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What Is The Functional Assessment Staging (FAST) Scale Of Alzheimer's Disease?

by Frank Herold
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As we age, we experience changes that can often make us forgetful of details or routine instances. Forgetting things could be characterized as just a normal part of aging that you don’t have to be worried about. However, if the occurrence of these forgetful moments becomes more and more frequent, and is paired with other issues arising over the course of time, it is important to reach out to a health professional for an accurate assessment.


Related Blog: Top Five Research Foundations that Dedicate Their Resources to Alzheimer's Disease

Alzheimer's Disease is a type of dementia categorized as a degenerative condition. It is most commonly contracted in an individual due to a progressive decline in cognitive function, thus resulting in problems with memory, thought patterns, and behavior.

Most people are familiar with the following terms:

  • early-stage Alzheimer's
  • mid-stage Alzheimer's
  • late-stage Alzheimer's

While these 3 terms do somewhat divide up the condition in general, there is a much more thorough scale defining a specific description of one's behavior within the 7 stages of Alzheimer's. It is important to note that symptoms do not just occur in a day, but gradually increase over time. The Functional Assessment Staging Scale, also known as the FAST scale, was developed by Barry Reisberg, MD, Clinical Director of New York University's Aging and Dementia Research Center.

The FAST scale can be analyzed as follows:


Stage 1: Unaffected Adult

Stage 1 represents an adult that does not show any signs of memory impairment. Any clinical tests performed would show that there is no measurable deficit to be found.


Stage 2: Older Adult

In Stage 2, the older adult may experience very temperate cognitive decline. This decline, where it's common to forget names or temporarily misplace items, is usually only noticeable to the individual and not to their health care provider, friends, or family members.


Stage 3: Early Alzheimer's Disease

During Stage 3, the forgetfulness the individual may have noticed in Stage 2 becomes more frequent. They now are also struggling to fully concentrate on certain tasks and may show hesitation during conversation. Stage 3 can manifest some confusion that is more noticeable to those around them, but still not a huge concern.


Stage 4: Mild Alzheimer's Disease

In Stage 4, symptoms are officially noticeable to family members and friends. These symptoms also include:

  • lack of enthusiasm in their social or work lives
  • meeting someone and then forgetting them almost instantly
  • disorganization (especially of those who were always more organized, methodical, and thorough in their approach to life)
  • decreased ability to complete common responsibilities such as planning and cooking dinner, paying bills, and keeping finances in order

Stage 5: Moderate Alzheimer's Disease

By Stage 5, the individual is no longer able to operate independently. More often than not, they are capable of recalling their own name or the name of loved ones, but not a home telephone number or address. As their forgetfulness and confusion increases and their confusion becomes much more common, more symptoms become evident:

  • Forgetfulness of personal history
  • Withdraws from social situations or situations they may find challenging. The individual tends to isolate themselves
  • Inability to make the correct clothing choices e.g. wearing a winter coat and boots in the middle of summer

Stage 6: Moderately Severe Alzheimer's Disease

In Stage 6, the individual will begin to display voids in their memory as well as a noticeable decline in their overall cognitive functioning. Their personality may begin to change and they could begin requiring more assistance with daily activities that they were once able to do independently. Along with these symptoms, they may also experience:

  • Wandering and getting lost
  • Forgetting family members names
  • Experiencing hallucinations, abnormal interactions with absent people or objects and paranoid behavior

Stage 7: Severe Alzheimer's Disease

Stage 7 is the final stage and by this time, the individual has lost most of their physical independence and their ability to communicate, almost completely. They may struggle to sleep and feel constantly disoriented and anxious.

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