The Seven Stages of Alzheimer’s

Alzheimer’s symptoms vary. Not everyone will experience the same symptoms or progress at the same rate. Below is a seven stage framework 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.

Stage 1: No Impairment (normal function) – In this stage, a person does not experience any memory problems. An interview with a doctor does not show any evidence of symptoms of dementia.

Stage 2: Very Mild Cognitive Decline (may be normal age-related changes or earliest signs of Alzheimer’s disease) – The person may feel as if he or she is having memory lapses- forgetting familiar words or the location of everyday objects.  However, no symptoms of dementia can be detected during a medical examination or by friends, family, or co-workers.

Stage 3: Mild Cognitive Decline (early-stage Alzheimer’s can be diagnosed in some, but not all, individuals with these symptoms) – Friends and family begin to notice difficulties. Doctors may be able to detect problem in memory or concentration.

Stage 4: Moderate Cognitive Decline (Mild or early-stage Alzheimer’s disease) – At this point, a careful medical interview should be able to detect clear-cut symptoms in several areas:
–    Forgetfulness of recent events; impaired ability to perform challenging mental arithmetic; forgetfulness about one’s own personal history; becoming moody or withdrawn, especially in socially or mentally challenging situations.



Stage 5: Moderately Severe Cognitive Decline (moderate or mid-stage Alzheimer’s disease) – Gaps in memory and thinking are noticeable, and individuals begin to need help with day-to-day activities. At this stage, those with Alzheimer’s may:
–    Be unable to recall their own address or telephone number; become confused about where they are or what day it is; need help choosing proper clothing for the season or the occasion; still remember significant details about themselves and their family; still require no assistance with eating or using the toilet.



Stage 6: Severe Cognitive Decline (Moderately Severe or Mid-Stage Alzheimer’s Disease) – Memory continues to worsen, personality changes may take place and individuals need extensive help with daily activities. At this stage, individuals may:
–    Lose awareness of recent experiences as well as of their surroundings; have difficulty with their personal history; have trouble remembering names; need help dressing properly; need help handling details of toileting; tend to wander or become lost.

Stage 7: Very Severe Cognitive Decline (Severe or Late- Stage Alzheimer’s disease) – In the final stage, individuals lose the ability to respond to their environment, to carry on a conversation and, eventually, to control movement. At this stage, individuals will need help with much of their daily personal care, including eating or using the toilet. They may also lose the ability to smile, to sit without support and to hold their heads up.





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