What are the Stages of Alzheimer’s Disease and Dementia?

The framework for this seven-stage cycle comes from a system that was created by Barry Reisberg, M.D., a clinical director of the New York University School of Medicine’s Silberstein Aging and Dementia Research Center.

Reviewing these seven stages comes in handy for both seniors and their caregivers. They are basic guides, and are a great way to get those with Alzheimer’s familiar with what is going on, and what could possibly happen. This is a disease that can take over the brain for several years. Alzheimer’s can vary from as little as 3 years to as much as 20. If not carefully managed and monitored it could lead to death quicker than it needs to.

 The Stages of Alzheimer’s Disease and Dementia

Stage 1: No Impairment (functions normally)

Everyday tasks can still be performed. Bodily functions are still in tact. He or she does not experience any memory problems and does not show any symptoms of dementia.

Stage 2: Very mild cognitive decline (may be normal aged-related changes or earliest signs of Alzheimer’s disease)

The person could feel as though there is a consistent pattern of memory lapses – not being able to remember familiar words or placement of everyday objects. In this stage there are no signs of dementia that can be seen or diagnosed.

Stage 3: Mild cognitive decline (early-stage Alzheimer’s can be diagnosed in some, but not all, individuals with these symptoms)

By this stage, those close to you and even co-workers begin to notice difficulties. Doctors at this point may be able to see problems occurring with memory or concentration. Common stage 3 difficulties can include:

• Noticeable problems coming up with the right word or name
• Difficulty remembering names of people just met
• Having noticeably greater difficulty performing tasks in social or work settings. Not remembering material that was just discussed.
• Not remembering the placement of a valuable item
• Trouble planning or organizing

Stage 4: Moderate cognitive decline (Mild or early-stage Alzheimer’s disease)

As the disease progresses, in this stage doctors could start seeing signs or problems in many different areas such as:

• Forgetting recent activities or events
• Weakened ability to perform challenging mental arithmetic. For instance, counting backward from 100 by 7s can be difficult
• A significant amount of difficulty executing complex tasks, such as planning dinner for guests, paying bills, or managing finances
• Having trouble remembering one’s own personal history
• Becoming irritable or solitary, especially in socially or mentally challenged situations

Stage 5: Moderately severe cognitive decline (Moderate or mid-stage Alzheimer’s disease)

The “white spaces” in memory and thinking are more noticeable at this point. Day-to-day activities will not be able to be performed without assistance. By this time, those with Alzheimer’s may:

• Be unable to recollect his or her address or telephone number or the high school or college from which they graduated.
• Not knowing or remembering where they are or the current day and month
• Have difficulty with less mental arithmetic; such as counting backward from 40 by subtracting 4s or from 20 by 2s
• Need assistance with dressing for the appropriate season or occasion
• Can still remember significant details about themselves and their family
• Can still be able to eat and use the restroom without help from a caregiver

Stage 6: Severe cognitive decline (Moderately severe or mid-stage Alzheimer’s disease)

By this time the individual’s memory continues to deteriorate, personality changes may occur and they may need wide-ranging help with daily activities. Individuals may:

• Lose knowledge of recent occurrences as well as of their surroundings
• Remembers their own name but have a hard time reminiscing their personal history
• Able to tell familiar and unfamiliar faces apart but have problems remembering the name of a spouse or caregiver
• Need help dressing properly and may, easily make the mistake of putting on the wrong clothes or shoes on the wrong foot if not watched
• Have changes in their sleep patterns – sleeping during the day and becoming agitated at night
• Needs help with using the restroom (for example, flushing the toilet, wiping or washing and drying hands)
• Have trouble controlling their bladder or bowels
• Have severe personality and behavioral changes, including suspiciousness and delusions (such as coming to the conclusion that a loved one or caregiver is not real) or compulsive, repetitive behavior like hand-wringing or tissue shredding
• Tend to roam or become lost

Stage 7: Very severe cognitive decline (Severe or late-stage Alzheimer’s disease)

This is the final stage of the disease, in some cases individuals will lose the ability to function on their own, adapt and respond to their surroundings, and carry on conversations. However, they are still capable of saying words or phrases.

Due to the fact that this stage is so severe, those that reach this point will require complete assistance. They will lose knowledge of how to do something as simple as walking. Their reflexes will become abnormal, and the muscles will become limp.

The stages listed above can be different for each person that encounters Alzheimer’s disease. It’s important that both seniors and caregivers know signs of Alzheimer’s and dementia and can determine which stage one may be in. Having Alzheimer’s disease can dramatically change a person’s life, so it is up to those that can still function and live a normal life to help the ones that can no longer enjoy day-to-day activities as they once did.