31 Jan, 2023

Understanding the stages of dementia is one of the greatest tools to help you and your loved one prepare for what’s to come. As more parts of the brain get affected by the disease, manifesting symptoms change and become severe. Hence, knowledge is essential not only to predict when a loved one requires higher care and constant monitoring but also to know at what stage of the disease a particular treatment method will work best.

At Senex Memory Advisors, we aim to support caregiver education for families to stay well-informed about dementia. Here’s a summary of the different stages of dementia and some tips to help a loved one as they brave through the changes caused by the disease.

Stages of Dementia

There are three phases of dementia: pre or early dementia, mid or moderate dementia, and late or severe dementia. These are further categorized into seven stages depending on the severity of the symptoms. Care experts use the Global Deterioration Scale (GDS) to measure dementia and assign a stage to it.

    Stage 1: No Cognitive Impairment

    As the name suggests, no cognitive impairment is evident during this stage. Memory functions are normal.

    The GDS identifies Stages 1 through 3 as pre-dementia levels. These are stages when recognizable dementia symptoms don’t manifest often and are not very disruptive, so doctors can’t obtain enough evidence for diagnosis.

    Stage 2: Very Mild Cognitive Decline

    At this stage, some signs of memory problems surface. Your loved one may forget people's names or words and phrases used in everyday conversations. However, these symptoms aren't always obvious to doctors or surrounding people. They also look like age-related problems, so they’re unlikely to be linked with dementia. During a clinical interview, the doctor won’t recognize these problems as memory deficits.

    Stage 3: Mild Cognitive Decline

    Stage 3 is where dementia symptoms are noticeable and begin to disrupt a person's day-to-day activities. The ability to concentrate and focus on tasks declines. The person may not remember where they place their phone or other personal things. If they're employed, reduced work performance is reflected in needing more time to complete tasks and reduced productivity.

    At this stage, driving can be dangerous, so it’s best to ask a loved one to stop driving.

    Stage 4: Moderate Cognitive Decline

    During a clinical review of a health provider, memory deficits are visible, but the person may vehemently deny their condition.

    The person won't be able to recall many things, such as recent events and some personal history. The more obvious cognitive decline makes it more strenuous to complete daily tasks. Problems with language will happen more frequently and can lead to social withdrawal.

    Following the GDS, health providers diagnose this stage as mild dementia.

    Stage 5: Moderately Severe Cognitive Decline

    Memory loss advances from moderate to severe. The person won't recall many life facts, including their home address, the phone number they've used for years, the name of the university they graduated from, and more.

    They’ll still likely remember their name, the names of their children, and their spouse. They get disoriented by the time of the day, season, and year. Moreover, they also become prone to wandering and sundowning.

    At this point, their care needs increase, so hiring a caregiver to provide support with dressing, personal care, meal preparation, and activities of daily living (ADLs) is ideal. Moving to a memory care community may be better if they can't age in place.

    Stage 6: Severe Cognitive Decline

    Damage to the brain is significant, requiring the person to rely more on their caregivers to accomplish basic day-to-day activities. This includes self-care tasks, toileting, eating, and cleaning. The person may also become incontinent.

    At this stage, the person can still recall their name but occasionally forgets their spouse's name and other loved ones and will be substantially unaware of recent experiences and events.

    You will also notice some personality and emotional changes, such as:

    • They become delusional and paranoid or have scary hallucinations. You may see them talk to an imaginary figure.

    • They wander and get lost.

    • They won’t be able to recognize their caregivers.

    • They become aggressive, easily agitated, obsessive, and anxious.

    • Their circadian rhythm dysfunctions and leads to sleeping problems.

    Stage 7: Very Severe Cognitive Decline

    Over the two and a half years of the expected duration of Stage 7 dementia, all communication abilities get lost. A loved one won't be able to communicate verbally or through body language. On a rare occurrence, they may be able to utter a word or phrase. Symptoms are also severe and become increasingly difficult to manage.

    As the brain's connection to the body gets severed, psychomotor skills slowly decline and get lost until the person can no longer walk without assistance.

    A loved one becomes tremendously weak and susceptible to infections, particularly pneumonia, the common cause of fatality among people with dementia.

How Fast Do the Stages of Dementia Progress?

Dementia progresses differently for each case. The pace of how it progresses depends on factors like genetics, lifestyle, the age when dementia is diagnosed, the type of dementia (e.g., Alzheimer's disease has a higher life expectancy compared to vascular dementia at around ten years versus five years), and overall state of health.

Some people with a healthy lifestyle and manageable health conditions delay the development of symptoms and live for up to 20 years (for those with Alzheimer's disease).

Your next steps after diagnosis play a role in ensuring that a loved one can prolong their cognitive ability and independence for as long as possible. After diagnosis, here are things you can do to prepare for the future:

    • Learn everything about the type of dementia that your loved one has. You can learn more about dementia education and care tips from one of the Senex Memory Advisors.
    • Attend regular checkups to keep track of the changes in the symptoms and disease and identify the best treatment options for specific changes.
    • Get help from local support groups, such as Eldercare Locator. There are multiple online and offline support groups to get the best care tips and advice and learn new coping strategies.
    • Sit down with a lawyer and plan for long-term care, financial, and legal arrangements. Planning is vital to ensure that your loved one’s preferences and wishes are met and avoid stress when future problems relating to finances and legal matters arise.
    • Lead a healthy lifestyle. Help your loved one establish their morning routine and make it as healthy as possible. Physical activity is crucial as it keeps your loved one active. It also has excellent benefits for the brain. A healthy diet is equally important. Many people living with dementia go for a MIND diet or Mediterranean diet with several wholesome food choices that are good for the brain and general health.

Learning to Navigate Each Stage of Dementia

Dementia is challenging to navigate for everyone in the family. Knowledge obtained by caregivers is one of the keys to helping a diagnosed loved one prolong a better quality of life.

If you’re a family caregiver, educating yourself on the symptoms and disease patterns, staying informed of effective coping strategies, and always being there to provide emotional support can give a loved one courage and motivation to brave the challenges of dementia.

If you want more dementia care tips, connect with a dementia advisor. Senex Memory Advisors has licensed dementia specialists who can give personalized memory care advice. If your loved one needs to move to a memory care community, we can recommend the best ones near your area. Fill in this contact form.


Syed Rizvi

Syed has years of experience dealing with people, understanding their needs, and helping them find solutions to their problems.
As a Certified Senior Advisor (CSA), Certified Dementia Practitioner (CDP), Certified Montessori Dementia Care Professional (CMDCP), Syed is committed to working closely with Senior and their family knowing what is it like for individuals facing a challenging time, at times groping in dark trying to figure what is the appropriate next step or care level for their unique situation.
Syed and Senex Memory Advisors are fully committed to working closely with families in creating a personalized, step-by-step process memory care plan at zero cost.

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