The stages of Alzheimer disease usually follow a pattern that progresses. But each person moves through the disease stages in their own way. Knowing these stages helps doctors and family members make decisions about how to care for someone who has Alzheimer disease.
Preclinical stage
Changes in the brain begin years before a person shows any signs of the disease. This time period is called preclinical Alzheimer disease and it can last for years.
Mild, early stage
Symptoms at this stage include mild forgetfulness. This may seem like the mild forgetfulness that often comes with aging. But it may also include problems with concentration.
A person may still live without help at this stage but may have problems:
- Remembering a name.
- Recalling recent events.
- Remembering where they put a valuable object.
- Making plans.
- Staying organized.
- Managing money.
The person may be aware of memory lapses. Their friends, family, or neighbors may also notice these difficulties.
Moderate, middle stage
This is typically the longest stage, often lasting many years. At this stage, symptoms include:
- Increasing trouble remembering events.
- Problems learning new things.
- Trouble with planning complicated events, like a dinner.
- Trouble remembering their own name, but not details about their own life, such as address and phone number.
- Problems with reading, writing, and working with numbers.
- Making bad decisions or having poor judgment.
As the disease progresses, the person may:
- Know that some people are familiar but not remember their names, or forget the names of a spouse or child.
- Lose track of time and place.
- Need help choosing the right clothing, getting dressed, and doing daily activities, such as brushing teeth.
- Become moody or withdrawn, or have personality changes, such as hallucinations, paranoia, or delusions.
- Be restless, agitated, anxious, or tearful, especially in the late afternoon or at night.
Physical changes may occur as well. Some people have sleep problems. Wandering away from home is often a concern.
Severe, late stage
At this stage, a person:
- Loses many physical abilities, including walking, sitting, and eating.
- May lose bowel and bladder control.
- May be able to say some words or phrases but not have a conversation.
- Needs help with all activities all the time.
- Is unaware of recent experiences and of their surroundings.
- Is more likely to get infections, especially pneumonia.