The Stages of Alzheimer’s Disease

Jeff Hayward

Published on October 5, 2017 Updated on December 1, 2021

Health Check Certified By: Dr. Gerald Morris

While memory loss may seem like a normal part of aging, Alzheimer’s is far from normal. It is a serious and sometimes aggressive form of dementia that will eventually rob the patient of his or her cognitive and physical abilities. Complications often arise, which can even be fatal. According to the Alzheimer’s Association, it accounts for 60 to 80-percent of all dementia cases.

While there are treatments that can slow down the progression, there’s no cure for Alzheimer’s disease. Also, it tends to follow a particular pattern from initial symptoms to the end result. If you’re the patient, you may be aware of your illness in the first few stages but won’t know you’re sick by the end.

Here are the seven steps to expect if you’re caring for someone with the disease…

Preclinical Alzheimer’s

Healthline says the first stage of Alzheimer’s is not very much like dementia at all. In fact, at this point you may only know about your risk (or a loved one’s risk) of developing Alzheimer’s based on your family history “or your doctor may identify biomarkers that indicate your risk,” adds the source.

You will be interviewed by a doctor about your memory if you’re at risk, but there probably aren’t any noticeable symptoms in this first stage, “which can last for years or decades,” notes the source. (To help read about Normal Aging vs. Alzheimer’s: Key Differences).

Very Mild Decline

Alzheimers.net explains that, after the first stage has passed, you or your family member will start to notice some problems (that some seniors may confuse for normal memory loss). They include things, such as forgetting where they put their car keys, which is nothing too alarming, notes the source.

In fact, even at this stage, doctors will have a hard time pinpointing the problem. The disease is not yet to the point where “the memory loss can easily be distinguished from normal age-related memory loss,” explains the site, noting patients will likely still do well on memory tests.

Mild Cognitive Decline

AgingCare.com explains that the third stage of this brain disease will cause noticeable symptoms in some patients but not in others. By this point, the patient may stumble when trying to recall names or being able to find the right word for things. These symptoms include “decreased ability to remember names of newly introduced people,” adds the source.

The individual may also display “unusual” performance issues at work or in social settings, or have a problem planning and organizing. If you notice a number of these symptoms happening at the same time, it’s definitely time to visit a doctor for an assessment. Here are the Most Common Early Warning Signs of Alzheimer’s Disease.

Moderate Decline

According to Alzheimers.net, by this stage, the disease won’t be easy to hide, and there will be “clear cut” symptoms. This is when cognitive decline (that is, problem-solving and even performing routine tasks) will be noticeably impacted.

The source explains that, in moderate decline (stage 4), a patient may have trouble with simple math problems or forget details of their past. They may also show more of a decline in short-term memory (such as not being able to remember what they had for breakfast) or have trouble keeping up with bills due to forgetfulness.

Moderately Severe Decline

WebMD says that this stage might mean the patient could start forgetting details like where they are and what time it is. They might also forget key pieces of information from their memory bank, such as their home address and phone number.

Because of an impact on a patient’s sense of time, they may also start to wear clothing that’s not appropriate for the season, adds the source. As a caregiver, you can assist by laying out clothing for the patient each morning, so they can maintain a “sense of independence.” It’s important to try and be patient at this point, as the patient may ask the same question several times.

Severe Decline

HelpGuide.org explains at severe decline (stage 6), there’s a “total lack of awareness of present events and inability to accurately remember the past.” During this stage, patients will have increasing amounts of difficulty taking care of themselves and following daily routines.

However, patients in stage 6 patients can still respond to “nonverbal stimuli” including pleasure and pain, but can also suffer from hallucinations and become increasingly agitated (these symptoms are more apparent in the late afternoon or evening). “Dramatic personality changes,” such as wandering away from home or having paranoid thoughts about close family members (who might still be familiar to the patient but out of context) may also occur, adds the source.

Very Severe Decline

This is the final stage of the terminal disease and it unfortunately means the patient is nearing death, explains Alzheimers.net. During this stage, the individual may still use some words but “lose [the] ability to respond to their environment or communicate,” notes the source.

The patient will not be aware of their condition at this point and will need help with almost all daily activities. Because the disease robs the person’s ability to physically function (brain cells are rapidly dying), the patient is at risk of becoming unable to swallow.

Dr. Gerald Morris

Gerald Morris, MD is a family medicine/internal medicine physician with over 20 years expertise in the medical arena. Dr. Morris has spent time as a clinician, clinical research coordinator/manager, medical writer, and instructor. He is a proponent of patient education as a tool in the diagnosis and treatment of acute and chronic medical conditions.