping Strategies."

Wood, D.L. Biological Research Nursing, October 2002.

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