Alzheimer’s Stages
Though Alzheimer’s disease affects each person differently, these seven stages to cover most aspects of its normal progression. Some symptoms may appear earlier or later in the disease process and progression differs on a case-to-case basis. Based on a system developed by Barry Reisberg, M.D., clinical director of the New York University School of Medicine’s Silberstein Aging and Dementia Research Center, these stages are helpful both in the condition’s prognosis and in developing a caregiving program.
Stage 1:
Normal function – though early changes may have started in the brain, symptoms like memory problems and personality changes aren’t detectable.
Stage 2:
Slight cognitive decline that may be due to either normal aging or early disease effects. This can manifest as memory lapses with commonly-used words or confusion about “lost” or “misplaced” objects. Dementia symptoms may be identified by medical examination or noticed by family or acquaintances.
Stage 3:
Mild cognitive decline, which may be conspicuous enough for Alzheimer’s to be diagnosed by a trained professional. Difficulties in memory and concentration may be noticed by those who interact with the individual on a regular basis. Difficulties may include:
- Perceptible difficulties recalling words or names
- Issues remembering names of new people
- Problems functioning in social or work settings
- Forgetting recently-read or learned material
- Difficulties planning or organizing
Stage 4:
Moderate deterioration (Mild or early-stage Alzheimer’s), which can be identified by a medical professional through a thorough interview to detect symptoms such as:
- Short-term memory issues
- Diminished ability to perform complex calculations mentally
- Difficulty performing multi-step tasks, such as planning social events, paying bills or balancing a bank account
- Forgetting details of his/her life
- Poor moods and introverted behavior, particularly in complex social or intellectual situations
Stage 5:
Noticeable decline (Moderate to mid-stage Alzheimer’s), manifesting in clear lapses in memory and logic as well as a need for assistance with daily activities, however eating or using the bathroom may not be affected. General problems at this stage include:
- Inability to remember personal address, telephone number or other specific details from their past such as schools or favorite books
- Confusion about day, time and location
- Difficulty with basic calculations
- Confusion selecting clothing appropriate to social occasions or weather
Stage 6:
Severe decline (moderately severe or mid-stage Alzheimer’s), memory problems continue to worsen, possible changes in personality and an increased reliance upon others for help with daily activities. Characteristics of stage 6 are:
- Lost awareness of recent past and environment
- Awareness of his/her name but problems recalling their past
- Ability to recognize familiar people, but difficulty remembering relationships (discerning between family, friends, caregivers, etc.)
- Help is required dressing to ensure clothing is both appropriate and worn correctly
- Drastic alterations in sleep patterns (sleeping during the day, insomnia at night)
- Problems handling details of using the bathroom
- More frequent difficulty controlling bladder and/or bowels
- Severe personality and behavior changes, including mistrust and delusions
- Wandering, which may lead to getting lost when combined with memory issues
Stage 7:
Very severe decline (Severe or late-stage Alzheimer’s disease), with effects including the inability to respond to environment, interact with others and (over time) to control movement. Patients in stage 7 need help with almost all aspects of personal care, and it is common for them to lose the ability to smile, sit without support and hold up their head. Muscle rigidity and impaired reflexes are also common, which can lead to trouble swallowing.
