One of the most difficult things to hear about dementia is that, in most cases, dementia is irreversible and incurable. However, with an early diagnosis and proper care, the progression of some forms of dementia can be managed and slowed down. The cognitive decline that accompanies dementia conditions does not happen all at once - the progression of dementia can be divided into seven distinct, identifiable stages.

Learning about the stages of dementia can help with identifying signs and symptoms early on, as well as assisting sufferers and caretakers in knowing what to expect in further stages. The earlier dementia is diagnosed, the sooner treatment can start.

Stage 1: No Cognitive Decline

Stage 1 of dementia can also be classified as the normal functioning stage. At this stage of dementia development, a patient generally does not exhibit any significant problems with memory, or any cognitive impairment. Stages 1-3 of dementia progression are generally known as "pre-dementia" stages.

Stage 2: Age Associated Memory Impairment

This stage features occasional lapses of memory most frequently seen in:

  • Forgetting where one has placed an object
  • Forgetting names that were once very familiar

Oftentimes, this mild decline in memory is merely normal age-related cognitive decline, but it can also be one of the earliest signs of degenerative dementia. At this stage, signs are still virtually undetectable through clinical testing. Concern for early onset of dementia should arise with respect to other symptoms.

Stage 3: Mild Cognitive Impairment

Clear cognitive problems begin to manifest in stage 3. A few signs of stage 3 dementia include:

  • Getting lost easily
  • Noticeably poor performance at work
  • Forgetting the names of family members and close friends
  • Difficulty retaining information read in a book or passage
  • Losing or misplacing important objects
  • Difficulty concentrating

Patients often start to experience mild to moderate anxiety as these symptoms increasingly interfere with day to day life. Patients who may be in this stage of dementia are encouraged to have a clinical interview with a clinician for proper diagnosis.

Stage 4: Mild Dementia

At this stage, individuals may start to become socially withdrawn and show changes in personality and mood. Denial of symptoms as a defense mechanism is commonly seen in stage 4. Behaviors to look for include:

  • Decreased knowledge of current and/or recent events
  • Difficulty remembering things about one's personal history
  • Decreased ability to handle finances, arrange travel plans, etc.
  • Disorientation
  • Difficulty recognizing faces and people

In stage 4 dementia, individuals have no trouble recognizing familiar faces or traveling to familiar locations. However, patients in this stage will often avoid challenging situations in order to hide symptoms or prevent stress or anxiety.

Stage 5: Moderate Dementia

Patients in stage 5 need some assistance in order to carry out their daily lives. The main sign for stage 5 dementia is the inability to remember major details such as the name of a close family member or a home address. Patients may become disoriented about the time and place, have trouble making decisions, and forget basic information about themselves, such as a telephone number or address.

While moderate dementia can interfere with basic functioning, patients at this stage do not need assistance with basic functions such as using the bathroom or eating. Patients also still have the ability to remember their own names and generally the names of spouses and children.

Stage 6: Moderately Severe Dementia

When the patient begins to forget the names of their children, spouse, or primary caregivers, they are most likely entering stage 6 of dementia and will need full time care. In the sixth stage, patients are generally unaware of their surroundings, cannot recall recent events, and have skewed memories of their personal past. Caregivers and loved ones should watch for:

  • Delusional behavior
  • Obsessive behavior and symptoms
  • Anxiety, aggression, and agitation
  • Loss of willpower

Patients may begin to wander, have difficulty sleeping, and in some cases will experience hallucinations.

Stage 7: Severe Dementia

Along with the loss of motor skills, patients will progressively lose the ability to speak during the course of stage 7 dementia. In the final stage, the brain seems to lose its connection with the body. Severe dementia frequently entails the loss of all verbal and speech abilities. Loved ones and caregivers will need to help the individual with walking, eating, and using the bathroom.

By identifying the earliest stages of dementia as they occur, you may be able to seek medical treatment quickly and delay the onset of later stages. Though most cases of dementia are progressive, some may be reversible, and sometimes dementia-like conditions may be caused by treatable underlying deficiencies or illnesses. The more aware you are of these stages, the quicker you will be able to react and seek help, either for yourself or for a loved one.

Source: Global Deterioration Scale for Assessment of Primary Degenerative Dementia