7 Stages of Alzheimer's and How to Recognize their Symptoms

The classification for the stages of Alzheimer’s disease differ slightly by organization and experts. The 7 stage model developed by Dr. Reisberg of New York University is used widely, including by the Alzheimer’s Association. Though a person’s symptoms do not always fall cleanly into one stage or another, and the rate of progression of symptoms is not predictable, the following can act as a guide to help plan and enact care as a loved one.

Stage 1
Normal behavior (no observable cognitive impairment) – Even though changes have started to occur on a small level within the brain, you are not likely to notice problems with memory or concentration at this stage.

Very mild decline – Small changes in everyday life may be noticeable to the person affected, such as forgetting or misplacing common items, or troubles with names and words they know. Overall work and activities of daily living will not be affected. A physician will not likely pick up on anything out of the ordinary at this stage.

Mild decline – This stage is noticeable by friends and family. Word and name finding are increasingly difficult, valuable items are easily misplaced, there is a lessened ability to perform at work and socially, memory is increasingly impaired, and family may notice that the same question is repeated over and over. A caregiver can help at this stage by aiding in paying bills and assisting in other errands and helping ensure that tasks are not forgotten.

Moderate decline – In stage 4 of Alzheimer’s, symptoms are clearly apparent. In addition to symptoms that developed earlier, new symptoms may include problems with arithmetic, a lack of ability to manage finances and bills, forgetfulness about the month or season, trouble taking care of themselves such as cooking meals, and forgetfulness about details from their lives. A caregiver can help in this stage by assisting with chores and driving, as well as ensuring they have a permanent driving alternative other than themselves.

Moderately severe decline – In this stage, people begin to have trouble with many basic day-to-day functions, such as dressing appropriately to the season, or remembering their address or phone number. Caregivers can help in this stage by helping with activities like laying out clothes appropriate to the weather, in addition to helping with chores and other activities necessitated from previous stages.

Severe decline – During this stage, a person’s ability to recognize faces may remain intact, but the ability recall names may be lost. Delusions, such as thinking that they are at a childhood home, when they are not, could set in. Additionally, activities of daily living such as going to the bathroom may be much more difficult, and a caregiver can assist with this in this stage.

Very severe decline – In this stage, there is often a loss of ability of many basic functions like eating, standing up, sitting, and walking. There is also possibly a loss of ability to communicate with the external environment or to talk. Caregivers are needed to help with all activities of daily living, including toilet use, nutritional intake, and bathing.