The speed at which dementia progresses varies a lot from person to person.

—Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN

How does Alzheimer’s disease and dementia progress?

The speed at which dementia progresses varies a lot from person to person based on a lot of factors.

Tune in to today’s episode where I’ll talk you through the progression of dementia through the different stages and access two free resources that you can download: One on the 10 Warning Signs of Alzheimer’s disease and a Checklist of things your provider should check if you’re worried about your memory or the memory of someone you love.


Alzheimer’s disease is a degenerative disease that starts with preclinical Alzheimer’s disease which is age-related memory changes. Symptoms are usually noticeable, but not significant. People will report growing trouble with their memory, such as forgetting names of people they’ve known for a long time. Or trying to remember where they put their keys or their wallet – but in most cases they do remember these things later.


Over time, this forgetfulness may develop into a true mild cognitive impairment. At this stage, there’s much clearer evidence of memory loss that the person’s close family and friends will notice, but not other people. Biomarkers may show up on a PET scan or an analysis of the cerebral spinal fluid and the brain is not able to compensate as well.


The next stage is mild dementia which is a moderate level of cognitive decline. We can detect clear signs of this disease in a clinical situation and will have the biomarker changes. With careful evaluation, people in this stage often have trouble remembering different parts of their personal life experiences and may not be able to understand current events or have more trouble with math.

There’s also a lot of denial that there is a memory problem and you may see less emotional expression, known as either having a flat affect or being apathetic.


The next stage is moderate dementia. Memory issues are going to show up on a clinical exam. People living in this stage have trouble remembering important parts of their life, including their address, the names of their close friends or family members, their hometown, or what school they went to.

While they have trouble with recent memories, a lot of times, the major life events from their past are still retained, and they can still get to the bathroom and eat by themselves. But they would not be safe to stay at home alone.


The next stage is Severe dementia. The person has occasional trouble remembering the name of their spouse, partner, or caregiver. They will continue to have a hard time recalling recent life experiences or events. And they will have trouble counting down from 10. We may see some changes in personality and behavior, trouble with sleeping and may begin to need assistance for basic daily activities.


The last stage is Very severe or end- stage dementia where the person has lost all of their independence related to thinking, memory and control over their body. They are going to need assistance with eating, bathing and using the bathroom. They will become incontinent, and they have lost the ability to use and/ or understand words. They will become bedridden and begin to have trouble with chewing and swallowing food. When someone gets to end stage dementia, they typically do not live longer than six months.

Get your FREE downloads at from the Blog page that goes with this episode or using the links below.

10 Warning Signs

Diagnosis Checklist



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AgeWiseU is a hub of digital courses with curated resources and video content – PLUS an interactive community for caregivers of people living with dementia, adult children caring for aging parents, anyone wanting to learn more about brain health, and people who want to learn more about staying healthy as they age.

About Melissa:

Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN. I am a nurse, nurse practitioner, nurse educator and nurse researcher with over 25 years of experience in the aging and long-term care healthcare space. You can visit my website at to learn more about me, how you can work with me directly,
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Find out more about her work HERE.