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Stage 1: No impairment
Stage 2: Very mild cognitive decline
Stage 3: Mild cognitive decline
Stage 4: Moderate cognitive decline
Stage 5: Moderately severe cognitive decline
Stage 6: Severe cognitive decline
Stage 7: Very severe cognitive decline


Alzheimer's disease gets worse over time. Experts have developed "stages" to describe how a person's abilities change from normal function through advanced Alzheimer's.

It is important to keep in mind that stages are general guides, and symptoms vary greatly. Not everyone will experience the same symptoms or progress at the same rate.


Stage 1: No impairment
(normal function)


Stage 2: Very mild cognitive decline


Stage 3: Mild cognitive decline

Early-stage Alzheimer's can be diagnosed in some, but not all, individuals with these symptoms. Friends, family or co-workers begin to notice deficiencies. Problems with memory or concentration may be measurable in clinical testing or discernible during a detailed medical interview. Common difficulties include:

  • Decreased ability to remember names when introduced to new people
  • Reading a passage and retaining little material
  • Losing or misplacing a valuable object
  • Decline in ability to plan or organize

Stage 4: Moderate cognitive decline
(mild or early-stage Alzheimer's disease)


  • Decreased knowledge of recent occasions or current events
  • Impaired ability to perform challenging mental arithmetic – for example, to count backward from 100 by 7s
  • Decreased capacity to perform complex tasks, such as marketing, planning dinner for guests or paying bills and managing finances
  • Reduced memory of personal history

Stage 5: Moderately severe cognitive decline
(moderate or midstage Alzheimer's disease)


  • Be unable during a medical interview to recall such important details as their current address, their telephone number, or the name of the college or high school from which they graduated
  • Need help choosing proper clothing for the season or the occasion
  • Usually retain substantial knowledge about themselves and know their own names and the names of their spouses or children
  • Usually require no assistance with eating or using the toilet

Stage 6: Severe cognitive decline
(moderately severe or midstage Alzheimer's disease)


  • Recollect their personal histories imperfectly, although they generally recall their own names
  • Occasionally forget the name of their spouses or primary caregivers but generally can distinguish familiar from unfamiliar faces
  • Experience disruption of their normal sleep/waking cycles
  • Have increasing episodes of urinary or fecal incontinence
  • Experience significant personality changes and behavioral symptoms, including suspiciousness and delusions (for example, believing that a caregiver is an impostor); hallucinations (seeing or hearing things that are not really there); or compulsive, repetitive behaviors such as hand-wringing or tissue shredding
  • Tend to wander and become lost

Stage 7: Very severe cognitive decline
(severe or late-stage Alzheimer's disease)


Individuals at this stage need help with much of their daily care, including eating or using the toilet. They may also lose their capacity to smile, to sit without support and to hold their heads up. Reflexes become abnormal. Muscles grow rigid. Swallowing is impaired.

Next: Asians and Pacific Islanders and Alzheimer's


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