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What is stage 5 Alzheimer's?

The fifth of seven stages is called the moderately severe decline. The individual begins to need help with daily activities. A person may experience confusion with time and place, difficulties recalling personal details, and difficulties dressing oneself. For example, buttoning a shirt is increasingly difficult for a person in stage five. The seven stages system was developed by Dr. Barry Reisberg.

As mentioned in “What are the 7 stages of Alzheimer's”, Alzheimer’s is a progressive disease.

Moving from the fourth to the fifth stage brings a new set of problems with it.

Table of Content
Significant confusion with time and place
Difficulties recalling personal details
Difficulties with everyday activity
A Word from the author
List of Resources
About the Author

Significant confusion with time and place

Your beloved person might face confusing situations with places and time daily.

The Mini-Mental-Status-Test is assessing the severity of this confusion. For example, a question can be “where are you right now”, “in which hospital are you right now”, or “in what room number are you”.

They seem like very simple questions for a healthy person. But, keep in mind Alzheimer's is a progressive disease beginning with mild memory loss and possibly leading to loss of the ability to carry on a conversation and respond to the environment.

However, damaged neuronal circuits responsible for spatial orientation can not anymore deliver the information needed to answer correctly.

The brain structure responsible to navigate the spatial environment is called the hippocampus.


The Hippocampus is responsible to navigate through a spatial environment.

Hippocampus is embedded deep into the temporal lobe.

The confusion with time and seasons is also tested by the Mini-Mental-Status-Test.

Again, the Mini-Mental-Status-Test is assessing the severity of this confusion. For instance, a question can be “what day of the week is it today?” or “what month do we have currently?”.


The Mini-Mental-Status-Test measures cognitive impairment.

There are various brain regions associated with the sense of time, including the basal ganglia, cerebellum, frontal cortex, hippocampus, and parietal cortex.

Damaged neuronal circuits in these areas might be responsible for the confusion with time.

Therefore, the beloved person begins to need help with daily activities.

Difficulties recalling personal details

In stage five recalling details about oneself becomes difficult. On a good day, the information might be present, however, other times it might not be.


In stage five recalling details about oneself becomes difficult.

Typically, recalling one’s phone number is not anymore possible.

The first numbers might come easy, but your beloved one might forget ending numbers or mix numbers in-between.

One’s age is often not the right one. My grandpa always thought he would be 70, however his age was 89 at this time.

Other personal details that either get mixed up or are not anymore recallable are:

What do stage 5 Alzheimer’s patient forget?
8 Examples
1. Date of Marriage
2. One’s own birthday
3. Birthday of Others
4. Passwords
5. One’s own middle name
6. One’s own place of birth
7. How many children one has
8. Specific personal dates (e.g. engagement day)

There is more to the list, however, it depends on the person.

Difficulties with everyday activity

In the fifth stage, the individual is capable to go to the toilet and shower themselves, usually.

Besides, keep in mind worldwide, around 50 million people have dementia, and there are nearly 10 million new cases every year.. Thus, there are plenty individuals needing help in their daily activities.

Such daily activity can include:

Daily activities someone with stage 5 Alzheimer's needs help with
10 Examples
1. Cutting paper
2. Preparing food
3. Finding things (e. g. keys)
4. Making financial decision
5. Going shopping
6. Having a hobby
7. Walking (e. g. in a park)
8. Going to bed
9. Cleaning the house
10. Brushing teeth

A Word from the author

I would like to point out, that someone in this stage is still capable to do a lot of things. However, the help is most needed where the fine motor skill is required.

The additional help should only serve as a way to keeping one’s independence.

In “What are the 7 stages of Alzheimer's” you will see that in the following stages the sense of independence decreases more and more.

So there you have it. These are things to expect in stage five. However, independence is still given in most aspects of life.

List of Resources

Patric Pförtner

B. Sc. Psychology

Hi, my name is Patric Pfoertner and I graduated 2020 from the NBU. Currently, I work and study in Germany. My specialisations are Cognitive Psychology paired with a good slack of Clinical Psychology. Just this year I started publishing my research in the CBB Journal. Feel free to read about it at ResearchGate. Otherwise, click the other button to read my full CV.

About Author ResearchGate

P.S.: I am available for psychological consultation, too.