Understanding the Stages of Alzheimer’s Disease

April 30, 2018

Alzheimer’s disease looms ever larger in our minds as loved ones age. But for something so fearsome, many of us don’t have an understanding of the disease, especially how it progresses. While some break it into three phases, generally referred to as “mild/early,” “moderate/middle,” and “severe/late,” most discussion of Alzheimer’s disease focuses on seven different stages.

Stage 1 –Preclinical Alzheimer’s Disease

When Alzheimer’s disease first sets in, it shows no symptoms or signs. That’s one of the things that can make it so frightening. You may be looking critically at every “It’s on the tip of my tongue!” moment that your loved one displays. But the reality is, the first stage of Alzheimer’s doesn’t involve memory lapses or personality changes. Generally, a known family history is the only thing that may clue medical professionals in to the presence of Alzheimer’s. This stage can last for years, or even decades.

Stage 2 –Very Mild Cognitive Impairment

In the second stage of Alzheimer’s, memory lapses begin to occur. However, their frequency and severity puts them on even footing with age-related memory loss. In other words, it’s still difficult for doctors or loved ones to tell whether or not Alzheimer’s disease is to blame. These memory lapses often take the form of common occurrences like misplacing something in the house or momentarily forgetting someone’s name.

Stage 3 – Mild Cognitive Impairment

Alzheimer’s starts to differentiate itself from age-related memory loss in this third stage, as the symptoms of Alzheimer’s progress at a faster rate than those of age-related memory loss. It’s also at this stage that medical professionals, family, friends, and the one suffering from Alzheimer’s begin to understand what’s going on. In addition to increasing memory lapses, planning and organization become difficult. Conversation also becomes more challenging, as the right words can be tough to find. It’s important to note that Alzheimer’s affects personality and mood just as much as it does memory. In this stage, mild anxiety and depression may begin to set it. While caregiver support is likely not needed yet, counseling can be beneficial.

Stage 4 – Moderate Cognitive Impairment/Decline

At this stage, the presence of Alzheimer’s disease is clear and readily diagnosable. The rate of decline speeds up, and the symptoms present increasing limitations. Everyday tasks become more difficult, and short-term memory deteriorates. Those in this stage of the disease may forget whether or not they’ve eaten, whether they paid their bills, and what they need to buy from the store. The severity of the disease at this stage often leads to increased withdrawal and denial.

Stage 5 – Moderately Severe Cognitive Impairment

Those suffering in this stage of Alzheimer’s typically still recall their family members and friends. But basic information like their address and phone number may be gone, along with several other personal details. Confusion mounts, as do difficulties with tasks like dressing. Bathing and eating are typically still possible, but independent living is likely no longer an option. Withdrawal and denial often give way to suspicion and anger. It’s at this stage that many families look to memory care.

Stage 6 – Severe Cognitive Impairment

Constant supervision is required for those in this stage of Alzheimer’s disease. This is where the disease begins to align with some of our worst fears—wandering, loss of bladder and bowel control, confusion, and a lack of awareness of surroundings. Only select family and friends will still be recognizable. Frustration, shame, and fear are common.

Stage 7 – Very Severe Cognitive Impairment

Alzheimer’s is a terminal disease, and this is the final stage. Communication is limited to short phrases or words, and in many cases stops completely. Physical movements become rigid and painful, and constant care is needed. Pneumonia is often the final symptom.


Even with knowledge of the disease’s progression, there’s little that can be done to combat Alzheimer’s. The focus instead is on care and comfort. If you have any questions about Alzheimer’s care for yourself or a loved one in or around the Chicago suburbs, please give us a call here at Lexington Square at 630.812.7241.

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