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Seven Stages of Alzheimer's Disease
Organizing and summarizing search results for youThe seven stages of Alzheimer's disease are:
- No impairment
- Very mild cognitive decline
- Mild cognitive impairment
- Moderate cognitive decline
- Moderately severe cognitive decline
- Severe cognitive decline
- Very severe cognitive decline
These stages are based on the Global Deterioration Scale (GDS) developed by Dr. Barry Reisberg, a clinical professor of psychiatry and an expert on aging and dementia. 1 2 3 The GDS helps doctors, caregivers, and patients understand the progression and impact of Alzheimer's disease on memory, thinking, behavior, and daily functioning. The stages range from normal to very severe cognitive decline, with different symptoms, duration, severity, and treatments for each stage. Here is a chart that summarizes the main features of each stage: 4
Stage Description Duration Severity Treatments and Care Options 1. No impairment No noticeable symptoms of cognitive decline. Normal memory and functioning. N/A None No treatment needed 2. Very mild cognitive decline Subjective memory loss, such as forgetting names or words, or misplacing objects. Normal performance on cognitive tests. 2 to 4 years Mild No treatment needed; monitor for changes 3. Mild cognitive impairment Objective evidence of cognitive impairment, such as difficulty with complex tasks, planning, organizing, or finding the right words. May have mood swings, anxiety, or depression. 7 years (average) Mild to moderate Consult a doctor for diagnosis and evaluation; blood tests and brain imaging may be done to rule out other causes; cholinesterase inhibitors may be prescribed to slow down cognitive decline; cognitive stimulation and physical exercise may help maintain brain health; plan for future care and legal matters 4. Moderate cognitive decline Clear-cut deficits in memory and cognition, such as forgetting personal details, having trouble with finances, getting lost, or confusing time and place. May have personality changes, mood swings, or social withdrawal. 2 to 10 years Moderate Cholinesterase inhibitors may be continued or started; lecanemab may be prescribed to reduce amyloid plaques in the brain; cognitive and behavioral therapies may help with mood and communication; assist with daily activities and safety; provide social support and engagement 5. Moderately severe cognitive decline Major gaps in memory and mental abilities, such as forgetting phone number, address, or names of family members. May need assistance with daily activities, such as dressing, bathing, or eating. May have behavioral problems, such as agitation, delusions, or hallucinations. 1 to 3+ years Moderate to severe Cholinesterase inhibitors and lecanemab may be continued; memantine may be added to regulate glutamate levels in the brain; brexpiprazole may be prescribed to treat agitation; provide personal care and supervision; use simple and clear instructions and reminders; create a calm and familiar environment 6. Severe cognitive decline Loss of awareness of surroundings and recent events. May not recognize faces, but may respond to nonverbal cues. May have difficulty communicating, walking, or controlling bladder and bowel. May exhibit personality changes, aggression, or uninhibited behavior. 1 to 2.5 years Severe Medications may be continued or adjusted; monitor for side effects and interactions; manage pain and other medical conditions; provide comfort and dignity; use nonverbal communication and sensory stimulation; consider palliative or hospice care 7. Very severe cognitive decline Near-total loss of verbal and motor skills. May not be able to speak, smile, or swallow. May be bedridden and dependent on others for all aspects of care. 6 months to 1.5 years Very severe Medications may be continued or discontinued depending on goals of care; provide end-of-life care; prevent infections and bedsores; ensure adequate hydration and nutrition; offer emotional and spiritual support 
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