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How to Identify the 7 Stages of Dementia

Dementia is a general term that encompasses different types of disorders, including Alzheimer’s disease, dementia with Lewy Bodies, frontotemporal dementia (FTD) and others. While each type of dementia progresses differently, there are two general diagnostic models used to describe the progression of dementia: the three-stage model and the seven-stage model. With the latter, the decline of a patient is separated into more specific stages than the earlier. The seven-stage model is based off of the Global Deterioration Scale, an assessment tool created by Dr. Barry Reisberg to assist friends, family and caregivers with recognizing the clinical signs of the disease.

Prior to assessment, caregivers look at different behaviors demonstrated by the individual. Not only is memory assessed, but the person’s judgment, sense of direction, personal care and daily activities are considered as well. Based on the severity of the dementia, a care plan can be devised by a physician and the individual’s caregivers. In the earlier stages of dementia, an individual will still have independence and be able to perform many activities without assistance. When entering the later stages of dementia, the individual will need around-the-clock assistance for most daily activities.

The timeline for the stages of dementia vary from individual to individual. A doctor will never tell an individual or a caregiver when exactly to expect the next progression of the disease. Life expectancy for dementia individuals is also very different. No two individuals are exactly alike and there have been cases of individuals being diagnosed with more than one form of dementia.

The following is a summary of the seven stages of dementia, according to the model created by Dr. Reisberg:

Stage 1: No Memory Deficit

During the first stage of dementia, no signs of memory impairment are evident. The individual would not demonstrate any types of behavioral problems, memory loss or confusion. Individuals without a diagnosis are considered Stage 1 on the Global Deterioration Scale.

Stage 2: Slight Cognitive Decline

For Stage 2, signs of mild cognitive decline, also known as Age Associated Memory Impairment, are common. Caregivers and family members may notice slight forgetfulness from time to time, but memory issues may go undetected. For instance, familiar names may slip the person’s mind, or the individual may forget where he or she left an object. During this period, lost keys or misplaced cell phones could become a common occurrence. This stage does not warrant a dementia diagnosis and signs of the disease would not be seen during any memory tests. The person would still be able to have a job and participate in normal social activities. Not all individuals with these signs will move on to the later stages of dementia.

Stage 3: Mild Cognitive Impairment

This is typically the first stage that people begin to notice memory impairments in their family member or friend. The forgetfulness will become much more apparent, and close relatives or friends may notice unusual memory slips like the following:

  • Forgetting the names of people they just met
  • Struggling to find the right words when attempting to have a conversation
  • Difficulty retaining new material (i.e. he or she may read a passage in a magazine or book and immediately forget the content)
  • Losing valuable items

Some additional signs to keep in mind include trouble concentrating and completing complex tasks that require ongoing mental effort. If employed, work performance may become impacted. Co-workers may notice that the individual frequently shows up late or forgets important deadlines.

Driving difficulties, poor organization skills, time management and difficulties with chores may also raise a red flag for people close to the individual. For example, the person suffering memory loss may become lost when traveling to a new location. They may struggle making plans or have a hard time managing ordinary household tasks like paying bills, cleaning the house, doing the laundry or caring for pets. If any of these signs seem out of the norm for your family member or friend, consider bringing the incidents to their attention or recommend consulting a doctor.

Dementia is not diagnosed during the third stage, but the signs are important to recognize for early intervention. Furthermore, Stage 3 can last for years. Some individuals may not develop Stage 4 symptoms for seven years or longer after entering Stage 3.

Stage 4: Moderate Cognitive Decline

Stage 4 is often referred to as the “mild dementia” stage. When an individual enters this period, he or she will clearly demonstrate deficits when given cognitive examinations.

During Stage 4, you can expect your family member or friend to show continued difficulties with concentration as well as trouble recalling recent events. Short-term memory issues may include things like forgetting what they ate for lunch that day. Memories about past events may begin to fade or become increasingly hard to recall.

