7 Alzheimer’s Disease Stages and Symptoms

Alzheimer’s disease is a progressive deterioration of mental function that primarily affects individuals aged 60 to 65 or older. Early onset Alzheimer’s can occur in individuals aged 40 to 65. The cause of Alzheimer’s is unknown. It is the most common cause of premature senility. In 2014, approximately 5 million Americans aged 65 and older had Alzheimer’s, and around 200,000 had early onset Alzheimer’s. By 2060, it is predicted that around 14 million people will have the disease.

QUESTION

What are the signs, symptoms, and stages of Alzheimer’s disease?

Although the course of Alzheimer’s disease varies, several stages are recognized. The number of stages recognized depends on the expert consulted, ranging from 3 to 7. Generally, there are three major stages:

1. Mild (early stage)
2. Moderate (middle stage)
3. Severe (late stage)

Some experts break these stages down further, resulting in up to seven stages. These stages are defined by specific signs and symptoms. However, some individuals may exhibit symptoms that cross over stages.

People with Alzheimer’s may be described as having mild, moderate, or severe disease. Another classification system, the Global Deterioration Scale (GDS), includes seven stages. However, the stages and their names can vary, causing confusion. To provide clarity, all seven GDS stages will be presented and rated as mild, moderate, or severe.

The Alzheimer Association provides a list of 10 early signs and symptoms of Alzheimer’s disease:

• Reduced ability in planning or problem-solving
• Difficulty completing familiar tasks
• Confusion due to loss of understanding of dates and time
• Difficulty understanding visual images and spatial relationships
• Memory loss that disrupts daily life
• Problems with speaking or writing
• Misplacing things and inability to retrace steps
• Decreasing judgment and poor judgment in finances and personal hygiene
• Avoiding work and social activities
• Changes in personality, behavior, and mood

If these signs and symptoms raise concerns about a potential diagnosis of Alzheimer’s disease, it is important to seek evaluation by a healthcare professional.

Stage 1: No impairment

GDS stage 1 is termed "no impairment." This stage signifies no noticeable symptoms, with full independence and no memory or reasoning problems (mild Alzheimer’s disease).

• No noticeable memory problems
• No noticeable reasoning problems

Stage 2: Very mild cognitive decline

Stage 2 is termed "very mild cognitive decline." It is characterized by mild memory loss, forgetting names of known individuals, and minor problems with concentration. Usually, individuals in this stage can function socially and at work (mild Alzheimer’s disease).

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Stage 3: Mild cognitive decline

GDS stage 3 is termed "mild cognitive decline." It is characterized by worsening of symptoms from previous stages, along with forgetting new information, declining work performance, difficulty with making future plans, becoming less able to organize, and repeating questions. Family members and coworkers may notice these changes, but diagnosis may still be undetermined at this stage (mild Alzheimer’s disease).

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Stage 4: Moderate cognitive decline

Stage 4, termed "moderate decline," involves worsening of symptoms from previous stages. Memory loss and deficits become more prominent, along with difficulties with complex actions, mood changes, withdrawal from social contacts, and avoidance of challenging situations. This is the stage when most people receive a diagnosis of Alzheimer’s disease (moderate Alzheimer’s disease).

IMAGES

Stage 5: Moderately severe decline

Stage 5, termed "moderately severe decline," is characterized by the individual’s inability to perform routine tasks without assistance. Problems from previous stages worsen, and the person may struggle to remember common information, perform routine tasks, and maintain personal hygiene. Disorientation to time or place may also occur (moderate Alzheimer’s disease).

Stage 6: Severe decline

Stage 6, termed "severe decline," is marked by a considerable worsening of all problems seen in the previous stages, especially memory. Daily activities become compromised, names are forgotten, and personality changes may include paranoia, hallucinations, and delusions. Personal assistance is required for daily tasks and monitoring is necessary as some individuals may wander (severe Alzheimer’s disease).

Stage 7: Very severe decline

GDS stage 7, "very severe decline," requires continuous assistance for basic activities such as movement and feeding. Communication may be limited, muscle control is lost, and swallowing becomes difficult. (severe Alzheimer’s disease).

Conclusion

• Diagnosis usually occurs during the moderate stages of Alzheimer’s disease.
• The disease progresses at different rates with varying symptoms in each individual.
• Treatments can help reduce or slow the development of symptoms.
• There is currently no cure for Alzheimer’s disease.
• Staging can help individuals and caregivers understand the disease better.

Medically reviewed by Jon Glass, MD; Board Certification: Neurology

Reisberg, B. "Clinical stages of Alzheimer’s." Fisher Center for Alzheimer’s Research Foundation.

Reisberg, B. "Clinical stages of Alzheimer’s." Fisher Center for Alzheimer’s Research Foundation.