What Are The 7 Stages of Alzheimer’s? | From “Business As Usual” to Late Stage Alzheimer’s

Everyone experiences Alzheimer’s differently. There is no one path everyone with the disease follows.

Yet, for caregivers, it’s common to want to have an idea of what to expect. To understand how the disease progresses.

In this article, answer the common question “What are the 7 stages of Alzheimer’s?”.

As you read about each stage, keep this in mind:

The stages, and how long they last, varies from individual from individual.  Some individuals may live with the disease for 25 years or more. Many of them with no outward symptoms.

Others may jump to Stage 4 or 5 seemingly overnight.

And the stages may not go in order. Someone in say, Stage 3, may progress to Stage 4 or, they could go back to Stage 2 for a while.

Again, it varies from person to person. But whatever the specifics for your loved one, understanding these stages will help you prepare for the road ahead.

What Are the 7 Stages of Alzheimer’s Disease

Stage 1: “Business As Usual”

Here’s something most people don’t realize:

Medical evidence shows that Alzheimer’s may start damaging the brain almost 2 decades before symptoms appear.

This is the period we refer to as Stage 1. There are no outward signs of the disease. A person’s cognitive function is totally normal at this stage. It’s “business as usual” for the individual.

Stage 2 – “Just Getting a Little Forgetful”

We all get forgetful from time to time. Especially as we age.

In fact, at least half of those 65 and over report they occasionally have difficulty remembering someone’s name or remembering where they left things like keys or eyeglasses.

Forgetfulness can be caused by a number of factors. Many unrelated to Alzheimer’s Disease. In confirmed cases of Alzheimer’s, however, it’s often discovered that the individual had previously exhibited “Stage 2” symptoms.

Stage 3 – “Symptoms Becoming Noticeable”

Stage 3 is where family members and close associates start to notice a person is having trouble performing certain mental tasks. Maybe they can’t find the right word when speaking. Or they have trouble remembering something they just read.

If the person is still employed, supervisors and/or co-workers may notice a decline in job performance. Especially for tasks involving complex planning or organizational skills. The person may also find it increasingly difficult to master new job skills, understand technical information or follow detailed instructions.

Concentration becomes a problem at this stage. And the inability to concentrate will often cause anxiety. When this happens, professional counselors may recommend retirement. Or they may suggest withdrawing from demanding activities to ease the psychological stress.

For the majority of people in Stage 3, obvious signs of dementia appear within two to four years.

Stage 4: “Diagnosis: Alzheimer’s”

Stage 4 is there the diagnosis of Alzheimer’s disease can be made with considerable certainty. In this Stage some of the symptoms include:

  • Increased difficulty with numbers, often apparent in their inability to manage finances (i.e., they frequently write the wrong date or wrong amount on checks or payment slips).
  • Trouble remembering the day of the week or month of the year.
  • Forgetting details from their own past.

As their personal frustration with these previously simple tasks increases, they become more reserved and less responsive to others. Rather than acknowledge the pain of their decreased mental capacity, they attempt to deny it or hide it (even from themselves). Often this is done by withdrawing from conversations and social interaction.

This Stage tends to last for an average of about 2 years.

Stage 5 – “Memory Gaps and Confusion”

This is when cognitive decline interferes with basic day to day activities.

It’s at this stage when it’s unlikely an individual will be able to live alone safely. Without help, the individual may not be able to prepare their own foods. Their ability to recall vital information such as their age, address or the current year is sporadic. They may wear the same clothes day after day – unable to choose appropriate clothes for current weather conditions.

Because they can’t make reasonable choices, they can become vulnerable to strangers and scam artists.  Loved ones and close associates will notice a marked change in the individual’s behavior, with increasing instances of unprovoked anger and suspicion.

Stage 5 lasts an average of one-and-a-half years (though this depends on other non-related health conditions).

