7 Stages of Alzheimer’s Disease

stages of alzheimer's disease

People with Alzheimer’s disease (AD) experience the illness differently but research shows that affected individuals tend to go through similar stages of Alzheimer’s from the beginning to the end.

The categorization of the illness is useful when it comes to understanding what to expect to plan for appropriate care and treatment through each stage.

What Are the 7 Stages of Alzheimer’s Disease?

Some professionals use a simple 3-phrase model (early, moderate, and end) while others will use a more comprehensive breakdown that explains the progression of the disease.

The most common system breaks down the progression of Alzheimer’s into 7 stages.

It was developed by Dr, Barry Reisberg from New York University.

Below we will incorporate both systems discussing the three main stages of the disease and its seven sub-stages.


pre-diagnosis for alzheimer's disease
Also known as preclinical Alzheimer’s, these are the stages of Alzheimer’s that a person goes through before there is an “official” diagnosis of the progressive illness.

Note that changes in the brain usually start years before an individual can showcase any warning signs of the illness.

In the beginning, most people will not have a clue that they have the disease because the symptoms they may experience are usually associated with growing older.

People will continue to function independently at this stage.

There is currently no treatment for the pre-clinical stage of Alzheimer’s.

Experts are, however, hoping that in the future, there will be a medication that can halt the progression before people start showcasing symptoms to prevent the illness.

Let’s take a closer look at what affected persons may experience during the three pre-diagnosis stages.

Stage1: No Cognitive Decline

In the early stage of the progressive illness, most people will not showcase any subjective or objective cognition symptoms or functional decline.

They are also free from any mood or behavioral changes and have what is considered to be normal outward behavior.

Individuals at this stage can be referred to as mentally healthy persons. Alzheimer’s disease at this stage cannot be detected.

Stage 2: Basic Cognitive Decline

The 2nd Alzheimer’s stage is primarily characteristic of forgetfulness that occurs with normal aging.

A majority of people who are over 65 years will experience typical forgetfulness.

Alzheimer’s usually affects people who are above the age of 65. Elderly persons may no longer recall names as they would when they were younger.

Some may forget where they had placed their purse, keys, glasses, or other things around the house.

Many people in this stage will perform well on memory tests be able to go on working, drive, and be social.

The symptoms are normally not noticed by the individual, their family, or physicians.

Stage 3: Mild Cognitive Decline

Certain symptoms are common in the 3rd stages of Alzheimer’s.

For instance, a person with mild cognitive decline may find it hard to concentrate or focus on something.

Most people will also experience increased forgetfulness. If an individual is working, their performance at the workplace may be compromised.

People who stay at home may experience decreased performance in household chores like cleaning or even staying updated with paying bills.

Learning a new skill at this point becomes difficult. People may get lost in familiar places and they can find it challenging to find the correct words to speak when having a conversation.

Someone with stage 3 Alzheimer’s may frequently lose their possessions including prized items.

In this stage, a person’s family may begin to notice the changes that are happening in their loved one’s life.

The affected person may not do too well on memory tests and doctors can detect impaired cognitive function.

This stage can last up to seven years and the symptoms may start to be clearer in 2-4 years.

A person may need professional counseling at this stage especially if they have been conducting complex job responsibilities.

Most people will experience mild to moderate denial and anxiety during the 3rd stage of AD.

It is best to consult a physician during this point so that they can come up with care planning and treatment options that will keep the symptoms at bay.

Early-Stage Alzheimer’s

stages of Alzheimer’s early-stage alzheimer's
Also known as early-onset AD, this is one of the stages of Alzheimer’s where physicians can diagnose the disease.

The professionals use a combination of medical and neurological exams as well as imaging tests to help in the diagnosis process.

A team of different doctors like neurologists, geriatricians, psychiatrists, and psychologists among others can work together to help diagnose AD.

Stage 4: Moderate Cognitive Decline

Individuals at this stage will start to have more challenges with daily tasks. Denial of symptoms is usually more evident in this stage.

Some people will also have socialization issues where they withdraw from their relatives and friends.

