The 7 stages of Alzheimer’s Disease
December 3, 2020

Every person with Alzheimer’s experience the disease differently, but there are some commonalities with this complex disease which run from the beginning to its end. There are actually many stages to Alzheimer’s, but specialists tend to use a three phase model (early, moderate and late) to describe its stages.

However, Dr Barry Reisberg, of New York University, explains the progression of Alzheimer’s into seven key stages and this has been adopted by a number of healthcare providers to help their patients and patient’s families, understand this complex disease.

1. No Impairment

Alzheimer’s is not detectable and there are no memory problems or evident symptoms of dementia.

2. Very Mild Decline

The patient may notice a very minor change in their memory or notice themselves losing things around their house. However, this is generally indistinguishable from normal age-related memory loss and the patient will perform well in memory tests. The disease will likely remain undetected by family members, friends and doctors.

3. Mild Decline

People may begin to notice a rise in cognitive problems with the patients. This is the stage where memory test performance can decline and doctors will likely be able to detect an impairment in the patient’s cognitive function.

Key signs include:

  • Finding the right word during conversations
  • Organizing and planning issues
  • Remembering the names of new acquaintances

At this stage, you may notice the patient losing personal possessions and valuables much more regularly.

4. Moderate Decline

This is the stage where clear symptoms of the disease are noticeable. This includes:

  • Short Term memory issues e.g. forgetting what they ate for breakfast
  • Inability to manage their finances
  • Forgetting key details in their life history

5. Moderately Severe Decline

During this stage, patients will need help with many day-to-day activities. Key issues include:

  • Difficulty dressing appropriately
  • Inability to recall simple details about themselves e.g. phone number
  • Serious confusion

However, the patient can often still practice basic hygiene routines such as bathing and going to the bathroom independently. They can generally remember their family members and personal history, especially with their childhood.

6. Severe Decline

Patients in this stage need constant supervision and professional care. Symptoms include:

  • Confusion regarding their surroundings and environment
  • Inability to recognise faces except for close friends and relatives
  • Unable to remember most of their personal history
  • Loss of bowel and bladder control
  • Potential for behaviour problems due to personality changes
  • Needing assistance with basic hygiene practices such as toileting and bathing as well as daily activities
  • Wandering

7. Very Severe Decline

At this stage, due to the fact the disease is a terminal illness, the patient will be nearing death. They will lose the ability to communicate or respond to their environment and will have little to no insight into their condition. They may lose their ability to swallow and are at severe risk of choking. Help will all aspects of daily living is essential.

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