Stages of Alzheimer's and Dementia
Alzheimer’s disease and dementia are degenerative diseases, meaning that they will worsen over time, especially if not treated. Alzheimer’s disease and dementia progress through four general stages: Pre-Clinical, Mild, Moderate, and Severe or Final.
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Progression Overview
In this article we discuss the symptoms an individual will experience in each stage, how long each stage will last (on average) and how an individual and their family should prepare for each stage.
The lengths of the stages and the amount of mental ability lost during each may vary from person to person. However, it is critical to begin prevention and treatment as early as possible, as the disease progresses much more rapidly in the later phases. While memory loss can be slowed, in many cases significantly, it cannot be reversed.
Pre-Clinical Stage
Length: 10 to 20 years
During the pre-clinical stage there are no observable (or clinical) symptoms of Alzheimer’s or dementia. However, changes are beginning to take place in the brain and individuals can benefit from preventative measures.
Changes During the Pre-Clinical Stage
An individual will begin the pre-clinical phase with no memory or cognitive loss. As they progress through this stage they may begin to notice small changes in memory, like more frequently forgetting names and words or misplacing objects.
Common Symptoms
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Normal mental functioning.
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No significantly noticeable memory or cognitive loss.
Medical and Care Plans
Individuals should share their memory concerns freely with family members or physicians and should ask for help monitoring their symptoms. Individuals with a family history of Alzheimer’s or dementia should take additional steps to begin monitoring themselves for memory loss and to begin preventative measures.
Mild Dementia or Alzheimer’s disease (also called Mild Cognitive Impairment)
Length: 3 to 10 years
During the mild stage, symptoms of memory and cognitive loss begin to appear and worsen faster than in the pre-clinical stage. Initially, these symptoms may be indistinguishable from normal memory loss, but they will progress to the point where they can be noticed by family members or the affected individual. At this point a medical professional may be able to detect the disease.
Changes During the Mild Stage
An individual will begin the mild phase with noticeable, but minor difficulties with memory. As they progress through the mild stage, these difficulties will worsen and will likely become noticeable to family and friends. In addition to more frequently forgetting words or misplacing objects, individuals in this phase may experience increased difficulty in completing familiar tasks.
Learn More: How Much Memory Loss Is Normal?
Common Symptoms
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Increased confusion with time or place
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Forgetting words or names more frequently
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Increased difficulty performing complex, but familiar, tasks
Medical and Care Planning
The mild stage is the critical stage to begin speaking with medical professionals and begin treatment. The mild stage is when symptoms can first be identified and is also when the rate of decline begins to significantly increase.
Individuals can still benefit from preventative measures during this stage and should begin to carefully monitor their symptoms and speak with medical professionals about treatment.
Individuals should discuss medical and care plans with family and should arrange for estate-planning, if they have not already.
Learn More: Preventing Alzheimer's and Dementia
Moderate Dementia or Alzheimer’s disease
Length: 2 to 4 years
During the moderate stage symptoms of memory and cognitive loss are noticeable and will affect the daily lifestyle of the individual. Symptoms will continue to worsen and will worsen more rapidly. During this stage individuals will begin to require help caring for themselves.
Changes During the Moderate Stage
An individual will begin the moderate phase with noticeable memory loss that affects daily life. As they progress through the moderate stage, these difficulties will worsen and impact their ability to perform daily tasks and care for themselves. Eventually, individuals in the moderate stage will require help caring for themselves and performing basic daily tasks.
Common Symptoms
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Difficulty performing simple tasks
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Confusion about time or place
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Loss of interest in activities or hobbies
Medical and Care Planning
Individuals in this stage can still benefit from some preventative measures, but prevention has the highest impact when started as early as possible. Individuals should continue to monitor the state of their disease and its treatment with their healthcare practitioner.
During this stage family members will need to begin to take an increased role in the medical treatment and care of the affected individual as their ability to oversee it themselves decreases.
Severe or Final Stage of Dementia or Alzheimer’s disease
Length: 1 to 3 years
During the severe or final stage, symptoms of memory and cognitive loss will prevent the individual from caring for themselves and they will require full time care. During this stage the individual may lose the ability to communicate and will have difficulty with basic hygiene.
Changes During the Final Stage
An individual will begin the final stage with significant memory and cognition loss and will require help performing daily tasks. During this stage the memory and cognitive loss will worsen until the individual is unable to perform simple tasks and will require full-time care.
Common Symptoms
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Significant confusion with time and place
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Frequent incontinence
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Requires assistance with most aspects of self-care
Medical and Care Planning
Individuals should continue to monitor the state of their disease and its treatment with their healthcare practitioner. At this stage, individuals may wish to consider medications to reduce agitation or aid sleep.
During this stage family members will need to begin preparing for end of life care.
Summary and Recommendation
Alzheimer’s disease is a progressive disease that begins 10-20 years before any symptoms appear. As the disease progresses, it worsens at a faster rate. It is critical to begin monitoring, prevention, and treatment as early in the disease as possible. While memory loss can be slowed, in many cases significantly, it cannot be reversed.
Individuals with a family history of Alzheimer’s or dementia should take additional precautions to minimize risk.