This is mostly because they begin to be aware of the changes happening.

Other warning signs prominent in this stage include:

  • Having poor short-term memory
  • Decreasing awareness of recent or current events
  • Having challenges with simple arithmetic
  • Forgetting details about life history
  • Having difficulties paying bills and managing finances
  • Decreased emotional response
  • Having challenges cooking or even ordering from a menu
  • Forgetting about the season or month
  • Vision loss can also happen in some individuals. It can be as simple as having a hard time reading
  • Personality and mood changes may also occur some of the most noticeable ones being depression, confusion, fearfulness, and anxiety
  • Some individuals may also become increasingly irritated when something out of the norm happens.

This stage lasts about 2 years.

Individuals at this stage may need assistance from caregivers. Carers can lend a hand with day-to-day chores and making sure affected persons are well-fed and safe.

This includes looking out for them to ensure no one takes advantage of them financially because many affected individuals can become victims of financial scams.

Some affected adults may not be fit to drive and caregivers should ensure they do not get behind the wheel and endanger their lives and those of others.

Middle-Stage Alzheimer’s

middle-stage alzheimer's
Middle stage (mid-stage) AD consists of the fifth and sixth stages of Alzheimer’s that we will discuss below.

Stage 5: Moderate/Severe Cognitive Decline

In the 5th stage, most people with AD will have significant memory impairment.

Memory loss can either be moderate or severe.

It is usual for some people to forget major bits of details that affect their day-to-day lives such as phone numbers or home addresses.

Many people are unable to tell what time it is or where they are. It is one of the reasons many people in the 5th stage will get lost even after visiting a place they were once familiar with.

Affected individuals might require help with daily living activities like preparing meals, eating, bathing, and grooming.

Most people at this point will also have a hard time dressing.

It is common for a person to pick the wrong clothing for the season. For instance, an individual can insist on wearing summer clothes during winter.

Some individuals will start to wear the same outfit day in day out unless someone reminds them to change.

Caregivers can help out with dressing by laying out clothes for the day on a person’s bed. Depending on the level of independence, carers may have to dress up the person so that the individual with Alzheimer’s is always in proper attire.

A decline in personal hygiene habits may become more noticeable. For instance, a person may not brush their teeth or practice bathroom hygiene.

This stage can last an average of one and a half years.

Stage 6: Severe Cognitive Decline

The 6th stage of AD marks the point of the illness where many affected people will require more help with their daily tasks.

Taking a bath becomes challenging where persons cannot adjust the temperature of bathwater or handle other aspects of bathing.

Persons in this stage normally have limited memory of past and recent events.

Most will not remember the name of the school they went to or life events like their first job and the place where they were born.

Some retain details about their names but they may begin to confuse the names of people they are close to.

For example, a person may call their spouse the name of a deceased parent or use a different name to address someone they know. Most people in stage six might also start to experience incontinence of the bladder or bowel.

Speech ability may also start to diminish.

At this stage, personality changes become more pronounced. Individuals may experience different AD symptoms such as:

The ability to calculate becomes challenging where even a well-educated person may not be able to count backward from 10 to 0.

Some people may start to wander at night and sleep more during the day.

The stage can last for around two and a half years.

Caregivers at this stage can offer help with personal care from hygiene to daily tasks.

Late-Stage Alzheimer’s

late-stage alzheimer's
After going through the middle stages of Alzheimer’s persons with the disease will go through the final and last stage of the illness.

This is the 7th stage which is also known as late-stage AD. Read on to find out what affected persons can expect from this stage.

Stage7: Severest Cognitive Decline

At this stage, most people with AD lose their ability to communicate. Research shows that for most individuals, speech is limited to 6 words or fewer.

After sometime speech will decline to a single recognizable word before it is lost.

For survival, they usually require help with most daily activities including bathing, toileting, eating, and other activities around the clock.

Stage 7 is also associated with loss of psychomotor capabilities implying individuals at this stage may require help with ambulation and some might not be able to walk at all.

Affected individuals normally lose their ability to smile and instead they only have grimacing facial movements.

After a while, individuals may also lose their ability to hold their heads without support and others are not able to swallow.

