Progression of Alzheimer’s disease

Depending on the source, the course of the disease is either divided into three phases (early stage, intermediate stage and late stage) or into seven stages, which is based on a classification according to the American researcher Dr. Barry Reisberg.

In this way, the 7 phases of the disease are presented to give a reasonable impression of the limitations associated with Alzheimer’s disease.

Stage 1 No symptoms

At this stage of the disease, Alzheimer’s is not detectable and there are no symptoms or problems that could indicate dementia. Nevertheless, this phase is already included because it is known that even the smallest changes in the metabolism of the brain have occurred years to decades before the outbreak of the disease or the symptoms.

Stage 2 Very slight impairment of perception and cognition

Very slight cognitive changes can be observed, although at this point (often at an advanced age) it is not possible to distinguish between “normal” age-related forgetfulness and Alzheimer’s dementia. Memory tests will be inconspicuous at this stage.

Stage 3 Slight limitations of perception and cognition

In this phase of the disease, family members or the social environment begin to notice cognitive limitations here and there. Now a memory test would also show some initial abnormalities. This mainly refers to the areas of word finding, organization and planning of actions or memory of names. Typical is also to confuse the place of personal (valuable) objects.

Up to level 3 almost everything is reversible!

Stage 4 Moderate limitations of perception and cognition

At this point, the limitation associated with the disease becomes quite clear. Those affected find it difficult to solve simple arithmetic tasks, pay simple bills, plan simple things like cooking for guests, and begin to forget details of their life history. Here a change of mood can often be observed: people withdraw, are in a more closed or bad mood.

Stage 5 Moderate to severe limitations of perception and cognition

Affected people need help in everyday situations, they show difficulties in dressing appropriately, cannot remember their own address or telephone number and forget important events in their lives. They often lose their connection to the time of day. However, at this stage, people are still able to go to the toilet on their own and to wash themselves.

Stage 6 Severe limitations of perception and cognition

Persons in this stage of injury require continuous help with daily tasks of life, changes in personality are evident. Those affected are no longer aware of their environment. Usually they do not recognize faces, even those of close relatives or friends, they have largely forgotten their own past. At this stage, patients lose control of their bladder and intestines and no longer manage their own body care alone. This usually goes hand in hand with the need to go away or drive, bundled with feelings of anxiety and fear.

Stage 7 Very severe limitations of perception and cognition

This is the final stage of Alzheimer’s disease and thus the stage at which those affected approach death. In this phase, people lose the ability to communicate and respond to their environment. Although individual words or short sentences may still be said, targeted communication is no longer possible and movements can no longer be controlled. Gradually, basic motor skills such as sitting, lifting the head or swallowing also become a problem.

More information at: and NYU Langone Health: