What Are the Seven Stages of Alzheimer’s Disease?

The seven stages of Alzheimer’s disease can occur over four to 20 years, but typically last 15 years once symptoms begin. Here's what you should know.

Everyone diagnosed with Alzheimer’s disease has a unique history with the condition. Caregivers can’t know exactly what to expect. There is one common progression, which can be thought of as three concurrent phases (early, moderate, and end), or more specifically seven. The Alzheimer’s Association has adopted the seven-stage Global Deterioration Scale, described in a paper by a team led by Barry Reisberg, MD, a professor of psychiatry at New York University.

The Alzheimer’s stages timeline, which can run from four to 20 years, is a useful guide to caregivers and observers.

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Stage 1: No impairment

Your loved one may not show any memory problems or other symptoms of dementia, although the disease may be building up in her body.

Stage 2: Very mild decline

At this point, she might lose things around the house and notice memory problems, but they are on par with typical problems for her age. She will still do well on memory tests.

Stage 3: Mild decline

Her family members and friends may begin to notice cognitive problems. Doctors will be able to detect the decline if she takes memory tests. She might have trouble finding the right word during conversations, organizing and planning, and remembering names of new acquaintances. She may frequently lose her possessions. If she is working, she may find it is more difficult to keep up her usual standards. On average, this stage lasts seven years.

Stage 4: Moderate decline

At this point, she is in the early stages of dementia. She may have difficulty with simple arithmetic, forget what she ate for breakfast, become unable to manage her money, and forget details about her own history. She can still travel to familiar locations but gets lost if she tries to go anywhere unfamiliar. It is very common to deny that you are losing your abilities, and you may withdraw from your social life. This stage typically lasts two years.

Stage 5: Moderately severe decline

At stage five of the seven stages of Alzheimer’s disease, patients begin to need help with day-to-day life. It may be difficult for her to choose her clothing or remember her phone number or address. She may forget the names of grandchildren and your college. But she can still bathe and go to the bathroom, recognize family and friends, and recall facts about her childhood. Stage five lasts, on average, one and a half years.

Stage 6: Severe decline

People in the sixth stage of Alzheimer’s must be supervised constantly. They are unaware of their environment, the year, or the season, and may wander off. They may not be able to count to 10. They can recognize only a few close people and may even forget the name of a spouse who is taking care of them. They lose bladder and bowel control.

Their personality changes, and they may develop unwelcome behavior that makes them hard to manage. Patients may accuse their spouse of being an impostor or may talk to imaginary figures or their own reflection in the mirror. They may continually repeat activities like washing their hands and become agitated or violent.

This stage lasts an average of about two and a half years.

7: Very severe decline

In stage seven, people lose the ability to communicate. They may utter words or phrases. They need help going to the bathroom and eating. Over time, they lose the ability to walk and eventually to swallow. The brain appears to no longer be able to tell the body what to do. This stage also lasts an average of two and a half years.

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