Dementia is a progressive disease with 7 stages that worsen over time. While each person with dementia is unique, their journey through the stages of dementia usually follows a predictable pattern. Each level of dementia brings with it new symptoms or a worsening of existing symptoms.
The seven stages of dementia are divided into three progressive phases:
i) Pre-dementia, often known as early-stage dementia
In this stage, a person can still live freely and may not exhibit obvious memory loss or trouble performing routine tasks. Mild dementia symptoms are similar to age-related forgetfulness.
ii) Moderate or middle-stage dementia
The symptoms of moderate dementia have a substantial impact on a person’s personality and behavior. A person with middle-stage dementia will typically require full- or part-time carer assistance with daily activities. Other symptoms of moderate-stage dementia include considerable cognitive impairment and mood changes.
iii) Severe or late-stage dementia
The ultimate stage is characterized by profound cognitive impairment as well as a loss of physical ability. Late-onset dementia symptoms include severe memory loss, incontinence, and the inability to move without assistance.
Knowing what to look for as dementia progresses will assist you in determining when it is time to reassess your loved member’s care needs. Recognizing early-stage dementia warning signs, as well as frequent symptoms of middle- and late-stage dementia is very important.
What are the Seven Stages of Dementia?
The Global Deterioration Scale is a comprehensive measure used by health care practitioners to assess the seven stages of dementia in older people. This trusted approach, also known as the GDS, allows caregivers and health professionals to estimate how quickly dementia progresses in senior patients and which symptoms to expect at each of the seven stages of dementia. A dementia stages chart can assist caregivers in keeping track of and monitoring their loved one’s health state in relation to stage-related symptoms.
The seven phases of dementia are as follows:
Stage 1: There is No Cognitive Impairment
Though it may appear strange, stage 1 dementia frequently appears to be normal mental functioning with no cognitive decline. Typically, someone in the first three stages of dementia does not display enough symptoms to be diagnosed. It is crucial to emphasize, however, that changes in the brain are still occurring. While some cognitive impairment may be present, pre-dementia is defined as stages 1, 2, and 3 on the GDS.
Stage 2: Very Mild Cognitive Decline
- A considerable proportion of the elderly population suffers from age-related forgetfulness, and caregivers or medical providers may be unaware of such little impairment. This explains why stage 2 is often referred to as “age-associated memory impairment” on the GDS.
“The estimated dementia prevalence for adults ages 60+ in India is 7.4%, with significant age and education gradients, sex and urban/rural differences, and cross-state variation.” According to the Alzheimer’s Association, the burden of dementia cases is unevenly distributed across states and subpopulations and may therefore require different levels of local planning and support.
Stage 3: Mild Cognitive Decline
- Mild cognitive decline (sometimes known as mild cognitive impairment) is a stage of dementia. Mild cognitive decline, also known as mild cognitive impairment (MCI), occurs when memory and cognitive impairments become more frequent, as well as visible to caregivers and family members. In most cases, stage 3 dementia has no influence on daily functioning.
According to another research, the prevalence of cognitive impairment in India varies from 3.5% to 11.5% from northern to southern parts of India in people aged >65 years. The prevalence of CI is high in rural areas of India compared to urban areas, whereas the studies in rural areas are very few compared to urban populations.
Stage 4: Moderate Cognitive Decline
- When a person is in stage 4 dementia, they have distinct, visible indicators of cognitive impairment as well as personality changes, both of which are significant dementia symptoms. Dementia is often not diagnosed until a person is in stage 4 or later. While the medical term for stage 4 dementia is moderate cognitive deterioration, the GDS officially classifies it as mild dementia.
Doctors and caregivers will likely see hallmark indicators of dementia progressing at this stage, such as language issues and diminished problem-solving skills.
Stage 5: Moderately Severe Cognitive Decline
- This stage represents the beginning of what many specialists refer to as the “mid-stage” of dementia’s seven phases. A person may no longer be able to perform typical activities of daily living such as dressing or bathing, or instrumental activities of daily living without the support of a caregiver at this time. Middle-stage dementia typically lasts between two and four years, while each dementia patient progresses at a different rate.
Your loved one will most likely require more intensive help and supervision in stage 5 dementia. They recall important details about themselves, including their name and the names of their children, but they may not remember the names of their grandkids, their long-term addresses, or where they attended high school.
Stage 6: Severe Cognitive Decline
- Stage 6 dementia indicates the need for caregiver assistance with basic daily tasks such as eating, using the restroom, and other self-care. Seniors at this stage of moderately severe dementia may struggle to regulate their sleep, connect with others, or behave appropriately in public.
As symptoms of dementia become more complex at stage 6, you may wonder if full-time care is required. You may prepare by keeping track of your loved one’s symptoms, evaluating their capacity to perform ADLs and IADLs, and researching care choices such as memory care or home care.
Stage 7: Extreme Cognitive Decline
- In stage 7, which is considered late-stage dementia, they are unable to care for themselves. In general, individuals with severe dementia lose all verbal capacity and have substantially limited movement. Late-onset dementia symptoms impair basic processes such as chewing, swallowing, and breathing.
It’s crucial to note that these stages are only guidelines; the progression of dementia varies from person to person. Furthermore, multiple staging systems may be utilized in different circumstances or by different medical specialists. The major goal of staging is to give a framework for analyzing the course of symptoms and establishing appropriate dementia care and support for patients.
What are the symptoms of dementia at each stage?
Stage 1 Dementia Symptoms:
- Memory problems, particularly remembering recent events
- Increasing confusion
- Reduced concentration
- Personality or behavior changes
- Apathy and withdrawal or depression
- Loss of ability to do everyday tasks.
Stage 2 Dementia Symptoms:
- Losing track of familiar objects
- Inability to recall names of friends, family members, and former acquaintances
Stage 3 Dementia Symptoms:
- Forgetting to go to appointments or events
- Losing things and minor memory loss
- Getting lost while traveling
- Decreased work performance
- Difficulty finding the right words
- Verbal repetition
- Challenges with organization and concentration
- Trouble with complex tasks and problem-solving
- Problems with driving
Stage 4 Dementia Symptoms:
- Social withdrawal
- Emotional moodiness
- Lack of responsiveness
- Reduced intellectual sharpness
- Trouble with routine tasks
- Forgetting recent events
Stage 5 Dementia Symptoms:
- Pronounced memory loss, including personal details and current events
- Wandering
- Confusion and forgetfulness
- Disorientation and sundown syndrome
- Further reduced mental acuity and problem-solving ability
Stage 6 Dementia Symptoms:
- Sleep difficulties
- Urinary or fecal incontinence
- Aggression and anxiety
- Personality changes including paranoia or delusions
- Inability to perform ADLs
- Pronounced memory loss
- Inability to recognize loved ones and caregivers
Stage 7 Dementia Symptoms:
- Inability to speak
- Lack of physical coordination and the inability to move without help
- Impaired bodily functions
Symptoms may also emerge gradually and go unrecognized for an extended period. Furthermore, some people may hesitate to act even when they are aware that something is wrong.