Fast Facts

Alzheimer’s is a progressive disease that consists of three stages: early (mild), middle (moderate), and late (severe).
Progression differs for each person, but on average, an individual lives four to eight years after diagnosis.
Early stage patients function independently, but begin to notice memory changes, and caregivers may begin to provide support with appointment setting, finances, medication management, transportation, etc.
Middle stage is typically longest, with symptoms becoming more obvious, requiring the simplification of daily tasks and assistance with personal care.
Late stage symptoms are severe, requiring 24/7 care, with the goal of providing comfort and maintaining quality of life.

Alzheimer’s stages and what to expect

Alzheimer’s is a progressive disease that consists of the following 3 stages: early stage (mild), middle stage (moderate), and late stage (severe). These stages offer an overview of the changes and symptoms expected as the disease progresses. It’s important to note that these are only guidelines as everyone’s experience is unique.

Typically, the brain begins experiencing changes long before people exhibit signs and symptoms. This is known as pre-clinical Alzheimer’s disease and can last several years. While disease progression differs from person to person, on average, an individual with the disease lives four to eight years after an Alzheimer’s diagnosis. Many factors, including age and other health conditions, factor into this. In fact, some individuals have lived up to 20 years following a diagnosis.

Early Stage (Mild)

Many people with Alzheimer’s still function independently in the early stages. They may still work and be socially engaged. They may begin noticing memory changes in themselves and friends and family may start noticing that they are having trouble remembering things such as familiar words or the location of everyday objects.

Common symptoms include:

Difficulty with word finding
Forgetting something she just read
Not remembering names of people she recently met
Difficulty performing routine tasks at work or socially
Losing or misplacing objects
Trouble planning or organizing

It’s important to allow the person to maintain their independence as much as safely possible. Since they are likely still independent in many areas at this stage, your role as a loved one can be to provide support with things such as:

Appointments
Managing finances
Remembering names or words
Transportation
Planning and organizing
Keeping track of medication

While individuals in this stage are generally more high-functioning and independent, you will want to keep a close eye on your loved one. You'll want to make eye contact when communicating and do so as clearly and calmly as possible.

Middle Stage

The middle stage is typically the longest and can be experienced for several years. In this stage, the dementia symptoms will start to become more obvious – for instance, they may start confusing words, become agitated, or respond in surprising ways. As the nerve cells in the brain deteriorate, they will experience challenges expressing thoughts and performing routine tasks independently. This likely means they will require more assistance with routine activities.

Symptoms, which vary by individual, include:

Forgetting personal history and events
Noticeable personality or mood changes
Disorientation regarding date and time
Increased need for assistance with personal care
Incontinence
Wandering and getting lost
Changes in sleep patterns
Thinking disturbances, such as suspicion and delusions

Individuals at this stage will require a greater level of care, but this doesn’t mean they can’t participate in their daily care. It’s critical to understand what they can do and help find ways to simplify those tasks. You will most likely have to adjust your loved ones daily routine to include more structure and may want to start looking into care options at this stage as well.

Late Stage

In the final stage of Alzheimer’s, the symptoms are severe, and can last from several weeks to several years. They may still use words or phrases but struggle with communicating emotions, pain, and preferences. They will become less tolerant of medical interventions and will require extensive 24/7 care.

Common characteristics of the late stage include:

Changes in physical abilities, including the ability to walk, sit, and eventually, swallow
Needing around-the-clock support with personal care
Not knowing their surroundings or recalling recent experiences
Increased difficulty communicating
Vulnerability to infections, particularly pneumonia

During this stage, you will want to reevaluate the goals of care and may want to use support services, such as hospice, which focuses on providing comfort and maintaining quality of life.

Though they may not engage in the same way during the late stage, you are encouraged to find new ways to communicate with them. Using your voice can offer comfort even if your loved one isn’t fully comprehending the message. Be advised to never underestimate the power of touch – such as a gentle hand massage or even holding a hand. You can also play music or read to your loved one. There are so many ways to make meaningful connections.

For more caregiving assistance, you can find live expert help by reaching out to a Care Guide via message or by scheduling a phone call.