Stage 6 – “Severe Mental and Physical Decline”

It’s at this stage where the symptoms of Alzheimer’s are severe enough to jeopardize the individual’s well-being.  Early signs of Stage 6 include:

  • An inability to dress without assistance (i.e., dressing backwards or putting street clothes over night clothes).
  • Issues with hygiene and cleanliness.
  • An inability to adjust the temperature of bathwater or brush their teeth.

As this stage progresses, they may become incontinent and require assistance with all aspects of toileting.  Because of the severity of cognitive decline, they may display little or no knowledge of their current circumstances. They may confuse loved ones with deceased relatives and/or forget the names of their parents or spouse. They exhibit difficulty in speaking. Their building fear and frustration can trigger angry emotional outbursts and aggressive behavior.

Again, based on other non-related health conditions, Stage 6 lasts an average of two-and-a-half years.

Stage 7 – “Functional Failure and Death”

Stage 7 is often referred to as “late-stage Alzheimer’s.” This is when individuals require continuous assistance in order to survive.

At this stage, speech is limited to a handful of intelligible words… at most. This is soon followed by a decrease in their ability to walk. Eventually movement itself is limited and the person becomes unable to sit or even hold their head up without assistance. The diminished functioning also affects their ability to smile, with the only observable facial expression being a grimace.

Victims of late-stage Alzheimer’s may live on in this tragic condition indefinitely, although because of other contributing factors such as pneumonia, aspiration, severe flu, infection, cancer, COPD, CHF, etc., this last stage rarely lasts more than two years. Those who do live on are likely to exhibit increased rigidity as well as “primitive” or “infantile” reflexes such as sucking before ultimately passing away.

More Alzheimer’s and Dementia Info

We hope this gives you a good answer to the question “What are the 7 stages of Alzheimer’s?”.

If you still have questions, please leave a comment below. Also, check out our other articles about Alzheimer’s and the stages of dementia.


  1. My mother in law has dementia bloodclots brain seizures HBp diebeties she is to the point she see’s and hear things that are not there she can’t remember the words she tries to say she asks for people who have passed away and doesn’t remember as well as thinking other people are ones who have passed, now she goes to the bathroom on herself a lot and doesn’t want to sleep at night at all I am her caregiver I dress her I bath her I change her diapers I cook for her and I have set up with her anywhere between 24 hours to 72 hours with no sleep I give her her medicine she is a fall hazard as well now she is to the point she lies on me she calls me names and threatens she has hit me and recently she really gotten to the point she wants to cause a problem with me she threatened to beat me and she told me I wood look beautiful in a wood box don’t know what that meant I also found a knife hid under her pillow so now I have his all my knives but she isn’t like that with other people I don’t know why I guess what I want to know is ,is it common for someone to act like that toward their caregiver? Will it get worse?can she hurt me? And at what stage do they experience the not sleeping the behaved problems the not going to the bathroom and refusing to eat or take medicine like a child. She has anxiety and on medicine but it didn’t help with the sleep are her behavior much she can’t go to family gatherings at all she doesn’t know what she wants to do most of the time and they had to restrain her to the bed at the hospital the whole time she was there I don’t understand why she treats me like this with anger but she doesn’t treat her children or other people like that this is the third time I have nursed her back to health only this time her dementia has a roll in her health she has had dementia for over seven years her children put her with me because I take good care of her I keep up with her medicine the names miligrams how its took when she takes it what not to take it with I keep up with her doctor visits as well as her health problems everything she has ever been hospitalized for and for how long everything .her children asked her about going into a nursing home she told them no and then pointed at me and said its up to her she the boss they were shocked she didn’t care what they said or thanked she was interested in what I said and thought, can you tell me what stage these things start occurring and do I have to worry about being harmed in anyway or is their a possibility she could harm me not being in the right mind not meaning to.

    • She’s lucky to have such a caring, wonderful daughter-in-law, Tammy. If you haven’t already, reach out to your local chapter of the Alzheimer’s Association. They will have some resources that can help.