Additionally, individuals at this stage of dementia find it hard to operate independently. You may notice they cannot manage their finances, or do not pay bills consistently or on time. The person may not be able to travel alone, especially to unfamiliar areas.

Social anxiety is common during this period. If you notice your family member or friend begin to withdraw themselves from social interactions, it may be due to memory difficulties. They may not remember names and begin to forget personal histories.

Lastly, he or she may also feel in denial about the symptoms and won’t want to accept medical assistance. At this stage, a diagnosis from a physician is most likely and a care plan would be recommended. A caregiver may need to assist with managing finances and driving duties. The person will also need a lot of emotional support during this difficult time. Although timeframes for this stage will vary, Stage 4 lasts an average of two years.

Stage 5: Moderate Dementia

In Stage 5, the cognitive decline of the individual becomes more severe than previous stages. At this point, the individual will not be able to manage without outside assistance. Major memory loss occurs, and the person will have trouble remembering things like his or her own phone number.

Episodes of confusion are commonplace. Individuals may not remember the time of day or where they are. The names of close family members, including children and grandchildren, may be challenging. However, the individual may still remember much about his or her personal history and recognize familiar faces.

An individual at this stage is often unable to perform daily living tasks without help. The individual may need help with dressing, bathing and preparing meals. For instance, the individual may not know how to pick out the appropriate clothing for the season; however, he or she likely will be able to eat independently and use the bathroom. Basic addition and subtraction problems could become difficult to complete. This stage tends to last an average of one and a half years, but the timeline varies from person to person.

Stage 6: Severe Cognitive Decline

This stage of dementia is often called “middle dementia.” When an individual enters this period, he or she needs a high level of care to complete daily living activities. The person will forget the names of close family members and friends. Furthermore, individuals have very little recall of recent events. Instead, individuals may have better recollection of past events from earlier in their lives. The individual can remember his or her name and identify familiar faces from unfamiliar faces. Basic skills like counting to 10 and reciting the alphabet become difficult.

During this time, incontinence becomes an issue with the individual having difficult controlling bladder and bowels. Communication is extremely hard with severe speech impediments. Emotional issues are very common during this stage. The individual will often become agitated or delusional. Sleep patterns are impacted with sleeplessness at night and exhaustion during the day. Some individuals demonstrate compulsions like repeating behaviors. He or she may clean the same thing over and over again.

Since the individual becomes very agitated in this stage, violence can occur in otherwise non-violent individuals. Wandering is also an issue at this stage and many caregivers need to have an alert system in place. This stage of dementia will usually last between two and three years.

Stage 7: Severe Dementia

Stage 7 is considered the final stage on the Global Deterioration Scale. At this stage, the person has lost all ability to speak or communicate effectively. The individual may utter a few words or phrases, but they will not likely relate to his or her current environment. Individuals need assistance with the majority of daily living activities. They will need to be helped with not only bathing, dressing and meal preparation, but also eating and toileting. In the final stages of Alzheimer’s disease, individuals often lose the ability to swallow.

Severe dementia individuals are also at an increased risk for developing infections — including pneumonia. Motor skills, including the ability to walk, occur at this stage. Angry outbursts are more widespread as the individual feels extreme agitation. Dementia individuals with these signs need around-the-clock care. This stage could last upwards of two years.

Top-Notch Memory Care for Your Parents

Family members often feel overwhelmed by the emotional and physical toll of caring for an individual with dementia. A team of caring professionals is needed to help out when a parent or spouse is diagnosed with dementia.

The Villages of Windcrest, located in beautiful and historic Fredericksburg, Texas, offers a welcoming place for those living with dementia to call home. This innovative wellness community is focused on health for the body and mind. With 24-hour health monitoring and programs like Valeo™ Memory Care, you can feel assured that you are choosing the right place for your family member. With top-rated amenities, all-day dining, 24-hour security and housekeeping, The Villages of Windcrest makes every resident’s happiness and health a top priority. Reach out today to schedule a visit at our lovely and serene community.


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