Stages of Alzheimer’s Disease

Alzheimer’s disease is a progressive brain disorder that typically develops in stages - early, middle and late. Each stage of Alzheimer's disease brings different symptoms and care needs as the disease advances.  

Whether you have been diagnosed with Alzheimer's disease or know someone who has, understanding the symptoms and challenges they pose is key for ensuring effective support for patients, caregivers and loved ones.

While there are tools and assessments used to determine the progression of Alzheimer’s disease, doctors often look at a patient's daily function and behavior to help identify their stage.

What is preclinical Alzheimer’s disease?

Alzheimer’s disease can start years or decades before the onset of symptoms. Doctors and researchers call this occurrence “preclinical Alzheimer’s disease” and the condition has no symptoms.

Silent changes in the brain can occur before other signs of Alzheimer’s are noticed. Doctors might be able to diagnose preclinical Alzheimer’s disease through PET scans, genetic testing and biomarker indicators.

What are the symptoms of early-stage Alzheimer's disease?

In the early stage, people with Alzheimer’s disease are still able to function independently and perform daily tasks, including driving, working and socializing. However, other people may begin to notice differences in behavior, memory or concentration.

The patient may have trouble:

• Word-finding difficulties, such as trouble recalling the right word or name
• Short-term memory lapses, like forgetting information they just read or heard
• Losing or misplacing important items, including valuables
• Difficulty completing routine tasks, such as cleaning, cooking or yard work
• Trouble managing finances, including paying bills or budgeting
• Forgetting new names, even after recent introductions
• Getting lost in familiar places, such as while driving around their neighborhood  

What happens in middle-stage Alzheimer's disease?

As symptoms worsen, the impact of Alzheimer’s on someone grappling with the disease becomes more noticeable as they struggle to take care of their own basic needs. Patients begin to require a greater level of care and supervision, as the damage to the brain makes it difficult to express thoughts and perform routine tasks. This is typically the longest stage, sometimes lasting several years.

Patients in the middle stage of Alzheimer's disease may experience symptoms such as:

• Increased confusion, such as being unable to recall their address or phone number
• Disrupted sleep patterns, including sleeping more during the day and restlessness at night
• Disorientation, not knowing where they are or what day it is
• Emotional changes, such as moodiness or withdrawal, especially in social settings
• Memory loss of past events, including parts of their personal history
• Behavioral changes, such as suspicion, delusions, or repetitive actions
• Wandering and getting lost, often without remembering how they got there
• Motor difficulties, such as forgetting how to walk without help or struggling to chew, swallow or sit up 

What are the symptoms of late-stage Alzheimer's disease?

Those in the late stage of Alzheimer’s disease are completely dependent in all aspects of life.

Patients become unable to respond to their environment, communicate and control their movement. Their personalities change significantly and they need extensive help with all aspects of daily activities, such as grooming, dressing, bathing, eating and using the bathroom. They also lose awareness of their surroundings and physical abilities such as walking, sitting or swallowing.

Patients in the late stage of Alzheimer’s disease may experience the following symptoms:

• Severe memory loss, including forgetting personal history, friends and family
• Loss of language skills, with difficulty understanding or using spoken or written words
• Inability to express needs, even with gestures or facial expressions
• Emotional flatness or frustration, with little ability to show or understand emotion
• Fear or confusion, such as becoming upset during bathing or afraid of water
• Physical decline, including losing the ability to walk, sit up, smile or swallow 

At Banner Alzheimer’s Institute and Banner Sun Health Research Institute, our compassionate team understands the emotional and physical toll Alzheimer’s disease can have on patients and their families. We offer a range of support groups, care resources and expert treatment options across Banner Health locations to help you navigate every stage of Alzheimer’s