Every person with Alzheimer’s disease experiences the disease differently, but patients tend to experience a similar trajectory from the beginning of the illness to its merciful end. The precise number of stages is somewhat arbitrary. Some experts use a simple three-phase model (early, moderate and end), while others have found a granular breakdown to be a more useful aid to understanding the progression of the illness.
The most common system, developed by Dr. Barry Reisberg of New York University, breaks the progression of Alzheimer’s disease into seven stages. This framework for understanding the progression of Alzheimer’s disease has been adopted and used by a number of healthcare providers as well as the Alzheimer’s Association.
Here is summary of the seven stages of Alzheimer’s disease based on the ideas of Dr. Resiberg:
Stage 1: No Impairment
During this stage, Alzheimer’s disease is not detectable and no memory problems or other symptoms of dementia are evident.
Stage 2: Very Mild Decline
The senior may notice minor memory problems or lose things around the house, although not to the point where the memory loss can easily be distinguished from normal age related memory loss. The person will still do well on memory tests and the disease is unlikely to be detected by physicians or loved ones.
Stage 3: Mild Decline
At this stage, the friends and family members of the senior may begin to notice memory and cognitive problems. Performance on memory and cognitive tests are affected and physicians will be able to detect impaired cognitive function.
Patients in stage 3 will have difficulty in many areas including:
- finding the right word during conversations
- remembering names of new acquaintances
- planning and organizing
People with stage three Alzheimer’s may also frequently lose personal possessions, including valuables.
Stage 4: Moderate Decline
In stage four of Alzheimer’s disease clear cut symptoms of Alzheimer’s disease are apparent. Patients with stage four Alzheimer’s disease:
- Have difficulty with simple arithmetic
- May forget details about their life histories
- Have poor short term memory (may not recall what they ate for breakfast, for example)
- Inability to manage finance and pay bills
Stage 5: Moderately Severe Decline
During the fifth stage of Alzheimer’s, patients begin to need help with many day to day activities. People in stage five of the disease may experience:
- Significant confusion
- Inability to recall simple details about themselves such as their own phone number
- Difficulty dressing appropriately
On the other hand, patients in stage five maintain a modicum of functionality. They typically can still bathe and toilet independently. They also usually still know their family members and some detail about their personal histories, especially their childhood and youth.
Stage 6: Severe Decline
Patients with the sixth stage of Alzheimer’s disease need constant supervision and frequently require professional care. Symptoms include:
- Confusion or unawareness of environment and surroundings
- Major personality changes and potential behavior problems
- The need for assistance with activities of daily living such as toileting and bathing
- Inability to recognize faces except closest friends and relatives
- Inability to remember most details of personal history
- Loss of bowel and bladder control
Stages 7: Very Severe Decline
Stage seven is the final stage of Alzheimer’s disease. Because Alzheimer’s disease is a terminal illness, patients in stage seven are nearing death. In stage seven of the disease, patients lose ability to respond to their environment or communicate. While they may still be able to utter words and phrases, they have no insight into their condition and need assistance with all activities of daily living. In the final stages of the illness, patients may lose their ability to swallow.
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