Different symptoms characterize the seven stages of Alzheimer’s disease, ranging from forgetfulness to significant changes in personality and behavior.

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Alzheimer’s disease is the most common type of dementia, a general term for a decline in mental abilities.

According to the Alzheimer’s Association, three general stages of Alzheimer’s help determine the severity of symptoms and the disease’s progression:

  • Mild (early stage): Mild symptoms, general forgetfulness.
  • Moderate (middle stage): Disabling symptoms, more care needed.
  • Severe (late stage): Significant behavioral and personality changes, lack of awareness.

Healthcare professionals may also use Dr. Barry Reisberg’s seven major clinical stages from his 1982 Global Deterioration Scale to help diagnose Alzheimer’s disease.

Not all doctors use the same staging system, so your doctor may use the one they’re most familiar with.

Keep reading to learn more about the seven stages of Alzheimer’s disease and how to prepare for what’s to come.

You may only know about your risk of Alzheimer’s disease due to family history or if a doctor identifies biomarkers that indicate your risk.

If you’re at risk of Alzheimer’s, a doctor will ask you about memory difficulties. Typically, there are no noticeable symptoms during the first stage, which can last for years or decades.

However, research suggests that changes are happening in your brain.

Abnormal accumulation of a type of protein called tau in the fluid around your brain and spinal cord has associations with Alzheimer’s disease. Changes in the levels of this protein may occur 15 years before symptoms start.

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Someone in this stage is fully independent. They may not even know they have the disease.

Alzheimer’s disease mainly affects people over ages 65 years.

At this age, it’s common to have slight functional difficulties, such as forgetfulness. However, if you have stage 2 Alzheimer’s, you may experience a quicker cognitive decline than people without Alzheimer’s.

For example, you may experience memory lapses, such as forgetting familiar words, a family member’s name, or where you placed something.

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Symptoms at stage 2 won’t interfere with work or social activities. Memory troubles are still mild and may not be apparent to friends and family.

Stage 3 Alzheimer’s is characterized by mild cognitive impairment.

According to the Fisher Center for Alzheimer’s Research Foundation, stage 3 lasts about 7 years, but symptoms slowly become more apparent over 2–4 years. Only people closest to you will likely notice the symptoms.

Some stage 3 symptoms and signs may include:

  • decline in work quality
  • trouble learning new skills
  • getting lost when traveling a familiar route
  • struggling to remember the right words or names
  • being unable to remember what you just read
  • not remembering new names or people
  • misplacing or losing a valuable object
  • decreasing concentration during testing

A healthcare professional may conduct a more intense interview than usual to identify memory loss.

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At this stage, someone with Alzheimer’s may need counseling, especially if they have complex job responsibilities. They may also experience mild to moderate anxiety and denial.

Stage 4 lasts about 2 years and marks the beginning of diagnosable Alzheimer’s disease.

In this stage, you may experience:

  • difficulties with more complex everyday tasks, such as finances
  • more evident mood changes, such as withdrawal and denial
  • decreasing emotional responses
  • decreasing awareness of current or recent events
  • losing memory of personal history

A clinician will look for a decline in areas mentioned in stage 3.

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It’s still possible for someone to recall weather conditions, important events, and addresses. However, they may ask for help with other tasks, such as writing checks, ordering food, and buying groceries.

Stage 5 lasts about 1.5 years, and a person in this stage of Alzheimer’s will require a lot of support. Those who don’t have enough support often experience feelings of anger and suspicion.

In this stage, you may remember your name and those of close family members but may have difficulty recalling major events, weather conditions, or current addresses. You may also feel confused about time or place and have difficulty counting backward.

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People will need assistance with daily tasks and may no longer be able to live independently. They should still be able to manage personal hygiene and eating, but they may need help picking the right clothing for the weather or managing finances.

During stage 6, five identifiable characteristics develop over 2.5 years:

  • 6a. Clothes: You may need help choosing and putting on your clothes.
  • 6b. Hygiene: A decline in oral hygiene begins, and you may need help adjusting the water temperature before baths.
  • 6c, 6d, 6e. Toilet: You may forget to flush or throw tissue paper away. As the disease progresses, you’ll likely lose control of your bladder and bowels and need help with cleanliness.

By stage 6, memory is much worse, especially around current news and life events. You might have difficulty counting backward from 10 and confuse family members with other people.

It’s possible to experience:

It’s important to continue counseling for behavioral and psychological symptoms.

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Assistance with personal care, from daily tasks to hygiene, is necessary at this stage. People with stage 6 Alzheimer’s disease may also start to sleep more during the day and wander at night.

There are substages to stage 7 of Alzheimer’s disease, which may last up to 2.5 years:

  • 7a: Speech is limited to six words or fewer. A doctor will need to repeat questions during the interview.
  • 7b: Speech declines to only one recognizable word.
  • 7c: Speech is lost.
  • 7d: You’ll be unable to sit up independently.
  • 7e: Grim facial movements replace smiles.
  • 7f: You’ll no longer be able to hold your head up.

Your body movements may become more rigid and cause severe pain. According to the Alzheimer’s Association, about 40% of people with Alzheimer’s also form contractures, or shortening and hardening of muscles, tendons, and other tissues. You may also develop reflexes characteristic of infancy, such as sucking.

Some people may become immobile during this stage. The most frequent cause of death in someone with stage 7 Alzheimer’s is pneumonia.

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At this stage, a person will likely have lost their ability to respond to the environment. They’ll need help with almost all their daily tasks, including eating or moving.

Alzheimer’s typically progresses slowly and transitions from mild to severe symptoms. How fast the disease progresses will vary widely for each individual.

For example, a 2018 study found people ages 65 years in the preclinical stage (1) had a 92% chance of maintaining the same levels of cognition the following year. People ages 75 years had a 90% chance of maintaining these levels.

Your risk of developing the disease also doubles every 5 years after ages 65 years.

Although there’s no cure for Alzheimer’s, treatment may help slow each stage of the disease. Treatment aims to manage mental function and behavior and slow down symptom progression.

Your treatment plan may include a combination of:

It’s important to work with a healthcare team and a support network of family, friends, and caregivers. Together, they can help develop the best treatment plan to help slow the disease’s progression and increase your quality of life.

Researchers are continuing to improve their understanding of Alzheimer’s disease and how to prevent it.

The following risk factors have associations with cognitive decline and Alzheimer’s disease:

Medications may have limited effects on altering the course of Alzheimer’s once symptoms develop.

However, some preventive steps may lower your chances of developing the disease. For example, regular physical activity may help delay the onset of Alzheimer’s disease or slow its progression.

What is the timeline for Alzheimer’s to death?

The outlook for Alzheimer’s disease ranges widely for each individual. People with Alzheimer’s live an average of 5.8 years after receiving their diagnosis. However, some people live more than 20 years.

At what stage do people with Alzheimer’s forget family members?

People with Alzheimer’s may experience memory lapses and forget family members’ names during stage 2. As the disease progresses into the subsequent stages, you may find remembering names becomes more difficult.

How long is the last stage of Alzheimer’s?

The average length of stage 7 Alzheimer’s is 1.5–2.5 years.

What is the average age of death from Alzheimer’s?

Alzheimer’s disease is the 5th leading cause of death in people ages 65 years and older in the United States. The death rate has increased most significantly in people ages 85 years and older.

Alzheimer’s is a progressive disease that causes cognitive decline. Some doctors and healthcare professionals classify it into seven stages, depending on the severity of your symptoms.

Caring for someone with Alzheimer’s disease is a big task. You’ll experience a range of emotions as a caregiver. Support groups may help you learn and exchange best practices and strategies for managing challenging situations.