Receiving an Alzheimer’s diagnosis can be overwhelming, both for the person living with the condition and for their loved ones. Along with understanding the diagnosis itself, it’s also important to know what stage of the disease you or your loved one may be in. Understanding these stages is not just about knowing what to expect. It’s also about knowing the best time to start treatments and lifestyle interventions that can help manage symptoms and improve quality of life.

Recognizing the stage can give you a clearer sense of what to expect, how symptoms may change over time, and how daily life might be affected. It can also guide you and your doctor in exploring treatment options and planning for the future with care and compassion. Here we’ll discuss the three main stages of Alzheimer’s disease, how the disease can be classified in different ways, and what you can expect during each stage.

What Are the 3 Stages of Alzheimer’s Disease?

Alzheimer’s disease can be classified in different ways. One classification involves three main stages. It’s important to note that each person may experience the stages differently. Sometimes, people may have symptoms that overlap with different stages, particularly when they’re transitioning between them. Additionally, symptoms can sometimes ebb and flow, so the progression of symptoms isn’t always a straight line. Still, understanding the stages of Alzheimer’s can help you grasp what’s going on now and know what to expect in the future.

1. Early or Mild

The earliest stage of Alzheimer’s disease is usually referred to as mild Alzheimer’s or early Alzheimer’s. In this early stage, you’ll notice that you or your loved one forgets things more often. This can look a lot like normal forgetfulness that happens when you get older. One key difference between normal aging and Alzheimer’s is that this forgetfulness can come alongside problems focusing or concentrating and difficulties with executive function, such as struggling to plan or organize. These symptoms often occur alongside memory problems and can significantly impact daily tasks.

Early signs of Alzheimer’s may look like:

• Forgetting people’s names
• Struggling to find the right word or forgetting common words
• Not remembering new information or recent events
• Misplacing objects of value
• Repeating tasks or stories
• Taking longer to finish regular, daily tasks
• Getting lost even in places that are familiar

In this stage of Alzheimer’s, many people still live on their own, care for themselves, hold a job, and take part in social activities. They may have trouble with detail-oriented tasks, like paying their bills on time, taking the right medications at the right times, or driving.

At this point, people with Alzheimer’s still have the ability to take part in planning for their future. They can decide factors like where they’ll live in the future, and they can set up their finances and have the legal documents their loved ones will need later on. They can also choose to focus the energy and cognitive ability that they have left on the things that matter the most to them. This will help improve their quality of life and sense of well-being.

2. Middle or Moderate

As Alzheimer’s disease progresses, people will have more symptoms. This may include experiencing more confusion, feeling disoriented, and having mood changes. The middle stage of Alzheimer’s usually lasts the longest. People can spend years in this stage. Within this stage, their symptoms will progress, and they’ll need more and more care to assist with daily activities.

People in this middle stage of Alzheimer’s can usually still be a part of daily activities — they just need more help and support. Caregivers can help people in middle-stage Alzheimer’s by focusing on the tasks they can still do on their own and simplifying difficult tasks. This allows people with Alzheimer’s to maintain a level of independence.

People with middle-stage Alzheimer’s may have difficulty remembering the names of loved ones and may act out in different ways. This can make it difficult to feel connected, both for the person with Alzheimer’s and their caregiver. Connection may start to look a little different than it used to, but you can both find ways to connect and spend time together during this stage.

In this stage, behavioral and psychological symptoms of dementia can become more prominent, including agitation, irritability, and social withdrawal. These behaviors are not a deliberate choice but a result of the disease affecting the brain’s emotional regulation. Seeking support from a healthcare team or joining a support group can provide strategies to manage these challenges.

What Are the Behaviors of Middle Stage Alzheimer’s?

The symptoms people experience with moderate or middle stage Alzheimer’s can vary from person to person. You may see all of these or only a few. Here are some symptoms you can expect:

• Trouble coping with new situations
• Difficulty remembering the past and learning new information
• A fluctuating ability to remember things, like their name
• Unexplained changes in mood or new personality changes, like becoming withdrawn, compulsive, or suspicious
• Changes in sleeping habits
• Problems with reading, writing, and basic math
• A greater need for help with daily tasks, like choosing clothing or personal hygiene
• A tendency to wander off and get lost

3. Late or Severe

In late-stage Alzheimer’s, people slowly lose both cognitive and physical abilities. They’ll need constant help with all aspects of their daily life.

Even though people at this stage of Alzheimer’s aren’t likely to start conversations, they still can interact with others in ways that are appropriate and helpful. Some people like to listen to music, and many respond well when they are touched gently and with love. If you’re caring for someone living with late-stage Alzheimer’s, consider showing them old photos and talking to them about the stories behind the pictures. They may not remember what happened, but they’ll see that they were surrounded by people who loved and cared for them.

During this stage, the focus of care shifts to comfort, dignity, and quality of life. This is often the time to consider involving palliative care or hospice services. These services can provide specialized support for both the person with Alzheimer’s and their family, help with symptom management, and ensure as much comfort as possible.

What Happens During Late-Stage Alzheimer’s?

During this stage, people with Alzheimer’s may:

• Lose the ability to communicate meaningfully, including communicating about their pain
• Experience changes in physical abilities, like the ability to eat, walk, or sit
• Lose control over their bladder or bowels
• Be unaware of the world around them

What Are the 7 Stages of Alzheimer’s Dementia?

There are different ways Alzheimer’s disease can be classified. In addition to the three-stage system, there’s also a system with seven stages. This is usually used by doctors and other healthcare professionals to provide more specificity about how the condition is progressing in a particular person. It’s called the Global Deterioration Scale.

Here are the stages of this scale:

• Stage 1 — The person seems normal to others, but small changes are starting in the brain. There are usually no signs of memory loss yet.
• Stage 2 — Mild forgetfulness may happen, similar to normal aging. Family and friends usually don’t notice these changes.
• Stage 3 — Memory problems and getting lost may start. The person might also have trouble finding the right words.
• Stage 4 — The person experiences moderate cognitive decline and may forget their personal history and may become more confused. They can still enjoy time with loved ones but may need more patience and support.
• Stage 5 — Daily life becomes harder without help. Confusion grows, and the person may forget many personal details.
• Stage 6 — The person experiences severe cognitive decline and may not recognize close family or friends. They need constant care; kindness and reassurance can make a big difference.
• Stage 7 — The person needs help with all daily tasks, including eating and moving. Communication is very limited, but loved ones can be there to provide comfort.

Understanding What’s Ahead

Alzheimer’s disease can feel overwhelming, but knowing what to expect at each stage can help you and your loved ones face the changes with greater confidence and compassion. While every journey is different, understanding the progression of the disease can make it easier to prepare for the future, seek the right support, and focus on meaningful moments along the way. Remember that care, patience, and connection continue to matter deeply, no matter the stage.

Join the Conversation

On myALZteam, people share their experiences with Alzheimer’s, get advice, and find support from others who understand.

Thinking about the three stages of Alzheimer’s, which signs or changes described here feel most important for you to watch for in yourself or a loved one, and why? Let others know in the comments below.