Understanding the 7 Stages of Alzheimer’s

Understanding the 7 Stages of Alzheimers

We all experience some degree of physical and mental decline, but dementia and the stages of Alzheimer’s are a whole ‘nother level.


Over the last decades, Alzheimer’s has been on the rise and it’s not looking to change direction any time soon. In fact, in the US alone, a staggering 12.7 million people over age 65 are projected to have Alzheimer’s dementia by 2050, and 13.8 million by 2060.


projected number of people aged 65 and older in the US population with Alzheimer's Dementia from 2020 to 2060
We sadly expect Alzheimer’s to continue to rise in future decades. Source: Alz


What’s more, one in three seniors sadly passes with Alzheimer’s or another dementia.


We’re not sharing these stats and stages of Alzheimer’s to depress you, but rather to alert you to the importance of being proactive and learning more about the rampant disease.


It makes a tremendous difference for both you and your loved ones.


To help you better prepare for the future, we explain the seven stages of Alzheimer’s, each of which can last anywhere from a few months to several years. 


If you or someone you love has been diagnosed with this condition, it is so helpful to know the prognosis for each stage. 


If you or someone you love has NOT been diagnosed, it is also extremely helpful to learn about the seven stages of Alzheimer’s.


So, without further ado, here they are.

seven stages of alzheimer's


7 Stages of Alzheimer’s Disease

#1 No Impairment

The first stage often goes undetected because there aren’t any noticeable symptoms. 


There are several diagnostic tools your doctor can use to determine if you’re at risk for Alzheimer’s disease before any symptoms occur. 


Which is a huge benefit, given that the disease can hack away at your brain 20 years (or even 22 years in some cases) before symptoms develop.


alzheimer's disease statistics
Alzheimer’s Disease can hack away at your brain 20+ years before experiencing symptoms. Source: Health Central


One way is through family history, but some biomarkers can indicate potential risk as well. 


The condition has long been associated with various factors, from genetics and lifestyle choices to age-related changes in brain chemistry. 


When you consider the fact that Alzheimer’s affects more than 1 in 9 people in the US (and that number is only projected to grow), it’s worth getting tested even if you don’t have any symptoms. 


This is the ideal stage to take proactive measures and do things that will help improve your memory and prevent Alzheimer’s Disease from developing in your brain later on down the road.  Your lifestyle choices, such as balanced nutrition and regular exercise, play a significant role in dementia development.


#2 Very Mild Decline

In stage two, you might not notice anything amiss in behavior and you’re certainly independently functioning with your activities of daily living (ADLs). 


Still, you or your loved ones may be picking up on minor nuances that even a doctor doesn’t catch. For instance, maybe you’ll notice questions arising that sound something like: 


  • Where did I forget my ID?
  • What was the name of that thing?
  • Where are my keys?


Basically, at this stage of Alzheimer’s disease, the subtle symptoms don’t interfere with the ability to work and live independently, nor do they cause alarm. 


They’re more of a slight inconvenience. 


#3 Mild Decline

At this stage, you may begin to notice small behavioral changes. But, they could still be associated with normal aging of the brain and forgetfulness.


The first noticeable aspect is memory issues


For instance, it’s harder to remember people’s names. You may have trouble remembering the name of someone who just introduced themselves or what they do for work. 


And it’s not just because you focus on what you were saying during the introduction. It’s generally more of a need to ask the same question repeatedly.


(I know what you’re thinking because we all do this. I’ve been forgetting names since I was a kid and I’m currently only 25.) 


Name remembering aside, someone in this stage might also experience other symptoms, like forgetting plans they made shortly before. Or losing valuables, like a wallet or credit cards, or not finding keys where you normally place them.


Note that there’s a significant difference between, “where did I put my keys?” and “why are my keys in the fridge?”


These are the signs that something more severe than normal forgetfulness could be going on, especially if these symptoms persist over time.


#4 Moderate Decline

Stage four is the first stage of actual dementia, which starts to impact functionality. 


It goes beyond memory loss and decrease in mental endurance, which are part of the normal aging process.


Here’s a snapshot of the signs of normal aging, so you can spot the difference between normal aging vs dementia:


the normal aging process includes bone fragility, higher blood pressure, cognitive decline, hearing and eyesight trouble, decrease in mobility and stamina


With moderate dementia, personality changes will occur, and a person in this phase might need more guidance to perform ADLs and care for themselves.


Research has found that by the time people with Alzheimer’s disease reach this fourth stage, their impairments become more apparent and easier to distinguish from normal aging. 


To name just a few “moderate decline” Alzheimer’s symptoms, some people with early-stage Alzheimer’s disease have difficulty understanding and doing simple arithmetic. They may forget details about their past, and even how to order or cook food.


One of the most challenging and confusing stages for caretakers is when a loved one has early-stage dementia. The person with this type of cognitive decline may still be independent in some aspects, like dressing themselves or driving their car, but they can’t do things easily anymore, like cooking dinner or ordering from a menu. 


What’s the best way to curb this initial frustration?


Try to make them feel safe and keep them active – carry on conversations about their favorite music, play games with family members, go outside every day.


It’s also worth mentioning, at this stage of Alzheimer’s, a patient may need counseling to help them cope with their condition. Like with any condition, the more proactive the better.


#5 Moderately Severe Decline

At stage five, your loved one might start to feel like they’re living in a fog. 


Like their days blur together. For people with dementia, the passage of time can be challenging to keep track of. 


cartoon representing a forgetful senior man who has alzheimer's
They often have a hard time remembering what day, month, or year it can lead them into feeling lost and confused at times. Source: Vecteezy


You may also notice clothing starts appearing mismatched for the current season. Or forgetting simple details stored in your long-term memory, like a phone number or home address. 


These mistakes happen when there’s stress. And also when normal day-to-day activities take up all the brainpower, spreading the brain’s energy thin.


Amid all the stress of Alzheimer’s, it’s important to remember what brings you and your loved ones together. 


When someone wants something done endlessly, indulge that wish until they tire of it. If there’s an old dish they love from childhood, cook up some nostalgia, too. 


Forcing yourself into seriousness isn’t going to help anyone through these trying times – be silly instead.


#6 Severe Decline

As the stages of Alzheimer’s progress, your loved one might recognize faces but forget names. They might also mistake a person for someone else to think their husband is their son. 


Delusions, such as thinking they need to go to work or pick up their children, when in fact, they’ve retired years ago, may happen. At this point, you’ll likely find yourself helping with basic tasks, like going to the bathroom.


Focus on connecting with Alzheimer’s patients through senses – many people are comforted by using music as therapy or reading stories aloud – basically, something that triggers emotional memory from happier, more vibrant times.


If you want to see the powerful impact of music memory, check out this heartfelt 6-minute clip from the documentary Alive Inside, where Alzheimer’s patient Henry comes alive after hearing music that triggers deep memories from his youth. 



Even at this late stage, looking over old photos brings up emotional memories of happier times that will hopefully remind both of you just how special your relationship is.


#7 Very Severe Decline

With the final stage of Alzheimer’s, communication, and even essential bodily functions, become difficult. 


Basically, in this stage, all ADLs and needs must be taken care of by other caregivers. Now is a good time to consider in-home care options or assisted living facilities.


The difficulty of watching someone you love slowly forget who they are can be hard to bear. And I can only imagine the frustration of being the person who’s touched by Alzheimer’s and how frustrating and confusing that experience must be.


As if that’s not bad enough, when your loved one has lost their memory, it may seem as if the relationship is fading away, too. 


If you’re wondering how to make the most of this severe stage of Alzheimer’s the answer is in the importance of creativity. 


Be it visual art, music, dance, or clapping, a wide range of creativity can still spark a positive experience for someone with Alzheimer’s with effects that last even days after the creative experience. 


According to Barbara Bagan, PhD, ATR-BC, a registered and board-certified arts therapist:


“Various art activities – painting, drawing, music, movement/dance, poetry, or drama – are offered for pleasure, relaxation, and socialization as well as a variety of treatment goals like reduced boredom, enhanced morale, and even improved cognition.” 


Remember that there’s a chance for real connection in those subtler cues when names and moments go missing, such as behavior or body language.


Stages of Alzheimer’s Affect Everyone Differently

Alzheimer’s is the disease of our time that most people fear as we age (beyond our pandemic, of course). 


Rightly so, considering the progression between stages of Alzheimer’s is not linear. 


Some caregivers report their loved ones seem to be in two stages at once, while others stagnate for years before progressing at a rapid rate without any warning signs. 


But there’s good news: 


The fact that you’re reading this article is amazing. With over half of adults unaware of the risks of dementia, you are doing your job in educating yourself. 


Being proactive in knowing what to expect from each stage and getting help from loved ones makes it easier. Both the person who lives with Alzheimer’s and those close to them.


While there’s no way to pinpoint the exact experience and progression rate, learning how individuals respond to the different phases and stages of Alzheimer’s teaches you what symptoms might come next and prepares you and your loved ones as best you can for its challenges.


Like with any of life’s challenges, it’s worth preparing mentally, emotionally and physically for the stages of Alzheimer’s.


You and your loved ones will benefit greatly.


Written by Tena Prvulovic, Content Manager at Second Wind Movement

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