Understanding and being aware of Alzheimer’s 7 stages can serve as a guide and assist in making plans for your friend or relative’s treatment.
Medically Reviewed by Dr. K on 18 October 2021
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7 Stages of Alzheimer’s Disease
You can support your Alzheimer’s-affected loved one by knowing more about the disease’s progression.
The stages don’t all fit perfectly into categories, and the symptoms can differ, however, they can serve as a guide and assist in making plans for your friend or relative’s treatment.
Stage 1: Normal Outward Behavior
When your loved one is in this stage, you won’t be able to identify any symptoms. Only a PET scan, a form of imaging examination that reveals how the brain functions, will tell whether they have Alzheimer’s disease.
As they progress into the following stages, more and more changes in their thought process, judgement and reasoning will be more evident.
Stage 2: Very Mild Changes
You might not notice anything unusual about your loved one’s behaviour, but they themselves might notice subtle changes that even a doctor might ignore. For eg, they could forget a phrase or misplace things.
Subtle Alzheimer’s signs should not interfere with their capacity to function or live peacefully at this time.
Bear in mind that these signs may be the result of natural ageing rather than Alzheimer’s.
Stage 3: Mild Decline
You can see changes in your loved one's thought and reasoning at this stage, such as:
- Forgets words they just read
- Repeat asking the same question over and over again
- Difficulty making plans or organizing that become worse with time
- Unable to remember names when meeting new people
You can help your loved ones by helping them by becoming their “memory centre”. For example, reminding them to pay bills on time or to attend appointments on time. You could also advise them to relieve their stress at this stage, possibly by retiring from work. It would also be very good advice for them to get their affairs in order at this stage – making plans for their legal and financial affairs – when they still have the capacity to do so.
Stage 4: Moderate Decline
During this period, the logic and reasoning challenges you encountered in stage 3 become more apparent, and new concerns emerge. It's possible if they:
- Forget personal details
- Struggle with dates and times
- Have trouble remembering the months and seasons
- Find it difficult to prepare food or order from a menu
You may assist them with their daily tasks as well as their well-being. Check to see if they're really traveling and if someone is willing to take advantage of them financially.
Stage 5: Moderately Severe Decline
Your loved one can become disoriented as to where they are and what time it is. They could forget their home address, contact details, or where they attended school. They might become confused as to what to dress for the day or season.
You can support them by setting out their clothes for the first thing in the morning. It will help them in dressing independently and retaining their sense of independence.
If they ask the same question again, respond with a calm, supportive tone. They could be posing the question just to let you know they're there than to get a response.
And if your loved one has lost their capacity to recall information and specifics, they may be able to relate a memory. During those moments, encourage them to use their creativity.
Stage 6: Severe Decline
Your loved one will remember faces but forget names as Alzheimer's progress. They can often misidentify others like someone else, such as mistaking their wife for their mother. Delusions can arise, such as the belief that they must go to work despite the fact that they do not have a job.
You will need to assist them with using the restroom.
Even if it's difficult to communicate, you can always interact with them through your senses. Most Alzheimer's patients like listening to songs, being listened to, or scrolling at old photographs.
Stage 7: Very Severe Decline
During this time, a person with Alzheimer's loses many basic abilities, such as eating, walking, and sitting up. You will help your loved ones stay involved by feeding them soft, easy-to-swallow food, helping them to use a spoon, and making sure they drink. This is important since many people at this point can't say when they're thirsty.
Referenced on 2.3.2021:
- Alzheimer's Association: “Early-Stage Caregiving, “Late-Stage Caregiving," “Middle-Stage Caregiving, “Seven Stages of Alzheimer's."
- Fisher Center for Alzheimer's Research Foundation: “Clinical Stages of Alzheimer's."
- Fritsch, T. The Gerontologist, March 18, 2009.
- Johns Hopkins Medicine: “Stages of Alzheimer's Disease."
- Lloyd, J. Dementia, Dec. 29, 2014.
- Daniel L. Murman, MD, director, behavioral and geriatric neurology program, professor of neurological sciences, University of Nebraska Medical Center, Omaha.
- National Institute on Aging: “Understanding How AD Changes People-Challenges and Coping Strategies."
- Wood, D.L. Biological Research Nursing, October 2002.