Stages of dementia: the 7-stage FAST scale, with a checklist
Clinicians describe how far dementia has progressed on a seven-stage scale of everyday abilities. Tick what has been true for the person you care for over the last month and this page places it on that scale, in plain words, with what the stage looks like and what typically changes next. It is a record to bring to the care team, not a diagnosis.
The seven stages at a glance
| Stage | Name | What everyday life looks like | Typical time reported* |
|---|---|---|---|
| 1 | No noticeable change | Daily life is unchanged, and neither you nor they notice anything. | — |
| 2 | Very mild change | They mention forgetting names or where they put things, but manage everything as before. | — |
| 3 | Mild | Others notice: trouble with demanding tasks, finding the way somewhere new, or keeping organised. | — |
| 4 | Moderate | Complex tasks need help: money, planning a meal for guests, shopping. | about 2 years |
| 5 | Moderately severe | Choosing clothes that suit the day or the weather needs help. | about 1.5 years |
| 6 | Severe | Help is needed with dressing, washing or the toilet, and bladder or bowel control is lost. | about 2.5 years |
| 7 | Very severe | Speech fades to a few words, then walking, sitting up, smiling and holding the head up need support. | 6 years or more |
*Averages reported for Alzheimer's disease in Reisberg (1988). Not a prediction for any one person; other dementias follow different paths.
How to use the stage
The stage is most useful as a sentence you can say to a doctor, a care home or a respite carer: "She reads as stage 6b on the FAST scale, she needs help washing now, and that changed since June." It tells them what support is needed today and how fast things are moving. It is not a score to chase, and a lower number on a good month is not a recovery.
Record it once a month, on an ordinary day. Answer for most days, not the worst one. If the person has been ill or in hospital, note it: function often dips with an infection or a fall and recovers afterwards.
What changes next is the most practical part. Each stage below says what typically follows, so you can set up help, equipment and respite before the day you need them.
What does not belong on this page
A diagnosis. Memory problems have many causes, several of them treatable, and only a clinician can tell them apart. If you are filling this in for someone who has not been assessed, the checklist is still useful: bring it to the first appointment as a description of what you see.
Frequently asked questions
What are the 7 stages of dementia?
On the FAST scale: 1 no noticeable change; 2 very mild change the person notices themselves; 3 mild, noticed by others in demanding tasks; 4 moderate, help with complex tasks such as money; 5 moderately severe, help choosing clothes; 6 severe, help with dressing, washing, the toilet and continence; 7 very severe, speech fades to a few words and then walking, sitting, smiling and head control need support.
Is this an Alzheimer’s stage quiz or test?
No. It is a checklist of everyday abilities, in plain words, placed on a published scale. It produces a caregiver’s record to bring to a clinician, who is the only person who can stage dementia. It does not diagnose or predict anything.
What is the FAST scale?
The Functional Assessment Staging Tool (Reisberg, 1988) orders everyday abilities in the sequence they are typically lost in Alzheimer’s disease, from stage 1 to stage 7, with stage 6 split into five steps and stage 7 into six. Clinicians and hospices use it because it describes function rather than test scores.
How is the FAST scale different from the GDS?
The Global Deterioration Scale (GDS) also has seven stages but describes thinking and memory; FAST describes what the person can do day to day. The two line up stage for stage. Our guide on FAST vs GDS explains both.
How long does each stage of dementia last?
Reisberg’s paper reports typical durations in Alzheimer’s disease of about 2 years at stage 4, 1.5 years at stage 5, 2.5 years at stage 6 and 6 years or more at stage 7. These are averages across many people, not predictions for one person, and other dementias follow different paths.
Can dementia stages go backwards?
A person can read earlier on a bad month and later on a good one; illness, pain, poor sleep or a hospital stay can make function dip and then recover. That is one reason to record the stage monthly rather than once, and to show the record to the care team.
Keep it over time in Anchorly
Anchorly keeps this checklist month by month, next to the daily log, the sundowning tracker and the life story, and puts the latest stage on the one-page care snapshot. Everything stays on the phone.
Free, no account, works offline. Your loved one's information stays on the phone.
Sources and wording
- Reisberg B. Functional Assessment Staging (FAST). Psychopharmacology Bulletin 1988;24(4):653–659. The seven-stage structure, the order of steps 6a–6e and 7a–7f, and the typical durations quoted here come from this paper. The checklist lines on this page are Anchorly's own plain-language descriptions, not the published instrument.
- Reisberg B, Ferris SH, de Leon MJ, Crook T. The Global Deterioration Scale for assessment of primary degenerative dementia. American Journal of Psychiatry 1982;139:1136–1139.
- Alzheimer's Association, Stages of Alzheimer's; National Institute on Aging, What happens to the brain in Alzheimer's disease; NHS, Symptoms of dementia.
Last reviewed 2026-10-17. Found something wrong? dev@adelyons.com.
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