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Providing Evidence-based Oral Health Care to Individuals Diagnosed with Degenerative Disorders, Part 3: Alzheimer'€s Disease
Stages of Disease

Course Author(s): Melanie Simmer-Beck, RDH, PhD

Stages of Disease

There are three stages of AD: mild, moderate, and severe. The stages and symptoms associated with each stage are described in Table 1. Providers can use the stages listed in this table as a guide to predict how individual’s abilities may change. These stages should not be used to label an individual or to impose expectations.41 The rate each person transitions through AD will vary from individual to individual. The moderate stage generally lasts the longest. It is common for individuals to experience symptoms of more than one stage concurrently. As the disease progresses to the severe stage, individuals may experience difficulties moving which increases their susceptibility to infections such as pneumonia.1,40

Table 1. Stages of Alzheimer’s Disease.40
StageSymptoms individuals may experience
Mild
(early-stage)
  • Problems coming up with the right word or name
  • Trouble remembering names when introduced to new people
  • 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
(middle-stage)
  • Forgetfulness of events or about one’s own personal history
  • Feeling moody or withdrawn, especially in socially or mentally challenging situations
  • Being unable to recall their own address or telephone number or the high school or college from which they graduated
  • Confusion about where they are or what day it is
  • The need for help choosing proper clothing for the season or the occasion
  • Trouble controlling bladder and bowels in some individuals
  • Changes in sleep patterns, such as sleeping during the day and becoming restless at night
  • An increased risk of wandering and becoming lost
  • Personality and behavioral changes, including suspiciousness and delusions or compulsive, repetitive behavior like hand-wringing or tissue shredding
Severe
(late-stage)
  • Need for full-time, around-the-clock assistance with daily personal care
  • Loss of awareness of recent experiences as well as of their surroundings
  • Need for high levels of assistance with daily activities and personal care
  • Changes in physical abilities, including the ability to walk, sit and, eventually, swallow
  • Increasing difficulty communicating
  • Vulnerability to infections, especially pneumonia
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