Brain & Nervous System Alzheimer's Symptoms The 7 Stages and Symptoms of Alzheimer's Disease How Alzheimer's Typically Progresses By Carrie Hill, PhD Carrie Hill, PhD Carrie L. Hill, PhD has over 10 years of experience working for agencies in the health, human service, and senior sectors, including The Alzheimer's Association in St. George, Utah. Learn about our editorial process Updated on August 20, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Nicholas R. Metrus, MD Medically reviewed by Nicholas R. Metrus, MD LinkedIn Nicholas R. Metrus, MD, is a board-certified neurologist and neuro-oncologist. He currently serves at the Glasser Brain Tumor Center in Summit, New Jersey. Learn about our Medical Expert Board Print Alzheimer's disease is a progressive neurological disorder that leads to personality changes, memory loss, intellectual slowing, and other symptoms. Although each person with Alzheimer's is different, most progress through a series of stages, each of which is characterized by more serious Alzheimer's symptoms. The following seven stages were developed by researchers and healthcare providers to describe how you or your loved one will change over time. Your healthcare provider might collapse the seven stages into early/middle/late or mild/moderate/severe, so these classifications are provided as well. #: 157144420. BSIP / UIG / Getty Images Stage 1: Absence of Impairment There are no problems with memory, orientation, judgment, communication, or daily activities. You or your loved one is a normally functioning adult. Stage 2: Minimal Impairment You or your loved one might be experiencing some lapses in memory or other cognitive problems, but neither family nor friends are able to detect any changes. A medical exam would not reveal any problems either. Stage 3: Noticeable Cognitive Decline Family members and friends recognize mild changes in memory, communication patterns, or behavior. A visit to the healthcare provider might result in a diagnosis of early-stage or mild Alzheimer's disease, but not always. Common symptoms in this stage include: Problems producing people's names or the right words for objects Noticeable difficulty functioning in employment or social settings Forgetting material that has just been read Misplacing important objects with increasing frequency Decrease in planning or organizational skills Stage 4: Early-Stage/Mild Alzheimer's Cognitive decline is more evident. You or your loved one may become more forgetful of recent events or personal details. Other problems include impaired mathematical ability (for instance, difficulty counting backwards from 100 by 9's), a diminished ability to carry out complex tasks like throwing a party or managing finances, moodiness, and social withdrawal. Stage 5: Middle-Stage/Moderate Alzheimer's Some assistance with daily tasks is required. Problems with memory and thinking are quite noticeable, including symptoms such as: An inability to recall one's own contact information or key details about one's historyDisorientation to time and/or placeDecreased judgment and skills in regard to personal care Even though symptoms are worsening, people in this stage usually still know their own name and the names of key family members and can eat and use the bathroom without assistance. Stage 6: Middle-Stage/Moderate to Late-Stage/Severe Alzheimer's This is often the most difficult stage for caregivers because it's characterized by personality and behavior changes. In addition, memory continues to decline, and assistance is required for most daily activities. The most common symptoms associated with this stage include: Reduced awareness of one's surroundings and of recent events Problems recognizing one's spouse and other close family members, although faces are still distinguished between familiar and unfamiliar Sundowning, which is increased restlessness and agitation in the late afternoon and evening Difficulty using the bathroom independently Bowel and bladder incontinence Suspicion and paranoia Repetitive behavior (verbal and/or nonverbal) Wandering Stage 7: Late-Stage/Severe Alzheimer's In the final stage, it is usually no longer possible to respond very much to the surrounding environment. You or your loved one may be able to speak words or short phrases, but communication is extremely limited. Basic physical functions begin to shut down, such as motor coordination and the ability to swallow. Total care is required around the clock. Although the stages provide a blueprint for the progression of Alzheimer's symptoms, not everyone advances through the stages similarly. Caregivers report that their loved ones sometimes seem to be in two or more stages at once, and the rate at which people advance through the stages is highly individual. Still, the stages help us understand Alzheimer's symptoms and prepare for their accompanying challenges. Was this page helpful? Thanks for your feedback! When it comes to Alzheimer's, the MIND diet has shown promise in reducing risk and promoting brain health. Sign up for our Alzheimer’s and Dementia Newsletter and get your free recipe guide today. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 0 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Progression of Alzheimer's disease: The Global Deterioration Scale. Alzheimer's Society of Canada. October 2005. Stages of Alzheimer's. Alzheimer's Association. 2007. Understanding stages and symptoms of Alzheimer's disease. National Institute on Aging. October 26, 2007.