Key points

The functional assessment staging (FAST) scale for Alzheimer's was developed by Dr. Barry Reisberg to outline the decline of people with Alzheimer's disease into seven major stages.

Stage Situation Symptoms
Stage 1: Normal adult Intact functional abilities, both subjectively and objectively. Able to recall events that happened in the previous five to 10 years.
Stage 2: Normal older adult
  • Subjective functional impairments.
  • No objective evidence of decline in occupational and social functioning.
  • Complains of forgetting names and the location of object.
  • Shows concern regarding symptoms.
Stage 3: Early Alzheimer's disease
  • Objective evidence of decline in occupational and social functioning.
  • Forgets important appointments.
  • Difficulty in traveling to new locations.
  • May refuse to participate in demanding occupational and social activities.
  • Able to handle daily routines such as shopping and handling finances.
Stage 4: Mild Alzheimer's disease
  • Decreased ability to perform complex tasks in daily life.
  • Difficulties in shopping, handling finances and planning dinner for guests.
  • Limited use of vocabulary and less motivated to speak.
  • Able to dress, bathe, choose clothing and travel to familiar locations alone.
Stage 5: Moderate Alzheimer's disease
  • Needs assistance in performing basic tasks of daily life.
  • Needs assistance in choosing proper clothing for the season or occasion.
  • Often needs reminders for bathing.
  • Able to put on clothing and bathe independently.
Stage 6: Moderately severe Alzheimer's disease
  • Impaired ability to dress, bathe, and go to the toilet independently.
  • Unable to put on clothing or shoes properly or unable to tie shoelaces.
  • Unable to bathe independently, such as having trouble adjusting water temperature, washing properly, or dry oneself completely.
  • Unable to go to the toilet independently, such as having trouble flushing, wiping properly, pulling up pants and trousers.
  • Unable to speak in complete sentences.
  • Walks only with great concentration or in smaller steps.
  • Urinary incontinence.
  • Fecal incontinence.
Stage 7: Severe Alzheimer's disease
  • Loss of speech, locomotion and consciousness.
  • Able to speak about half a dozen words only.
  • Intelligible vocabulary limited to single terms like "yes," "no" or "OK." Expresses with grunts and screams if the ability to speak this last word is lost.
  • Unable to walk without assistance.
  • Unable to sit up independently.
  • Unable to smile.
  • Unable to recognize familiar people or objects.
  • Unable to hold up the head independently.
  • May make noise without external stimulus.

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