  2. You have all the Alzheimer’s stages and I want to know about the dementia stages I need to know what they are please.

  3. I’m going through the same stuff with my step mom. Every day I’m accused of stealing phone numbers, clothes anything that she misplaced and can’t find. I’ve been threatened had her throw stuff at my kids and had to restrain her from hurting me. I am still unsure of the whole stage thing cause one minute she’ll be ok and the next it’s like the psychotic bitch took over. It’s hard to decipher because she will deliberately do stuff and then conveniently “ forget” that she did it. But she gets agitated when people don’t listen to her because we’re all tired of listening to the same stuff every day. I’ve had to have her taken away twice for fear she’d hurt my dad who I am also taking care of, because she gets violent. It’s a very stressful situation but elderly care is so expensive and we can’t afford to put her somewhere.

  4. I really like to know more I think that’s what my mom has we can not get her to a dr she refuses iam really concerned I would like to know is there any support groups in my area

  5. Watching my father go through yhis is heart wrenching. We try so hard to maintain his dignity as much as we can, not always easy. Since Christmas my fafher has been bedridden, has been put in depends and we have a rough time getting him to eat. He made my mom promise years ago not to put him in the nursing home and we are honoring him thst, we owe it to him. The saddest part is we know we are watching my father die and at times its beyond overehelming. We know my Dad is basically in stage 7 but we do our best to keep him comfortable and whether he understands we show him all our love. This is such a horrible disease and I do het so angry sometimes but I also feel blessed that due to employment I have been honored to spend 3 years helping my mother everyday and spend time with my Dad.

  6. My husband has i believe stage 7 alzheimers. He needs to be taken care of like a todfler child. He cant speak and ecpress himself. He gets frustrated and is very defiant. The worst hing is that he refuses to sit on the toilet and if I force him he gets aggressive. By saying that in the enf he releases everything on himself. He is 83 years old and has been diangnosed with this awgul desease about 7 years ago. What am I to expect going forward? His physical health overall id good, he still eats slowly by himself and has a good appetite. I have two sons who help alot but they cant do some of the things I need to do . Im getting depressed and i gind congort in cooking, baking and eat to cope with stress. Im overweight and is not good for me. I feel hopeless and dont know if I can endure caring for him till the end.

  7. What a well written and extremely informative article. I have been the sole caregiver for my grandma for about 2 years now and have watched many of the things discussed in this article play out in front of me. My heart breaks for Tammy as I have been there and only thank our family physician Dr Terran for working with me side by side adjusting her seraquil levels until those behaviors that were not of her norm were put into check. Since our last increase we no longer experience any outbursts, i have not been hit nor threatened, she is not as mobile but she is manageable and im able to keep her at home. Which is our goal since that is what we have promised. We are currently using depends and Im cleaning her up most days. While others she uses the rest room. Thank you again for the article and helping to remind me where we are at and what to expect.

  8. Reading this article is like reading my mother’s personal history for the last 10 years. She has progressed through each of these stages in order, and, according to these symptoms, she is now in early stage 7. Her speech has become gibberish, which is very frustrating for her and me. I can’t respond to her requests, because I can’t understand what she wants. She is having difficulty sitting up and her head droops most of the time. She has been totally incontinent for about 8 months.

    The nursing home laws for the state of NC do not allow ANY kind of restraint for nursing home patients, physical or chemical, and she has fallen numerous times. The nursing home is wonderful about looking for ways to prevent her falls, but without restraints, she still falls frequently. Fortunately she has not experienced any major injury, but I hold my breath continuously and wonder when the major fall will occur.

    Understanding the stages and symptoms is very helpful to me. I know what to look for and am not surprised when it occurs. It also makes me aware that my mother is entering the very last stage of her life, and I have put her affairs in order and have made all preparations for her death and burial.

    I will miss my mother when she dies, but I know that I have done everything I can to understand her disease, to keep her safe, comfortable, and happy, and to prepare for her death. It is a difficult road to care for one with Alzheimers, but it has its comical moments, and it has a sweetness and an intimacy to it that I will always remember after she is gone.

    • We really appreciate you sharing this Diane. It seems like you are as well prepared as possible. We wish you and your mother the best in the remaining time you have together.

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