This 7-stage framework is based on a system developed by
Barry Reisberg, M.D., clinical director
New York University School of Medicine's Silberstein Aging and Dementia Research Center.
Not everyone will experience the same symptoms or progress at the same rate. Remember: It is difficult to place a person with Alzheimer's in a specific stage, as stages may overlap.
No impairment (normal function)
- The person does not experience any memory problems. An interview with a medical professional does not show any evidence of symptoms of dementia.
Very mild cognitive decline
(may be normal age-related changes or earliest signs of Alzheimer's disease)
- The person may feel as if he or she is having memory lapses — forgetting familiar words or the location of everyday objects. But no symptoms of dementia can be detected during a medical examination or by friends, family or co-workers.
Mild cognitive decline
(early-stage Alzheimer's can be diagnosed in some, but not all, individuals with these symptoms)
Friends, family or co-workers begin to notice difficulties.
During a detailed medical interview, doctors may be able to detect problems in memory or concentration.
Common stage 3 difficulties include:
• Noticeable problems coming up with the right word or name
• Trouble remembering names when introduced to new people
• Having noticeably greater difficulty performing tasks in social or work settings Forgetting material that one has just read
• Losing or misplacing a valuable object
• Increasing trouble with planning or organizing
Moderate cognitive decline
(Mild or early-stage Alzheimer's disease)
At this point, a careful medical interview should be able to detect clear-cut symptoms in several areas:
• Forgetfulness of recent events
• Impaired ability to perform challenging mental arithmetic — for example, counting backward from 100 by 7's.
• Greater difficulty performing complex tasks, such as planning dinner for guests, paying bills or managing finances.
• Forgetfulness about one's own personal history
• Becoming moody or withdrawn, especially in socially or mentally challenging situations
Moderately severe cognitive decline
(Moderate or mid-stage Alzheimer's disease)
Gaps in memory and thinking are noticeable, and individuals begin to need help with day-to-day activities.
At this stage, those with Alzheimer's may:
• Be unable to recall their own address or telephone number or the high school or college from which they
• Become confused about where they are or what day it is
• Have trouble with less challenging mental arithmetic; such as counting backward from 40 by subtracting 4's or from 20 by 2's
• Need help choosing proper clothing for the season or the occasion
• Still remember significant details about themselves and their family
• Still require no assistance with eating or using the toilet
Severe cognitive decline
(Moderately severe or mid-stage Alzheimer's disease)
Memory continues to worsen, personality changes may take place,
and individuals need extensive help with daily activities.
At this stage, individuals may:
• Lose awareness of recent experiences as well as of their surroundings
• Remember their own name but have difficulty with their personal history
• Distinguish familiar and unfamiliar faces but have trouble remembering the name of a spouse or caregiver
• Need help dressing properly and may, without supervision, make mistakes such as putting pajamas over daytime clothes or shoes on the wrong feet
• Experience major changes in sleep patterns — sleeping during the day and becoming restless at night
• Need help handling details of toileting (for example, flushing the toilet, wiping or disposing of tissue properly)
• Have increasingly frequent trouble controlling their bladder or bowels
• Experience major personality and behavioral changes, including suspiciousness and delusions (such as believing that their caregiver is an impostor)or compulsive, repetitive behavior like hand-wringing or tissue shredding
• Tend to wander or become lost
Very severe cognitive decline
(Severe or late-stage Alzheimer's disease)
In the final stage of this disease, individuals lose the ability to respond to their environment,
to carry on a conversation and, eventually, to control movement.
They may still say words or phrases.
At this stage,
- Individuals need help with much of their daily personal care, including eating or using the toilet.
- They may also lose the ability to smile, to sit without support and to hold their heads up.
- Reflexes become abnormal.
- Muscles grow rigid.
- Swallowing impaired. (reported by Shelly Monahan, KREM News, September 7, 2013)
- An estimated 10,000 people in Spokane have been diagnosed with Alzheimer's disease.
- Alzheimer's is the 3rd leading cause of death in the state of Washington. Nationwide, it is the 6th leading cause of death. (Alzheimer's Association of the Inland Northwest)
- 5.3 million people in the U.S.
have Alzheimer’s. One in 10 persons over 65 and nearly half of those
over 85 have Alzheimer's disease. 13.8 million people over age 65 will be afflicted by 2050. (Rush Institute for Healthy Aging)
- There is no cure for
Alzheimer's disease. 14 million Americans will have Alzheimer's by the
middle of this century unless a cure or prevention is found. (Rush Institute for Healthy Aging)
- Good news for grandparents. A
grandchild for one day keeps grandma mentally sharp and keeps dementia
away. Research shows that grandparents who look after their
grandchildren at least once a week are less likely to develop
Alzheimer’s. The Baptist study showed that post-menopausal women who
take care of grandchildren may help them reduce their risk of
Alzheimer’s and other forms of cognitive decline; however, if
grandparents were caregivers for 5 days or more, their cognitive
function declined. Although an exact reason for the correlation isn’t
clear, researchers speculate that regular social interaction can have a
positive effect on seniors.
“Spending Time with Grandma - Caring for Grandkids may reduce Alzheimer’s risk,” by George McIntyre, CBS This Morning, January 25, 2015.
"Grandma's brain benefits from time with the little ones," by Jessica Firger, CBS News, April 9, 2014
- Alzheimer's disease costs the U.S. at least $100 billion a year.
- A person with Alzheimer's disease will live an average of eight years.
- Alzheimer's disease, the most common form of senile dementia, accounts for more than 60 percent of the cognitive function disorders in the aging population.
- Research has found that smoking increases the risk
of Alzheimer’s disease (AD) by as much as 50% in people 55 or older who
do not have a genetic predisposition to the disease. It appears that
nicotine worsens the effects of a brain protein that causes AD. A test
developed in 2007 which detects unusual activity in 18 proteins
associated with the disease, may be able to help predict who will be
afflicted by this disease.
- Study the stages of Alzheimer's.
- Stimulate their mind.
- Do not do for them what they can do for themselves.
(509) 473-3390 Spokane Office
1-800-272-3900 Alzheimer's helpline which operates 24 hours/day, 7 days a week, in 140 languages. Their staff
is highly trained and knowledgeable about all aspects of this disease.
The local chapter connects patients and caregivers with a caregiver action plan, helps find physicians, connects to support group options and offers online support to connect with others in similar situations. There are numerous support groups in the Spokane area, at various times
and locations. Call the Spokane office for more information.
To find a Facility which provide care for dementia and Alzheimer's clients in Spokane County, go to
Click: "We can help" in the purple bar.
Click: Community Resource Finder
Click: Housing options. Choose a housing option, and enter your Zipcode.
DAWN (Dementia & Alzheimer's WellBeing Network)
They provide personalized local care on the Palouse. It includes The DAWN Method, a set of tools that lowers stress for caregivers and helps sufferers develop skills to progress through stages of dementia.
Providence Adult Day Health
They provide supervised daytime care for people with dementia and Alzheimer's, plus caregiver support groups and more.