What Are the Stages of Alzheimer's Disease?

Alzheimer’s disease is a brain disorder that is characterized by memory loss, confusion, and changes in personality. It is an irreversible condition that has no cure. As a result, symptoms get progressively worse, until the person is unable to perform simple daily tasks and care for themselves. Treatment can help manage the condition and slow its progression.

The progression of Alzheimer’s disease is generally categorized into four stages:

• Preclinical or prodromal stage
• Early or mild stage
• Middle or moderate stage
• Late or severe stage

However, it’s important to note that everyone experiences Alzheimer’s disease differently, and the timing and severity of their symptoms can differ. As a result, every individual may move through these stages at different rates. In some cases, the stages may even overlap, making it hard to determine exactly which stage the person is experiencing.

Preclinical Stage Alzheimer's Disease

Alzheimer’s disease is caused by harmful changes in the brain that start before any symptoms appear. These changes can begin several years or decades before symptoms become noticeable. This period is referred to as the preclinical stage of Alzheimer’s disease.

It can be hard to diagnose Alzheimer’s disease in this stage as the person doesn’t have any symptoms. However, imaging scans can detect the presence of a protein called amyloid in the brain. Alzheimer’s disease is characterized by deposits of amyloid protein in the brain, which interfere with the brain’s function.

Early Stage Alzheimer's Disease

In the early stages of Alzheimer’s disease, people may have difficulty with:

• Remembering names, particularly of people they’ve recently met
• Finding the right words to express what they want to say
• Recalling newly learned information such as recent events or something they’ve just read
• Keeping days, dates, and times straight
• Keeping track of their belongings and valuables 
• Performing daily tasks
• Concentrating on work
• Handling money and paying bills
• Planning and organizing
• Exercising sound judgment

The person may be aware of their forgetfulness, although it may be mistaken for normal signs of aging. Friends, family members, and neighbors may also start to notice the person’s memory lapses as they start to become more frequent.

Middle Stage Alzheimer's Disease

The middle stage is the longest—it can sometimes last years. 

These are some of the symptoms of middle stage Alzheimer’s disease:

• Severe memory loss and confusion
• Difficulty remembering their own name, family members, address, telephone number, and details from their personal history, such as which school they went to
• Tendency to wander and get lost
• Confusion about where they are and what day or time it is
• Inability to understand or learn new things
• Trouble with cognitive tasks like reading, writing, or dealing with numbers
• Altered sleep patterns, which may cause the person to sleep in the day and feel restless at night
• Personality changes, causing the person to become moody, withdrawn, anxious, frustrated, tearful, angry, abusive, or aggressive
• Difficulty with social situations
• Unexpected or inappropriate behavior, such as refusing to bathe or taking off their clothes in public
• Paranoid delusions, causing them to become suspicious of their loved ones
• Repetitive compulsive behaviors, such as shredding tissues or wringing hands

During this stage, symptoms start to disrupt the person’s life. Initially, the person may be able to manage with occasional assistance. Over time, they may require a greater level of care. For instance, they may need help with tasks like selecting appropriate clothing, brushing, bathing, or getting dressed. Symptoms may often get worse in the late afternoon or night.

Late Stage Alzheimer's Disease

The late stage of Alzheimer's disease is characterized by:

• Inability to sit, stand, walk, eat, swallow, or care for themselves
• Bladder or bowel incontinence
• Weight loss
• Seizures
• Skin infections 
• Difficulty with conversations, although the person may be able to say a few words or phrases
• Loss of awareness of their surroundings

Over time, the person may become bedridden and require full-time care. Family members may consider hospice services to help care for the person and ensure their comfort in the final stages.

A Word From Verywell

Being diagnosed with Alzheimer’s disease can be distressing for the individual and their loved ones. Learning about the condition and its progression can help people prepare for the road ahead and participate in their healthcare.