What Are the Stages of Alzheimer’s Disease?
If your loved one has Alzheimer's, you can support them by learning more about how the condition unfolds.
The stages don't always fall into neat boxes, and the symptoms might vary. But they can be a guide and help you plan for your friend or relative's care. Doctors call these different stages the progression of the disease.
There is no cure for Alzheimer's disease, so understanding what to expect at each stage can help you plan to meet your loved one’s needs. There are no hard-and-fast lines between mild and moderate stages, but over time, you can expect changes like the ones below.
Alzheimer’s Stage I: Normal Outward Behavior
Alzheimer’s disease usually starts silently, with brain changes that begin years before anyone notices a problem. When your loved one is in this early stage of Alzheimer's disease, they won't have any noticeable symptoms. Only a PET scan, an imaging test that shows how the brain is working, can reveal whether they have Alzheimer's.
As they move into the next six stages, your friend or relative with Alzheimer's will see more and more changes in their thinking and reasoning.
Alzheimer’s Stage II: Very Mild Changes
You still might not notice anything amiss in your loved one's behavior, but they may be picking up on small differences, things that even a doctor doesn't catch. This could include forgetting words or misplacing objects.
At this stage, subtle symptoms of Alzheimer's don't interfere with their ability to work or live independently.
Keep in mind that these symptoms might not be Alzheimer's at all but rather normal changes related to aging.
Alzheimer’s Stage III: Mild Decline
It's at this mild stage of Alzheimer's disease that you start to notice changes in your loved one's thinking and reasoning, such as:
- Forgetting something they just read
- Asking the same question over and over
- Having more and more trouble making plans or organizing
- Struggling to remember names when meeting new people
You can help by being your loved one's "memory" for them, making sure they pay bills and get to appointments on time. You can also suggest they ease stress by retiring from work and putting their legal and financial affairs in order.
Alzheimer’s Stage IV: Moderate Decline
During this period, the problems in thinking and reasoning that you noticed in stage III get more obvious, and new issues appear. Your friend or family member might:
- Forget details about themselves
- Have trouble putting the right date and amount on a check
- Forget what month or season it is
- Have trouble cooking meals or even ordering from a menu
- Struggle to use the telephone
- Not understand what is said to them
- Struggle to do tasks with multiple steps such as cleaning the house
You can help them with everyday chores and ensure their safety. Make sure they aren't driving anymore, and that no one tries to take advantage of them financially.
Alzheimer’s Stage V: Moderately Severe Decline
Your loved one might start to lose track of where they are and what time it is. They might have trouble remembering their address, phone number, or where they went to school. They could get confused about what kind of clothes to wear for the day or season.
You can help by laying out their clothing in the morning. It can help them dress by themselves and keep a sense of independence.
If they repeat the same question, answer with an even, reassuring voice. They might be asking the question less to get an answer and more to just know you're there.
Even if your loved one can't remember facts and details, they might still be able to tell a story. Invite them to use their imagination at those times.
Alzheimer’s Stage VI: Severe Decline
As Alzheimer's progresses, your loved one might recognize faces but forget names. They might also mistake a person for someone else, for instance, think their wife is their mother. Delusions might set in, such as thinking they need to go to work even though they no longer have a job.
You might need to help them go to the bathroom.
It might be hard to talk, but you can still connect with them through the senses. Many people with Alzheimer's love hearing music, being read to, or looking over old photos.
At this late stage of Alzheimer's disease, your loved one might struggle to:
- Feed themselves
- Swallow
- Get dressed
They also might have:
- Weight loss
- Skin infections
- Pneumonia
- Trouble walking
- Changes in their sleeping patterns
Alzheimer’s Stage VII: Very Severe Decline
For a person with Alzheimer's, many basic abilities, such as eating, walking, and sitting up, fade during this period. You can stay involved by feeding your loved one with soft, easy-to-swallow food, helping them use a spoon, and making sure they drink water. This is important, as many people at this stage can no longer tell when they're thirsty.
In this stage, people with Alzheimer's disease need a lot of help from caregivers. Many families find that, as much as they may want to, they can no longer take care of their loved one at home. If that’s you, look into facilities such as nursing homes that provide professional care day and night.
When someone nears the end of their life, hospice may be a good option. That doesn't necessarily mean moving them to another location; hospice care can happen anywhere. It’s a team approach that focuses on comfort, pain management, other medical needs, emotional concerns, and spiritual support (if desired) for the person and their family.
Alzheimer’s pneumonia
Pneumonia often happens in people with Alzheimer’s stage VII and is likely to cause them to stay in the hospital for treatment. It is the most common cause of death in people with Alzheimer’s, and those who have it are twice more likely to die from it than those without Alzheimer’s.
People with Alzheimer’s are prone to having serious and life-threatening pneumonia, possibly due to reasons such as:
- Having a weakened immune system
- Taking medications that affect their ability to fight off infections, such as immunosuppressants
- Having more severe pneumonia symptoms such as difficulty breathing
- Having health conditions that put them at a higher risk of having pneumonia, such as high blood pressure, diabetes, and obesity
Alzheimer’s Stages Timeline
Stage I
A person can be in this stage for years or decades and have no symptoms indicating Alzheimer’s disease or cognitive decline.
Stage II
People with Alzheimer’s may have symptoms such as not being able to remember names easily for 12 years.
Stage III
A person with Alzheimer’s disease may be in this stage for 7 years.
Stage IV
People with mild Alzheimer’s disease at this stage have it for about 2 years before their condition gets worse.
Stage V
People stay in this stage for a year and a half.
Stage VI
Stage VI Alzheimer’s lasts about 2.5 years.
Stage VII
This is the most severe stage, and it lasts up to a year and a half in each substage of the disease, which is from A to D.
Takeaways
Alzheimer’s happens in stages for everyone with the disease. These stages don't have firm timeframes, and the symptoms can differ from person to person. But because it has no cure and is irreversible, learning about the stages can empower you to better care for your loved ones with the condition and understand what they need to live the most comfortably at every stage of the disease.
Alzheimer’s Stages FAQs
What is the timeline for Alzheimer’s to death?
People with Alzheimer's disease usually live for about 3 to 11 years after they are diagnosed, but some people can live for 20 years or even longer.
What is the life expectancy of a person diagnosed with Alzheimer’s?
Many people live for about 3 to 11 years after diagnosis, and some can live for up to 20 years or more.
What is the end stage of Alzheimer’s?
Stage VII is the end stage of Alzheimer’s, and people in this stage may benefit from hospice care.