Body movements tend to become more rigid which can cause severe pain to the affected persons.

Healthline reports that at least 40% of persons with AD form contractures, or hardening and shortening of tendons, muscles, and other tissues.

It is also common for adults to develop infantile reflexes such as sucking.

As cognitive and memory skills continue to become worse, individuals may require extensive care.

At some point, caregivers may have to consider support services like hospice care that will offer dignity and comfort at the end of life.

Although engagement is minimal during the end stages of Alzheimer’s persons with the disease can still benefit from interactions like a gentle reassuring touch or listening to relaxing music. This final stage normally lasts for about 2 and a half years.

Most people with AD will succumb during this stage.

Persons in this stage are usually vulnerable to developing other medical conditions that can lead to their death such as pneumonia, cancer, heart disease, or stroke.

Some individuals survive for years in this stage with proper care and life support.

Stages of Alzheimer’s Closing Remarks

It is important to learn how Alzheimer’s unfolds through various stages of Alzheimer’s.

While these stages do not always fall into neat little boxes and the symptoms may vary from one person to the next, they can be beneficial in taking care of a person with the illness.

It helps in preparing for the challenges that come next by getting the necessary medical supplies and aids like wheelchairs.

It also helps to identify care facilities like assisted living when an affected person can no longer live on their own safely.

AD is a progressive disease that gradually becomes worse over 4-20 years. However, a majority of affected persons will live for about four to eight years after diagnosis.

It is challenging for people with the disease and their loved ones to go through the stages of the illness. Knowing what to expect during these stages can help ease stress and unpredictability.

Vascular Dementia Stages and Progression

vascular dementia stages

Vascular dementia is one of the most common types of dementia, and people who have this illness often have to go through several vascular dementia stages.

It is a disease that develops when the brain cells die because they are not getting enough nutrients and oxygen.

It can happen when there are impaired tiny blood vessels in the brain or after a person has gone through a major stroke or even a series of smaller strokes.

Because the condition does not have a cure yet, it progresses from a mild case to a severe one. Note that these stages will differ from one person to the next.

This is simply because this type of dementia is typically brought about by different conditions.

One person may experience vascular dementia following a stroke.

However, another may get it after the inner parts of the brain get damaged for one reason or another. Just like other forms of dementia, vascular dementia also tends to progress in gradual stages. This, however, happens in a more step-like manner.

Check out how the illness may affect an individual over time describing what happens during the three major vascular dementia stages below.

Vascular Dementia Stages

1st Stage

first stage of vascular dementia
At the onset of vascular dementia, things are usually not too serious. Many individuals during this first stage can go about their daily lives without any interference.

This is because the symptoms are still somewhat stable; thus, manageable.

Most of the time, it is difficult to tell whether a person has vascular dementia or Alzheimer’s disease.

Some people may even have what is known as mixed dementia, where one has both Alzheimer’s disease and dementia.

Some people may experience things like impaired memory (general forgetfulness), challenges finding the right words, and difficulty with planning, organizing, and carrying out several tasks in an efficient manner during the first stages of this illness.

A small percentage of individuals with vascular dementia will also go through a slight decline in walking and balance. The condition at this point may also affect thinking and decision making.

At this stage, a majority of people can live alone, but it is recommended that their loved ones always check on them often.

This helps to make sure that everything is in place and that the individuals are not a danger to themselves or any other people around them.

At times, small home modifications may also come in handy to create a more supportive and comfortable environment for individuals with vascular dementia.

2nd Stage

stages of vascular dementia
After a person has gone through the initial vascular dementia stages, it may reach a point where the symptoms are no longer stable.

Things become worse where you might find that the affected person now has a different personality.

Depending on the cause of this dementia, many people will start going through anxiety, depression and have mood swings.

This usually occurs because a person is more aware of the changes that are happening to their bodies. Some people will become overly emotional and a majority are prone to apathy.

Other behavioral changes may include increased agitation and irritability.

Increased agitation and irritability

There may also be sessions where they are certain outbursts where a person can either cry or laugh inappropriately.

