Alzheimer’s disease is a neurological condition that can cause dementia. This involves a group of symptoms that include decreases in memory, thinking, and other areas of cognitive (thinking) health. It progresses gradually, typically over several years.
Medical experts categorize Alzheimer’s disease and dementia progression into stages according to how severe your symptoms are and your level of independence. These stages may help inform treatment and care options.
Read on to learn more about how Alzheimer’s disease progresses, including what to expect at each stage.
Alzheimer’s disease stages and progression
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The Alzheimer’s disease stages can help you and your medical team plan treatment and know what to expect with the condition.
However, these stages are more of a general guide, as the symptoms you experience and when they develop can vary slightly per person. Some experts have also suggested different numbers of stages or staging systems to track the progression of the condition.
Overall, Alzheimer’s disease stages help measure the severity of symptoms.
The main stages of Alzheimer’s disease progression can include:
- Stage 1: no cognitive impairment
- Stage 2: very mild cognitive impairment
- Stage 3: mild cognitive impairment
- Stage 4: moderate cognitive impairment
- Stage 5: moderately severe cognitive impairment
- Stage 6: severe cognitive decline
- Stage 7: very severe cognitive decline
These stages are known as the Global Deterioration Scale (GDS), or Reisburg Scale.
Your cognitive health refers to how well you can think, reason, and remember.
Learn about the stages of dementia and the difference between Alzheimer’s disease and dementia.
Stage 1: No cognitive impairment
The process of Alzheimer’s disease starts before noticeable symptoms appear.
Stage 1 of Alzheimer’s disease involves no symptoms of cognitive problems, but the condition may have started to cause subtle brain changes.
The brain changes at stage 1 are so minimal that they are unnoticeable in individuals, even when using medical tools such as imaging scans.
Some experts may refer to this stage as preclinical Alzheimer’s disease.
Stage 2: Very mild cognitive impairment
In this stage, you may start to experience mild Alzheimer’s disease symptoms, such as minimal memory loss.
Sometimes, symptoms at stage 2 are so mild they can be hard to distinguish from typical levels of forgetfulness. Often, the symptoms are unnoticeable to others.
Possible symptoms of early Alzheimer’s disease include:
- misplacing objects
- forgetting names, places, or key information, particularly if the information is new
- not recalling recent events
- difficulty planning or completing tasks
- difficulty solving problems, making complex decisions, or thinking things through logically
- difficulty finding the right word
- more difficulty at work or with daily tasks
- decreases in judgment ability
- increased hesitance or decreased flexibility
- mood changes, such as more confusion, agitation, or anxiety
Read more about the early symptoms of Alzheimer’s disease.
Stage 3: Mild cognitive impairment
At stage 3 of Alzheimer’s disease, cognitive problems are still mild, and you may still be able to participate in your usual activities, such as work, driving, or social events.
However, your symptoms may be more noticeable and start to affect your life more.
For example, stage 3 Alzheimer’s disease may make it more likely that you get lost or have problems finding the right words.
Find out helpful self-care techniques for Alzheimer’s disease.
Stage 4: Moderate cognitive impairment
Experts refer to stage 4 as moderate cognitive impairment or moderate dementia.
In stage 4 Alzheimer’s disease, you may experience:
- worse short-term memory
- forgetting details of your life or personal history
- forgetting other important and familiar information, such as your address
- needing more help with self-care, such as choosing appropriate clothing for the weather
- difficulty with usual daily tasks, such as:
- managing your finances
- going out independently
- cooking or shopping
Some people may need help to live independently at this stage.
Stage 5: Moderately severe cognitive impairment
With stage 5, Alzheimer’s disease symptoms may get more severe, such as forgetting more key personal information and recent events.
Symptoms you may experience at stage 5 include:
- difficulty communicating your thoughts
- trips and falls
- incontinence
- changes in sleep patterns
- behavior symptoms, such as:
- anger, suspiciousness, or delusions
- repetitive or compulsive behavior, such as hand wringing or paper shredding
- having a tendency to wander or get lost
Stage 6: Severe cognitive impairment
Alzheimer’s disease symptoms at stage 6 can cause you to need permanent or constant care and supervision. This can be due to cognitive and physical symptoms, such as:
- lower mobility, or more difficulty moving around
- higher risk of falls
- higher risk of infections
- difficulty swallowing or needing help with eating
- incontinence
- walking more slowly
Other potential symptoms of later stage Alzheimer’s disease and dementia include:
- thinking you are at an earlier time of your life
- no longer recognizing familiar people or your face in a mirror
- not recognizing familiar places or objects
- understanding fewer words or having a more limited vocabulary
- losing the ability to speak a second language or a language you learned later in life
- delusions or hallucinations
- behavior or mood changes, such as:
- depression or apathy
- restlessness
- aggression
Stage 7: Very severe cognitive impairment
Stage 7 is the last stage of Alzheimer’s disease.
At this stage, people may experience physical symptoms and difficulties with communication, or these symptoms may worsen if you already have them.
Those with stage 7 Alzheimer’s disease may be less engaged with their surroundings but can still communicate nonverbally, such as through gestures or touch.
Read more about the life expectancy of Alzheimer’s disease.
How quickly does Alzheimer’s disease progress?
A 2021 analysis of studies, including 63,125 people with dementia, reported that those with Alzheimer’s disease had a life expectancy of around 5.8 years after diagnosis. However, the disease may have already developed and started progressing before diagnosis.
However, how quickly Alzheimer’s disease progresses can vary slightly per person. For example, your outlook can depend on:
The charity Alzheimer’s Society suggests that people typically live another 8 to 10 years with the condition, while some could live for up to 20 years.
Experts suggest that middle stage Alzheimer’s disease, or stages 4 and 5, may last the longest.
Learn about how fast Alzheimer’s disease progresses, including how to slow its development.
Alzheimer’s disease progresses in stages.
Early on, the disease may not cause noticeable symptoms but may have started to cause brain changes. As the condition progresses, you may notice memory problems and difficulty with daily activities.
By the later stages of Alzheimer’s disease, people may experience physical symptoms, behavioral changes, difficulty communicating, and memory loss.
Talk with a doctor if you have any questions about Alzheimer’s disease progression or would like further support.