The 7 Stages of Dementia

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By News Team on October 9, 2017

According to the World Health Organization (WHO), worldwide, around 47 million people have dementia, with nearly 10 million new cases every year.
In most cases, dementia is incurable and irreversible, but with an early diagnosis and proper care, some forms of dementia can be managed and in some cases slowed.
Knowing the stages of dementia not only allows physicians to determine the best treatment approach, but it also helps caregivers know what to expect as the disease progresses.
Below are the seven stages of dementia.
Stage 1: No impairment

  • Symptoms may be mimicking stress
  • No obvious signs of dementia
  • Able to function independently in the home and community 

Stage 2: Very mild cognitive decline

  • Experience daily memory problems that appear to be forgetfulness associated with aging
  • Possibly forgetting a person’s name you knew well or forgetting where you placed a familiar item such as car keys
  • You may have some subjective word finding difficulties
  • You are able to function well in the work place
  • You are able to compensate for your memory lapses
  • Able to function independently in the home and community 

Stage 3: Mild cognitive impairment

  • Some forgetfulness and memory loss reported more frequently
  • You may begin losing items without being able to retrace your steps to find them
  • Word finding and name recalling deficits become more evident to loved ones
  • More effort needed in remembering appointments, managing finances and managing medications. You may see patterns of repetition occurring.
  • Loss of concentration may be more apparent
  • You may experience confusion while driving
  • Your strengths may begin to break down
  • Your job performance may begin decreasing and coworkers are seeing it 

Stage 4: Moderate cognitive decline/mild dementia

  • You begin to have more difficulties doing daily routine tasks such as laundry, cooking and shopping
  • Increased trouble with keeping up with finances
  • Decreased ability to travel to unfamiliar places
  • Inability to find the right words or use the right words and phrases
  • You may see an increase in social withdrawal
  • Decreased knowledge of recent events
  • Increased difficulties with problem solving
  • Incontinence may begin in this stage
  • Family members and others see the breakdowns, but you may still remain socially appropriate. Denial is a dominant defense mechanism at this stage.
  • Difficulty with math seen with serial 7’s 

Stage 5: Moderately severe cognitive decline/moderate dementia

  • At this stage, assistance is required in the home for day-to-day activities
  • Increase in memory loss. For example, you may not be able to remember phone numbers, addresses or other personal data
  • Frequently some disorientation to time, date, day of the week, season, year or occasion 
  • Can still dress without assistance
  • Increased confusion about location or chain of events
  • Difficulties with less challenging math exercises, such as counting backwards from 40 by 4’s or 20 by 2’s 

Stage 6: Severe cognitive decline/moderately severe dementia

  • Assistance now needed in bathing, dressing and toileting
  • Increase in incontinence
  • Unaware of surroundings, the season, the year, etc.
  • Requires assistance with traveling
  • Personality and emotional changes could occur, such as paranoia, delusions and/or hallucinations
  • You may see an increase in getting lost or wandering occurring
  • Sleeping pattern changes
  • Decreased ability to recall family names
  • Will be more unaware of recent events and experiences in your life
  • Difficulties counting backwards from 10 and sometimes counting forwards to 10
  • Change in eating habits
  • Increase in social withdrawal
  • May see inappropriate behaviors occurring
  • Increased agitation and restlessness at night
  • Unable to perform complete tasks with cooking, cleaning, laundry and finances
  • Decline in speech occurring
  • Requires 24-hour care 

Stage 7: Very severe cognitive decline/severe dementia (final stage of the diseases process)

  • Loss of language skills throughout this stage
  • Incontinent
  • Requires moderate to dependent assistance with bathing, dressing, toileting and feeding
  • Problems with swallowing may occur
  • Loss of muscle control
  • May stop walking and may be confined to a wheelchair or bed at this time
  • Often cannot recognize family members
  • Almost always disoriented
  • Requires 24-hour care 

If you think you or a loved one may be showing signs of dementia, talk to your doctor immediately. The sooner the disease is diagnosed, the sooner treatment can start.

If you live in the Roanoke or New River Valley and would like to find out more about our Alzheimer's Disease and Dementia Management Home Care Program, please call 540-206-4190.
This article was reviewed by Lisa Hebert-Meritt, COTA/L, CDP, CADDCT, Carilion Clinic Home Care, program lead for Carilion’s Alzheimer's Disease and Dementia Management Home Care Program.

Learn about the symptoms of dementia and more from the World Health Organization.

If you are caring for a loved one with Alzheimer’s or another dementia-related disorder and find that detecting and soothing your loved one’s agitation is becoming increasingly difficult,  Carilion Clinic is currently conducting a research study that may help.

BESI, which stands for Behavioral and Environmental Sensing and Intervention, is a collaborative effort between clinicians at Carilion Clinic, electrical engineers at University of Virginia and systems engineers at North Carolina A&T.

The study uses wrist-worn sensors to predict what upsets a person with dementia. The hope is that the sensors can detect agitation in the stages before it becomes so severe that no one can effectively intervene.

Volunteers are currently being recruited throughout southwest Virginia. If you are caring for someone at home who has Alzheimer’s disease or other dementias and are interested in participating, please call Temple Newbold, M.S.N., R.N., research nurse coordinator for Carilion Clinic Center for Healthy Aging, at 540-266-6077 to see if you qualify for the research study.