Dementia: 7 Stages

Alzheimer’s disease is the most common form of dementia. Others include Lewy Body dementia, vascular dementia, and frontotemporal dementia. Different forms of dementia have their own symptoms and patterns of progression.

Understanding the stages can help plan for your or your loved one’s care. The stages below are related to people with Alzheimer’s disease.

No or Little Dementia

Stage 1: Normal outward behavior. No Dementia.
Quality of life: no impact

You won’t notice any changes with your loved one. 

How You Can Help:

If you and your loved one are concerned about dementia, start to plan now. Use our tools to help your loved one document his or her values and priorities about the type of care wanted during the various stages of dementia. You can also watch for new signs that you may not have seen before.  

Stage 2: Very mild changes. No Dementia.
Quality of life: little to no impact

You still might not notice any changes in your loved one. You’ll see daily memory problems that look like a normal part of aging. You may see:

• Some difficulty finding the right words.
• The ability to make up for memory problems, such as substituting one word for another.
• Normal functioning in the home, community, and workplace.

How You Can Help:

As with Stage 1, start to plan now. Use our tools to help your loved one document his or her values and priorities about the type of care wanted during the various stages of dementia.

You can also watch for new signs that you may not have seen before.  

Stage 3. Mild Changes.
Quality of life: very little impact

You likely will start to notice changes in your loved one’s thinking and reasoning. You also will see some memory loss. You may see your loved one:  

• Show some signs of forgetfulness, such as losing an item and not being able to retrace steps to find it.
• Have some difficulty finding the right words or names.
• Take more effort to remember appointments, manage money, and manage medicines.
• Have trouble paying attention all the time.
• Begin to have problems at work.

How You Can Help:

If you haven’t already done it, help your loved one plan for when he or she might have severe dementia. Use our tools to create a document that list his or her values and priorities at different stages of dementia.

If you have, help the health care team follow your loved one’s care preferences.

You can also help with:

• Organizing appointments.
• Paying bills.
• Managing medicines, such as using a pill organizer.
• Helping to put legal and financial documents in order.
• Start to do more of the driving, if possible.

Early-Stage Dementia

Stage 4: Moderate Changes/Mild Dementia
Quality of life: very little impact

Your loved one will remember all or most of his or her past and will recognize loved ones. You have the ability to make your own healthcare decisions. You may see your loved one:

• Forget familiar words and names of items.
• Forget where things were left, like their eyeglasses or phone.
• Have some trouble with daily tasks such as laundry, cooking and shopping.
• Make more mistakes with driving and feel uncomfortable in unfamiliar places.
• Have trouble Increased trouble with keeping up with finances
• Be unable to find the right words more often
• Decreased knowledge of recent events
• Increased difficulties with problem solving

How You Can Help:

If you haven’t already done it, help your loved one plan for when he or she might have severe dementia. Use our tools to create a document that lists care values and priorities at different stages of dementia.

If you have, help the health care team follow your loved one’s care preferences.

You can also:

• Take over the driving.
• Help with everyday tasks.

Mid-Stage Dementia

Stage 5: Moderately Severe Mental Decline/Moderate Dementia
Quality of life: Moderate impact

Your loved one will likely remember some of their past and still recognize loved ones. He or she may have trouble making healthcare decisions. You may need some care in the home for day-to-day activities. You may see your loved one:

• Experience personality changes and mood swings.
• Repeat the same questions over and over again.  
• Have gaps in memory and become confused about the date, where you are, or your address and phone number.
• Need help with eating or using the toilet.
• Have trouble choosing clothing, such as what kind of close to wear for the season. 
• Have bladder problems.

How You Can Help:

If you haven’t already helped your loved one document his or her care wishes, talk with the health care team and the options for care.

If you have, help the health care team follow your loved one’s care preferences.

You can:

• Help with dressing, toileting, and other daily activities.
• Respond to repeated questions with patience. 

Stage 6: Severe Mental Decline/Moderately Severe Dementia
Quality of life: Severe impact

Your loved one will not remember much or any of the past and may not recognize you and other family and friends. He or she may have trouble making healthcare decisions. You may need 24-hour care in the home for day-to-day activities. You may see your loved one:

• Show strong personality changes and mood swings.
• Have delusions, such as thinking it is time to go to work when there is no job.
• Not be able to use the toilet or get dressed without help.
• Getting lost or wandering off.
• Have problems sleeping at night but sleep during the day.
• Lack of awareness of events and experiences.
• Changes in eating habits.
• Difficulty speaking.
• Have bladder problems.

How You Can Help:

Help the health care team follow your loved one’s care preferences. You can:

• Help with dressing, toileting, and other daily activities.
• Continue to try to connect with your loved one. Sometimes connecting in ways other than talking can help, such as listening to music or reading a story.
• Respond with patience. 

Late-Stage Dementia

Stage 7: Very Severe Mental Decline/Severe Dementia (Final stage)
Quality of life: Very severe impact

Your loved one will not remember any of the past or recognize loved ones. He or she will have likely lost the ability to make healthcare decisions. You will need 24-hour care in the home for day-to-day activities. You may see your loved one:

• Lose the ability to speak, eat or swallow.
• Not be able to use the toilet or get dressed without help.
• Not be able to walk or sit without help.
• Loss of language skills throughout this stage
• Lose all bladder and bowel control.
• Loss of muscle control
• Stop walking and may be confined to a wheelchair or bed at this time
• Often cannot recognize family members
• Almost always disoriented

How You Can Help:

Help the health care team follow your loved one’s care preferences. You can:

• Help with dressing, toileting, and other daily activities.
• Continue to try to connect with your loved one. Sometimes connecting in ways other than talking can help, such as listening to music or reading a story.
• Respond with patience. 

If you think you or a loved one may be showing signs of dementia, talk to your doctor.
The sooner the disease is diagnosed, the sooner treatment can start.

Source: Alzheimer’s Association, Stages of Alzheimer’s Disease,  derived from the Global Deterioration Scale for Assessment of Primary Degenerative Dementia (GDS).