Stages of Alzheimer’s Disease

Alzheimer’s disease is the most common type of dementia. Dementia is a disease of the brain. We use “stages” to describe how severe the disease is. The stages explain how the person’s brain is working which helps the caregiver know what to expect. This can help you plan care for your loved one. The stages overlap and no two people progress through the stages at the same rate or with the same symptoms.

Stage 1: No Impairment (Normal Function)

The person’s memory and thinking seems to be normal. Doctors cannot find symptoms of Alzheimer’s disease during an exam. 

Mild Alzheimer’s Disease: Early Stages

Stage 2: Very Mild 

The person notices changes with their memory, such as not knowing where they put their keys. These may be normal changes from aging or early signs of Alzheimer’s disease. No symptoms can be found during a medical exam. 

Stage 3: Mild 

Friends, family or co-workers may begin to see memory problems. The memory issue shows up in daily life or work. A doctor may see problems with thinking or memory during an exam. These problems include: 

• Problems coming up with the right word or names of people they know.

• Trouble remembering new names. 

• Losing or misplacing items. 

• Struggling to organize or plan.

How to Help 

• Gain your loved one’s trust.

• Make daily routines simple.

• Break down tasks into smaller steps.

• Make the home safe.

• Watch for signs of changing abilities.

• Offer support and help solve problems.

• Learn about the disease.

• Get help from your doctor.

Moderate Alzheimer’s Disease: Middle Stages

Stage 4: Moderate 

Memory problems are easier to notice. 

• Trouble doing complex tasks. 

• Trouble paying bills or driving a car. 

• Changes with their mood or emotions. 

Stage 5: Moderately Severe 

• May not remember details about themselves or recent events. 

• Still have trouble doing complex tasks. 

• Might need help choosing proper clothing for the season or event. This task becomes too hard for them to do on their own.

How to Help

• Give one-step directions.

• Limit choices.

• Do things the same way each time.

• Encourage strengths.

• Remind and repeat gently.

• Limit noise and activity so they can focus on task.

• Speak softly, simply and clearly.

• Do not argue. Accept that your loved one may not talk to you at times.

• Make memory aids, such as, pictures of the toilet on the bathroom door.

• Check safety needs. They may need to be watched often.

• Get expert advice, outside help and support.

Severe Alzheimer’s Disease: Late Stages

Stage 6: Severe 

• Memory keeps getting worse. 

• Your loved one needs a lot of help with daily routines. 

• They may have trouble putting on their clothes, bathing, and using the bathroom on their own. 

• They may not be able to control their bowel and bladder. 

• They will need to be watched 24-hours a day at this stage. 

• Changes with sleep patterns, such as sleeping during the day and being restless at night.

• Changes in the way they act or behave. They might become fearful or suspicious of caregivers, wander or become lost. They might repeat actions over and over, such as hand-wringing. Some patients might even become violent and start hitting or kicking.

Stage 7: Very Severe 

• Will need help with almost all their daily personal care. This includes eating or using the toilet. 

• Physical changes will make it hard to sit up, smile, and walk. 

• May have trouble talking with others and will likely be unaware of where they are. 

How to Help 

• Reassure and comfort.

• Approach your loved one slowly.

• Show and tell before doing a task.

• Be aware of their feelings more than the words.

• Get expert advice about the best care setting. They will need 24-hour care.