Alzheimer disease: Severity, associated symptoms, and recommended treatment

Dementia categoryGlobal Deterioration Scale (stages 1–7)Medications
Not demented1 No cognitive impairment
2 Very mild decline: age-associated cognitive impairment
3 Mild cognitive impairment, minor neurocognitive decline
No indication for cognitive enhancers
Mild dementia4 Decreased knowledge of current and recent events
Decreased ability to travel, handle finances, and manage basic activities of daily living
Cholinesterase inhibitors
Moderate dementia5 Unable to recall a major relevant aspect of their current life, an address or telephone number of many years, or the names of close family members
Basic activities of daily living begin to be impaired
Cholinesterase inhibitors with or without an NMDA receptor antagonist
Severe dementia6 Occasionally forgets the name of the spouse or caregiver on whom he or she is entirely dependent
Unaware of all recent events and experiences in their lives
Most basic activities of daily living impaired
Cholinesterase inhibitor (donepezil) with or without an NMDA receptor antagonist
Advanced dementia7 Cannot speak or walk, has incontinence and difficulty swallowingNo randomized controlled trials in stage 7
  • NMDA = N-methyl-d-aspartate

  • Based on information in references 11 and 12.