Hallucinations and delusions may also be part of the equation.

In severe cases, a percentage of individuals who have vascular dementia will also experience epilepsy episodes. Loss of social skills is also common at this stage.

You may find that a person who has the disease no longer wants to be a part of the social circles they were in before. They may not want to talk to the people they love.

You may notice that they want to spend more time indoors as a means of shutting out the world.

Most of the time, this usually comes about because a person is embarrassed about what they are going through seeing that they are no longer in complete control of their lives.

Several physical signs may also be prevalent during the middle stages of vascular dementia.

This is where a person may experience loss of bowel or bladder control. Some may also experience dizziness and tremors often.

Caregivers may also notice that the persons under their care are experiencing arm and leg weakness and maybe moving around with shuffling rapid steps.

Language and speech problems

If a person was speaking well in the past, slurred speech and other language problems might also start to show up.

Individuals with this illness should also get close monitoring when they are on the move. That’s because they tend to get lost even when they are in familiar surroundings.

Doing things like paying bills handling money or engaging in their favorite hobby becomes challenging, which can prove to be quite frustrating to the ill individual.

It’s not uncommon for a person with the illness to have difficulties sleeping during this phase.

Some individuals also display repetitive, obsessive or even impulsive behavior.

If a person is staying alone at this point, it would be best to make different housing arrangements.

They can move in with relatives who will act as caregivers and also keep an eye on the persons with the illness to prevent avoidable accidents.

If this is not possible, the family might have to look into senior care facilities where persons with vascular dementia will get professional care.

This is simply because a person at this point may need support with multiple day-to-day activities.

These may include showering, walking, dressing, eating, cooking, and using the restroom, among others.

3rd Stage

vascular dementia stages
You can consider this one of the final vascular dementia stages. The symptoms that persons experience at this stage are normally severe.

These can be distressing to the weak person.

If one gets vascular dementia after suffering a stroke, the aftermath can bring out physical symptoms.

They can experience problems with speech, vision, and weakness of the limbs. These symptoms will surface if the stroke caused damage to certain parts of the brain.

Individuals who have vascular dementia may also experience similar symptoms to the people who are in their last stages of Alzheimer’s disease.

It is where issues with communication, reasoning, confusion, memory loss, and disorientation become worse.

Motor challenges

A majority of people with vascular dementia also experience motor symptoms that may include unsteady or slow gait disturbance and clumsiness.

Handling daily activities becomes increasingly difficult, too.

Delusions or hallucinations that would come and go during the previous stage worsen.

At times, persons with vascular dementia may also become violent, suspicious, and demanding of people who are around them.

Many persons have a difficult time eating and swallowing. This often leads to rapid unhealthy weight loss. Some may even experience loss of speech.

Almost everyone at this point will have significant problems with both long-term and short-term memory.

As the condition becomes worse, it may affect/damage all the functions of the brain. This is also the stage where the illness deteriorates and can end up being fatal.

Some people at this stage can also go through heart attacks or a major stroke that can end their lives.

During this stage, it might be difficult for the family to render the appropriate care. Especially if they are not around their loved ones 24/7.

This calls for other measures such as hiring a professional who will move in to look after the person who has vascular dementia.

Alternatively, the individual might have to move into a senior care community.

A place that looks after people with dementia to get the kind of assistance and care they need without compromising their health.

Closing Remarks

Anyone who has vascular dementia should not think of it as a death sentence. It is still possible to live a full life even when going through the various vascular dementia stages.

Always remember that different people will experience vascular dementia differently.

While some may go through gradual changes, others will experience a decline in cognitive abilities, which is followed closely by stability periods.

This does not last because there are other step downs in abilities and then stability for a while, and so forth. This is what is called “stepwise” or “step-like progression.”

When your grandparent manages to catch vascular dementia in its early stage, he or she can come up with an effective treatment plan.

This will slow down the illness, preventing it from becoming worse at a fast rate.

Professional doctors have the know-how to identify the underlying cause of the illness.

The expert will come up with a healthy program you can use to reduce the risk of complications that may crop up in the future.

