Alzheimer’s disease: Mapping Out the Journey through Its 7 Stages

Alzheimer’s disease is a complex neurodegenerative condition that progresses through distinct stages, each presenting unique challenges for individuals and their caregivers. Mapping out the journey through the seven stages of Alzheimer’s provides valuable insight into the evolving nature of the disease and guides the provision of appropriate care and support. In this article, we’ll explore each stage of Alzheimer’s disease, patient well-being from its earliest symptoms to its most advanced manifestations. Misplacing your car keys, calling your neighbour by the wrong name or forgetting to buy bread at the grocery store are common memory lapses. But with age, forgetfulness happens more often, and it’s easy to begin questioning what’s normal — like if it’s a sign of Alzheimer’s disease. Alzheimer’s has progressed is important, but that’s just the beginning. With this knowledge, you can communicate more easily with your loved one’s physicians and ensure they’re getting the treatment.

Stage 1: Preclinical Alzheimer’s

At the preclinical stage, Alzheimer’s disease begins silently, with no noticeable symptoms. However, subtle changes are occurring in the brain, such as the accumulation of abnormal proteins like beta-amyloid and tau. Despite the absence of outward signs, researchers believe that these biological changes may precede clinical symptoms by many years. Alzheimer’s increases with age, it’s important to keep up with regular primary care visits to allow for screening to detect the earliest signs of disease. If you notice your loved one’s cognitive abilities beginning to slip, that may mean they’re entering the second stage of Alzheimer’s disease.

Stage 2: Mild Cognitive Impairment (MCI)

Mild Cognitive Impairment (MCI) marks the earliest detectable stage of Alzheimer’s disease. Individuals may experience subtle changes in memory, language, or other cognitive functions that are noticeable to themselves and their loved ones but do not significantly interfere with daily activities. While MCI does not always progress to Alzheimer’s, it increases the risk, prompting close monitoring and early intervention.Your loved one might have memory lapses, including forgetting people’s names or where they left their keys, but they can still drive, work and be social. However, these memory lapses become more frequent. You will probably notice this before your loved one does — and you may be able to get them treatment sooner to slow the progression.

Stage 3: Mild Alzheimer’s disease

As Alzheimer’s progresses to its mild stage, symptoms become more apparent. Memory lapses and cognitive difficulties become more frequent and noticeable. Individuals may have trouble remembering recent events or information, struggle with problem-solving or decision-making, and experience changes in mood or behaviour. Despite these challenges, individuals can often maintain a level of independence with support from caregivers.These feelings are normal, but not talking to a physician will only allow symptoms to get worse. The best way to keep symptoms at bay is to talk to your loved one’s physician about treatment options, including medications, and care planning.

Stage 4: Moderate Alzheimer’s disease

Moderate Alzheimer’s marks a significant decline in cognitive function and independence. Memory loss becomes more severe, and individuals may have difficulty recognizing familiar faces or places. Complex tasks like managing finances or following instructions become increasingly challenging. Behavioural symptoms such as agitation or wandering may also emerge, requiring increased supervision and support. During this stage — which can last for many years — your loved one will experience major difficulties with memory. They may still remember significant details about their life, such as who they are married to or what state they live in. Their memory of the distant past will usually be significantly better than their memory of day-to-day information, such as what they saw on the news or a conversation from earlier in the day.

Stage 5: Moderately Severe Alzheimer’s disease

In the moderately severe stage, individuals require substantial assistance with daily activities. Memory loss is profound, and individuals may struggle to remember personal details or important events from their past. Communication becomes increasingly difficult, and individuals may have trouble following conversations or expressing them verbally. Physical health may also deteriorate, necessitating comprehensive care and support. At this stage, your loved one will likely have trouble remembering people that are important to them, such as close family and friends. They may struggle with learning new things, and basic tasks like getting dressed might be too much for them.

Stage 6: Severe Alzheimer’s disease

Severe Alzheimer’s represents a profound decline in cognitive and functional abilities. Memory loss is severe, and individuals may no longer recognize close family members or caregivers. Basic tasks such as eating, dressing, or using the bathroom require assistance. Behavioural symptoms like aggression, agitation, or hallucinations may escalate, posing additional challenges for caregivers. Significant personality changes may continue to occur, including increased anxiety, hallucinations, delusions and paranoia. As their independence continues to decrease, your loved one may become more frustrated with you. There are both medicines and behavioural strategies that may help in these instances which you can discuss with your care team.   While the above behavioural changes are not universal and some patients may be content throughout the course of the disease.  However, when they do occur, one should remember that they are unaware of what they’re doing at this point, so don’t take it personally.

Stage 7: End-Stage Alzheimer’s disease

The final stage of Alzheimer’s is characterised by extensive cognitive and physical impairment. Individuals lose the ability to communicate verbally, walk independently, or perform basic tasks. They become increasingly dependent on caregivers for all aspects of care, including feeding, bathing, and mobility. End-of-life care focuses on maximising comfort and quality of life for individuals with advanced Alzheimer’s disease. Because of their reduced mobility, their body can also become vulnerable to infections, such as pneumonia. To help avoid infections, keep their teeth and mouth clean, treat cuts and scrapes with an antibiotic ointment right away, and make sure they get their flu shot each year. At this point, your loved one’s needs will significantly increase. They may need round-the-clock care for help with walking, sitting and eventually swallowing.


Throughout the journey with dementia, focus on what is present versus what isn’t. From this perspective, we can improve the quality of life for those living with it and those who love them. Mapping out the journey seven stages of Alzheimer’s disease provides valuable insight into the progressive nature of the condition and helps caregivers, families, and healthcare professionals anticipate and address evolving needs.Knowing how far the dementia from Alzheimer’s has progressed is important, but that’s just the beginning. With this knowledge, you can communicate more easily with your loved one’s physicians and ensure they’re getting the treatment they need. By understanding the symptoms and challenges associated with each stage, we can provide patient well-being, compassionate care and support tailored to the individual’s unique journey through Alzheimer’s disease. Through ongoing research, education, and advocacy, we strive to improve outcomes for those affected by this devastating condition and work towards a future without Alzheimer’s has progressed is important, but that’s just the beginning. With this knowledge, you can communicate more easily with your loved one’s physicians and ensure they’re getting the treatment. Alzheimer’s is not all loss. Those living with a dementia diagnosis report that while some abilities disappear, others emerge. Many folks find a new and more profound connection with loved ones. It is essential to acknowledge the losses, but focusing only on loss increases suffering.

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