What are the 7 stages of dementia?

by | Sep 1, 2020 | Dementia Facts, Informed

Dementia progresses differently in different people. From a bio-medical perspective, the condition is, however, often discussed in “stages”.  Clearly specifying a stage allows health and social care staff to communicate the condition in a better way and put plans in place for the best possible care and the most appropriate way forward. The trajectory of dementia is broadly categorized into three stages – mild or early, moderate or middle and severe or advanced. However, a person’s symptoms are further classified into seven different stages based on symptoms.

Stage 1 – Normal Behaviour with No Cognitive Decline

In the early stages of dementia, changes will start occurring in the person’s brain but they won’t show any symptoms for it. This can go on for several years before any signs of dementia can show up. Mental functioning at this stage is completely normal. Symptoms
  • No memory loss
  • Normal cognitive functioning

Stage 2 – Forgetfulness or Mild Cognitive Impairment

Usually occurring in older people, this stage of dementia leads to forgetting everyday routine things and misplacing things around the house. On first analysis, these symptoms may appear similar to what happens in normal age-related memory deterioration.  Symptoms
  • Forgetting names, places and things.
  • Forgetting everyday phrases.
  • Misplacing familiar objects.
  • Dementia symptoms not clearly visible to family.
It should be noted here that Mild Cognitive Impairment does not always lead to a form of dementia.

Stage 3 – Mild Decline or Mild Dementia

People in stage 3 can still function independently but family and friends can clearly notice subtle changes and figure out that something “isn’t quite right”. People at this stage will compensate for their forgetfulness by putting measures in place to help such as keeping phone reminders and sticking post-it notes. The person may experience memory lapses where they lose their belongings or forget words and things. This stage can generally last from 2 years to about 7 years. Symptoms 
  • Increased forgetfulness.
  • Difficulty in concentrating.
  • Memory loss.
  • Verbal repetition.
  • Trouble with expressing thoughts or finding the right words.
  • Personality changes like being introverted and withdrawn.
  • Decreased work performance.
  • Misplacing objects or getting lost.

Stage 4 – Moderate Dementia Or Moderate Cognitive Decline

At this stage, the person cannot manage independently and need assistance to carry out daily tasks such as dressing, bathing and grooming. Increased confusion, greater memory loss, and worsening judgement are present. Symptoms 
  • Greater memory loss including past events.
  • Difficulty managing everyday tasks.
  • Behavioural changes such as withdrawal or irrational agitation.
  • Restlessness at night.
  • Mental confusion and poor judgement.

Stage 5 – Moderately Severe Cognitive Decline

As the condition worsens, the person needs increasing help with their day-to-day lives. They will find it difficult to dress and may increasingly dress inappropriately. They will find it difficult to remember simple things like their name, contact number, and where they are. Symptoms 
  • Need assistance with daily living activities.
  • Forget their personal information.
  • Cannot tell day, date or time.

Stage 6 –  Severe Cognitive Decline Or Middle Dementia

As people move closer to the final stages of dementia. constant supervision is needed at home. Along with bathing and dressing, incontinence may become a problem. Aside from these physical symptoms, personality and emotional changes may become more apparent.  The person may become increasingly anxious and confused.   They will find it increasingly difficult to communicate finding the correct words or expressing themselves. Generally, this stage can last for around 2.5 years before the condition steps into a more severe stage. It is, however, important to say that everyone with dementia experiences the condition in different ways. Symptoms
  • Unable to perform daily activities without help.
  • Loss of bladder control.
  • Experience delusions and compulsions.
  • Forgets names, recent or historical events.
  • Anxiety attacks.
  • Difficulty in speaking.
  • Changes in personality and emotional state of mind.

Stage 7 –  Very Severe Cognitive Decline Or Late Dementia

People at this stage of the disease will become dependent on others for day-to-day living. Help with feeding is likely to be a symptom at this stage.  They may require help with moving around the room or may become bedridden. Swallowing also becomes difficult and it can be the case that soft, pureed food is easier to swallow. Round-the-clock care, whether at home or in a nursing home, is often necessary. Symptoms
  • Difficulty in speaking or communicating.
  • Loss of motor skills.
  • Unable to walk.
Different people progress through these stages at different speeds. Even though there are stages to it, the disease takes a natural course and worsens over time. In some cases, the disease reaches the last stage in a few years.  In others the decline takes decades. While dementia has no permanent cure, early diagnosis helps families make future plans for care and inform treatment. Caring for a family member with dementia can be stressful, but knowing what is about to come and strategies for dealing with things can help provide some clarity and help families navigate through things.

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