The Alzheimer’s Tiered Progression Matrix (Pro-Ma): A Functional Framework for Clinical Staging and Care Planning in Alzheimer’s Disease

Abstract

Alzheimer’s disease is often staged using vague descriptors such as mild, moderate, and severe. These terms lack functional clarity and do not reflect the observable needs of individuals, or the support required by care teams. This paper introduces the Alzheimer’s Tiered Progression Matrix (Pro-Ma), a structured framework based on functional progression and observed behavioral stability. The Matrix includes three clinically relevant progressive phases Neuroamnestic, Neuroadverse, and Neuroabsentia and three dynamic functional tiers within each phase: Emerging, Sustained, and Transitional. The Pro-Ma enhances interdisciplinary communication, care planning, and person-centered support by grounding staging in real-world observation and supplementing with biomarker-informed insight. This framework is designed for broad application across clinical, residential, and community care environments.