This might include a total change in lifestyle that will slow down the progression of the disease.

Most professionals will recommend that you get moving to increase your physical fitness and blood flow. Additionally, eat a balanced diet, get on a routine, and quit smoking and drinking alcohol.

On average, reports indicate that persons with vascular dementia will live for about five years after they detect the symptoms.

There are, however, many people who have lived for more than five years.

3 Lewy Body Dementia Stages and Progression

lewy body dementia stages

It is important for individuals to know Lewy body dementia stages, especially if you or a loved one is affected by the condition.

This helps you to understand what to expect so that you can tackle it head-on without any unwelcome surprises.

Before we go deep into the stages, let’s get an overview of what Lewy body dementia (LBD) is and its progression.

What is Lewy Body Dementia?

Lewy body dementia is a type of brain disorder where Lewy bodies start to build up in areas of the brain.

These are microscopic deposits that damage the brain and may eventually lead to the death of the brain’s nerve cells.

Lewy bodies are abnormal protein deposits known as alpha-synuclein.

The build-up of these proteins can affect a person’s thinking capacity, movement, bladder and bowel movements, autonomic body functions, and behavior, etc.

A person with Lewy body dementia often showcases symptoms similar to those of Parkinson’s disease. One of the main reasons it is often misdiagnosed as such.

People with Alzheimer’s disease also have Lewy bodies.

The condition is diagnosed through a sequence of tests that include both neurological and physical tests. During these tests, a person’s memory, visuospatial skills, and attention span undergo assessment.

At times, the doctors may also recommend MRI and CT brain scans to confirm the diagnosis along with blood tests.

The disease mostly affects individuals who are above the age of sixty though there are a few cases where a person may get it when they are younger.

Progression of Lewy Body Dementia

progression of lewy body dementia
One of the things that you must note is that Lewy body dementia does not have a straight progression path. It, however, has some characteristics that are likely to show up during the early stages.

Other symptoms also come about when a person already has the illness in the later stages.

What stands out with LBD is that the symptoms often fluctuate.

Many at times a person may function well one day and the next, they experience intense and abrupt memory loss. This can be quite puzzling to people around them, as this may also happen in a single day.

Understanding the fluctuation aspect of the disease is helpful to the person with the condition and those around them as well.

This way, a person will not feel like the affected individual is pretending to forget or like they have moved from one stage of the disease to the next.

While in all honesty, variation in functioning is typically a constant with almost all of the stages of Lewy body dementia.

On average, after diagnosis, people with Lewy body dementia will live for six to twelve years though some live longer, for twenty or more years.

Lewy Body Dementia Stages

With a little bit of information about Lewy body dementia, it’s now time to jump into the stages of the disease. Like many other dementia types out there, the phases are not cast in stone.

This dementia type also tends to develop at a very slow pace.

Different people may have different experiences.

Below we will tackle three stages that a person with Lewy body dementia may go through.

Stage One

During the onset of the disease, there are a few changes that an individual with Lewy body dementia may experience. Some of the early symptoms may include:

  • Hallucinations
  • Restlessness
  • REM sleep disorder where a person acts out dreams
  • Minimal movement difficulties
  • Incontinence
  • Increased day time sleep (two hours plus)
  • Loss of interest and initiative
  • Vision, hearing and speech problems
  • Fluctuations in mood, etc.

At this point, memory is usually still intact, although some mild cognitive changes and slight confusion may be present.

The majority of individuals with LBD can live pretty healthy lives going to work and socializing.

Stage Two

As the disease develops towards the middle Lewy body dementia stages, the symptoms become more prominent. Many people usually start to seek medical attention at this point because the changes in the body become clearer.

The symptoms that people may showcase at this stage strongly mirror those of Parkinson’s disease. They may include:

  • Increased impairment of the motor functions of the body
  • Difficulties swallowing
  • Challenges with speech
  • Diminishing balance and stability
  • Delusions and paranoia becomes worse than before
  • Leaning to one side when sitting, walking, or standing
  • Agitation
  • Capgrass Syndrome (thinking or seeing identical duplicates of objects, people, locations, etc.)
  • Continued cognition decline which may bring about long periods of confusion

Most people at this stage are relatively independent and can perform a majority of daily living activities without needing a hand.

