The Stages of Alzheimer’s Disease

Jeff Hayward

Published on October 5, 2017 Updated on September 17, 2020

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 cognitive and physical abilities. Complications often arise that can even lead to death. 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, and 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 for 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 family history. “Or your doctor may identify biomarkers that indicate your risk,” it adds.

You will be interviewed by a doctor about your memory if you’re at risk, but there probably aren’t any noticeable symptoms at 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 the family member will start to notice some problems (that some seniors may confuse for normal memory loss). They include things like forgetting where they put their car keys, nothing too alarming, notes the source.

In fact, even at this stage doctors will have a hard time pinpointing the problem, it adds. 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 3rd-stage of this brain disease can turn up symptoms in some patients, but not in others. By this point, the patient may have stumbled 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,” it adds.

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

Alzheimers.net says 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 Stage 4, a patient may have trouble with simple math problems, or they’ll 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, it adds.

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 lose key pieces of information from their memory bank, such as their home address and phone number.

Because of an impact to 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, explains WebMD.

Severe Decline

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

However, 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), adds the source. “Dramatic personality changes” such as wandering away or having paranoid thoughts about close family members (who might still be familiar to the patient but out of context) may also occur, it adds.

Very Severe Decline

This is the final stage of the terminal disease, and unfortunately means the patient is nearing death, explains Alzheimers.net. During this stage, the individual may still use some words but “lose 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, adds the source.

Jeff Hayward

Jeff has more than 15 years of experience writing professionally about health, travel and the arts among other subjects. He continuously looks to improve his own overall health through exercise, diet and mindfulness. He is also a proud stay-at-home dad that loves taking photographs both professionally and as a hobby.