Alzheimer s Disease Stages and How They Progress Everyday Health MenuNewslettersSearch Alzheimer's Disease Alzheimer s Disease Stages and How They ProgressHow Alzheimer’s progresses can be very unique to each person, but you can recognize the general stages with this guide. By Pamela KaufmanMedically Reviewed by Michael R. Yochelson, MD, MBAReviewed: August 11, 2022Medically ReviewedOver time, Alzheimer’s disease causes neuron death and tissue loss throughout the brain.Getty ImagesAlzheimer’s is a progressive disease that damages neurons (nerve cells) in the brain, affecting a person’s ability to remember, reason, judge, use language, and otherwise meet the demands of daily life. While there are treatments that can help sharpen the mind for a short while and make behavioral symptoms more manageable, there is currently no cure. In a typical case, Alzheimer’s first destroys neurons and their connections in parts of the brain that retain memories, including the entorhinal cortex and hippocampus. Later the disease causes damage to regions in the cerebral cortex that control language, reasoning, and social behavior. Eventually many other parts of the brain are affected. (1) Ultimately the disease is fatal. On average people with Alzheimer’s live for four to eight years after diagnosis, although some can live as long as 20 years depending on other factors. (2) More than one-half of all Alzheimer’s-related deaths are caused by respiratory system diseases, such as pneumonia, an infection that can develop when swallowing issues result in food and liquid entering the lungs. (3) Every person with Alzheimer’s will experience the disease in a different way. Some retain their cognitive abilities for longer than expected, while others move more quickly through the various stages. Among the factors that influence the speed of progression are age, overall health, emotional resilience, medication regimen, and network of support. Outlining the stages of Alzheimer’s is helpful in understanding the overall arc of the disease and planning for changes to come. Still, it’s important to remember that:Some symptoms can appear earlier or later than is typical, in a different order, or not at all.Some stages can overlap.Some symptoms, such as irritability, may appear and then disappear while others, such as memory loss, continually worsen. (4) Alzheimer Disease Begins Long Before the First Symptoms Alzheimer’s disease can begin a decade or more before the first symptoms. Despite a lack of outward evidence, changes are happening in the brain. Researchers have identified a condition called mild cognitive impairment (MCI) that in some — but by no means all — individuals may be the earliest indication of Alzheimer’s or another type of dementia. MCI involves lapses in memory, language, thinking, and judgment that are noticeable to the person and his family and close friends yet are not serious enough to interfere with everyday life.According the Alzheimer’s Association, approximately one-third of those with MCI develop dementia due to Alzheimer’s within five years. (3) Unfortunately, people with MCI who experience symptoms of memory loss or impairment are less likely to recognize their own difficulties than someone with MCI who does not experience such symptoms, which can lead to delays in diagnosis. One of the highest priorities of Alzheimer’s research is understanding what happens inside the brain long before the first symptom. The hope is that these insights will lead to more effective treatments that slow or even prevent damage. After the onset of symptoms, the disease progresses through three main stages: mild (early-stage), moderate (middle-stage), and severe (late-stage). The First Stage Mild Alzheimer s Dementia A person experiencing the earliest symptoms of Alzheimer’s disease may still be able to work, drive, take part in social activities, and otherwise live independently. But they may begin to experience problems with memory or concentration. They may have trouble retaining new information — remembering the name of someone they’ve just met, for instance, or recalling material they’ve just read. Unfortunately, this symptom is often dismissed as a normal part of aging or the result of stress, delaying diagnosis and treatment. Other common symptoms of mild Alzheimer’s include:Misplacing itemsLanguage problems, such as having trouble coming up with the right wordsTrouble planning, organizing, or solving problemsLosing a sense of timeVision-related problems, such as with depth perception and color contrastIncreasingly poor judgment leading to bad decisionsMood and personality changes, such as becoming confused, anxious, irritable, or depressedDifficulty completing familiar home, work, or leisure tasks, such as managing a budgetWithdrawal from work or social engagements The Second Stage Moderate Alzheimer s Dementia In most cases of moderate Alzheimer’s dementia, the disease has spread to areas of the brain that control language, reasoning, sensory processing, and conscious thought, causing previous symptoms to become more pronounced. Damage to the brain can make it difficult for people to say what they’re thinking or complete basic tasks, such as paying bills. But they may still remember important details about their personal history. This is typically the longest stage, potentially lasting for many years. (2) Symptoms of this period may include:Increased memory loss and confusion, including forgetting names or personally significant eventsTrouble recognizing family and friendsInability to learn new things or cope with new situationsHallucinations, delusions, and paranoiaLoss of impulse control, such as undressing at inappropriate times or using vulgar languageRepetitive statements or movements, such as hand-wringing or tissue-shreddingTrouble carrying out activities that require multiple steps, such as getting dressedDifficulty reading, writing, or working with numbersIncontinenceBehavioral problems, such as moodiness or inappropriate anger outburstsRestlessness, agitation, anxiety, tearfulness, and increased risk of wandering, especially in the late afternoon or evening (a condition called sundowning) (5) The Third Stage Severe Alzheimer s Dementia People with severe Alzheimer’s dementia are completely dependent on others for around-the-clock care. They become increasingly unable to respond to their environment, communicate, and perform basic daily activities, such as dressing, eating, or bathing. They become bedridden or chair-bound. Eventually, they become unable to control movement. This stage may last from several weeks to several years. (2) Other symptoms of advanced Alzheimer’s may include:SeizuresWeight lossIncreased risk of infections, including skin infections and pneumoniaFailure to recognize family and friendsIncreased sleepingGroaning, grunting, and moaningDifficulty swallowingLoss of bowel and bladder control Even at this advanced stage, patients may experience flashes of lucidity (being aware of their situation) and some of their abilities may come back for a short while. A person with severe Alzheimer’s may be capable of experiencing a sense of happiness or safety in the presence of loved ones even when he doesn’t seem to recognize them. (4) NEWSLETTERS Sign up for our Healthy Living Newsletter SubscribeBy subscribing you agree to the Terms of Use and Privacy Policy. Editorial Sources and Fact-Checking ReferencesWhat Happens to the Brain in Alzheimer’s Disease? National Institute on Aging. May 16, 2017.Stages of Alzheimer’s. Alzheimer’s Association.2022 Alzheimer’s Disease Facts and Figures [PDF]. Alzheimer’s Association. 2022.The Progression and Stages of Dementia [PDF]. Alzheimer’s Society. 2020.What Are the Signs of Alzheimer’s Disease? National Institute on Aging. 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