These can include things like taking a bath, eating, and even taking medication though this differs from one individual to the next.

A few individuals may need supervision as they go about their day to day activities, while others may be more dependent on their caregivers.

During this stage, it is also advisable for caregivers to have Medical Power Of Attorney and Power of Attorney document on the person with the disease as it is usually downhill from here.

Individuals with the disease should also collaborate with their family members to identify ways of protecting their wealth and assets.

Some unscrupulous individuals can take advantage of people with the disease and may end up getting away with it if proper protection channels are not put in place.

Stage 3

During the final Lewy body dementia stage, symptoms become worse than what people experience during the early and middle stages.

Many will agree that during this point the illness affects almost every aspect of an individual.

From the way one moves, talks, thinks, and their mood amongst many others.

Some people may complain of extreme sensitivity to touch, as well as muscle rigidity. The speech also becomes difficult with some people whispering while others may not talk at all.

Proper diagnosis at this point is more likely. Other symptoms that a person will possibly showcase are:

  • Higher risk of falls
  • Problems with transfers and ambulation to an extent that one may need a Hoyer Lift, hospital bed, suction machine, or other aids.
  • Stronger autonomic dysfunctions
  • More frequent incontinence episodes of bowel and bladder
  • Impaired speech where volume/projection may significantly decrease
  • Inability to drive
  • Unable to take medications without help
  • Unable to take part in hobbies and other leisure activities a person may have enjoyed before
  • Higher confusion levels
  • Inability to comprehend the passing of time
  • Higher risk of skin breakouts
  • More muscle contractions especially in the arms, and legs
  • Difficulties eating and drinking (a few persons may require feeding tubes
  • Excessive drooling, chocking, and aspiration
  • Sleeping more hours during the daytime and having problems sleeping at night
  • Hallucinations are prevalent but they tend to be less troublesome
  • Mood fluctuations where a person may experience a mixture of anger, anxiety, paranoia, and depression. In such cases, medical monitoring becomes a priority.

It’s also important to note that symptoms from the earlier stages can also show up during this phase.

Many people at this stage cannot function on their own; thus, care becomes a necessity in almost all aspects of their lives.

It may mean that a person may have to resign if they were still working or running their businesses.

Some individuals may respond to simple commands or follow brief conversations without any difficulty.

It’s also worth mentioning that fluctuations may decrease or increase during these final Lewy body dementia stages.

Extra care is essential

Persons may require long-term care to avoid problems that come with a personal safety risk, psychological symptoms, health, and caregiver risk.

This implies that a person may need a professional caregiver who goes to their house regularly.

Alternatively, an individual may move into a senior care facility that offers care services to golden agers who have Lewy body dementia.

This heavily affects the finances of the person with LBD. The illness also causes people to become susceptible to other infections and diseases like pneumonia because the immune system becomes weaker over time.

The introduction of new medical conditions may hit someone hard because some cases end up being fatal.

Closing Remarks

Lewy body dementia is not a rare disease as it affects millions of individuals and their families all over the globe.

Each person, nonetheless, experiences LBD differently. After reading through Lewy body dementia stages, it is worth noting that a majority of the symptoms of the illness are treatable.

Your doctor can prescribe medication that will treat symptoms related to other illnesses like Parkinson’s and Alzheimer’s disease.

These usually offer symptomatic benefits for movement, cognitive, and behavioral problems.

Accurate and early diagnosis of LBD is also essential. This is because the affected person can jump on a comprehensive treatment plan as soon as possible to enhance the quality of life.

People who have Lewy body dementia should not be left to face this disease on their own.

They need all the support they can get from loved ones and professional doctors as well.

Further research on LBD is also required because currently, there is no sure way of preventing or curing Lewy body dementia.

More physician education about the disease is also vital as this will help to reduce the cases of misdiagnosis.

This way, the experts will be able to differentiate the symptoms of Lewy body dementia and other memory-related illnesses.

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