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What Are the Stages of Dementia?

October 30, 2023 / Dementia

Dementia is a complex condition that progresses through various stages, each presenting different challenges and symptoms. While every individual’s journey with dementia is unique, there are generally seven distinct stages of the disease that present with similar symptoms and challenges among individuals who are suffering from dementia. Understanding these stages is crucial for individuals with dementia, their caregivers, and healthcare professionals. The team at Senior Care AZ, an Arizona senior placement agency, is breaking down the phases of dementia and providing insights into the seven stages of dementia, along with the pace of progression and life expectancy.

Phases of Dementia

Dementia is an umbrella term for a decline in cognitive function that affects memory, problem-solving skills, language, and the ability to complete the activities of daily life for many individuals once they reach older age. There are different types of dementia, one of the most well-known being Alzheimer’s, each of which will advance at a different rate and may vary from person to person. However, most types of dementia progress through phases that mark the advancement of cognitive decline. While specific symptoms may vary from person to person, the phases provide a general framework for understanding the journey of dementia. The seven stages of dementia are separated into three different phases, including: 

Early-Stage Dementia (Pre-Dementia)

In the initial phase of dementia, an individual can still live independently and their symptoms are generally characterized by subtle memory lapses and mild cognitive impairments. Mild dementia symptoms may mimic episodes of age-related forgetfulness and may not seem like cause for concern in the early stages of dementia. 

Middle-Stage Dementia (Moderate)

Once an individual reaches moderate, or middle stage dementia, they may experience symptoms that will begin to significantly affect their personality and behavior. Individuals with middle-stage dementia often need a full or part time caregiver to assist them with the activities of daily life, such as feeding, dressing, or bathing themselves. Other symptoms include mood swings, significant cognitive impairment, and memory loss. Individuals may begin to notice major personality shifts and difficulty remembering even very important details, such as where they live or who their family members are. 

Late-Stage Dementia (Severe)

The final stage of dementia is often associated with severe cognitive impairment and the loss of many physical abilities. Pronounced memory loss, incontinence, and an inability to move without help are common among individuals with severe dementia. Individuals require significant assistance and support for basic activities.

What Are the 7 Stages of Dementia?

The Global Deterioration Scale (GDS) is a tool used by healthcare providers that categorizes dementia into seven stages. This method helps enable caregivers and healthcare providers to determine how quickly dementia is progressing and which symptoms can be expected as an individual continues to decline with the disease. Each stage represents a different level of cognitive decline, from no impairment to very severe decline:

Dementia Stage 1: No Impairment

Individuals in this stage exhibit no cognitive decline and have no memory problems. Stage 1 of dementia often resembles normal mental functioning without any recognizable cognitive decline. While an individual in this stage will not have symptoms and will not be diagnosed with dementia, there are still important changes occurring in the brain at this stage of dementia. 

Dementia Stage 2: Very Mild Decline

Very mild cognitive decline includes forgetfulness often attributed to normal aging, and this may seem like very normal age-related forgetfulness, such as misplacing keys or forgetting a new person’s name after being introduced. 40% of individuals aged 65 or older report having age-related forgetfulness, while only 1% of these individuals will progress to dementia. These symptoms seem common, but may be early signs to indicate further cognitive decline may occur in the future. 

Dementia Stage 3: Mild Decline

In this stage, individuals experience cognitive impairments beyond normal aging, with difficulties in concentration and memory lapses. The cognitive impairment and forgetfulness become more regular and noticeable to family members and caregivers. Although memory loss is occurring more noticeably, this stage of mild decline generally does not have a major impact on day-to-day functioning. 

Dementia Stage 4: Moderate Decline

Moderate cognitive decline is characterized by an increased memory deficit, decreased short-term memory, and difficulty with complex tasks. An individual with stage 4 dementia will have clear, visible signs of cognitive impairment and may exhibit personality changes. Generally, individuals will not be diagnosed with dementia until they have reached stage 4 or beyond. Individuals may begin exhibiting signs of emotional moodiness, social withdrawal, lack of responsiveness, trouble with routine tasks or forgetting about recent events. 

Dementia Stage 5: Moderately Severe Decline

In this stage, individuals exhibit significant memory gaps, disorientation, and trouble managing daily activities. This stage marks the onset of what many doctors call the mid-stage of dementia. At this point, many individuals begin having difficulty taking care of their activities of daily life without assistance, including dressing, bathing, and feeding themselves. Middle-stage dementia often lasts between two and four years, though everyone will progress at a different rate. 

Dementia Stage 6: Severe Decline

Severe cognitive decline results in an inability to recognize familiar faces, a decline in communication skills, and the need for assistance with daily tasks. Stage 6 of dementia may mark the need for a caregiver to help perform basic tasks, such as eating or using the restroom. Seniors with stage 6 dementia will have difficulty sleeping and interacting with others and they may begin behaving inappropriately in public settings. Symptoms may include incontinence, aggression, pronounced memory loss, and the inability to recognize loved ones or caregivers. 

Dementia Stage 7: Very Severe Decline

The final stage marks a very severe cognitive decline, with individuals losing the ability to speak, control movements, or swallow. At this point, they require full assistance and are unable to care for themselves. Many individuals with severe dementia lose all verbal ability and have impaired movements. 

How Fast Do the Stages of Dementia Progress?

The pace at which dementia progresses varies from person to person. Factors like the type of dementia, overall health, and individual differences can influence the rate of decline. Generally, the stages may span several years, with each stage’s duration varying significantly.

What Is the Life Expectancy of Dementia?

The life expectancy of individuals with dementia depends on multiple factors, including their age, overall health, and the specific type of dementia. On average, individuals may live from 4 to 8 years after a dementia diagnosis. However, this can be shorter or longer based on individual circumstances.

Understanding the stages of dementia is essential for planning and providing appropriate care, maintaining the best possible quality of life for those affected, and offering support to caregivers and loved ones throughout the challenging journey of dementia.