What are the Different Stages of Dementia and How it progresses?

Dementia isn’t just about forgetting names or misplacing keys. It’s a persistent thief, slowly robbing individuals of their memories, independence, and even their sense of self. According to the World Health Organization (WHO), over 55 million people worldwide currently live with dementia, and this number is projected to double every 20 years.

Dementia doesn’t happen overnight; it progresses through various stages, each presenting its own set of challenges and symptoms. It begins with mild cognitive impairment, characterised by the onset of memory lapses. It advances to severe stages where individuals lose their ability to communicate and need full-time care. This journey is both complex and heartbreaking.

In this blog, we will explore the different stages of dementia, providing insights into what to anticipate at each phase and how carers can offer the best support. By the end, you will be better prepared to identify the signs and take proactive measures to manage dementia, whether for yourself or a loved one.

What Is Dementia?

Dementia is an umbrella term for a decline in cognitive function that interferes with daily life. Dementia is a condition that affects memory, thinking, language, and behaviour, making it challenging for people to carry out daily tasks and communicate as the progression of dementia.

It’s not a specific disease but rather a term encompassing a decline in cognitive function severe enough to interfere with daily life. For many, dementia brings about difficulties in remembering, problem-solving, and even changes in behaviour. Caregivers need to spot the early signs and adjust care as the condition progresses.

Alzheimer’s disease is the most common cause of dementia, accounting for 60-80% of cases. Other types of dementia include vascular dementia, Lewy body dementia, and frontotemporal dementia.

Also read: What is the difference between Dementia and Alzheimer’s?

How common is dementia?

Dementia is more common in people aged 65 and older, but it can also affect younger individuals, with rare cases of early-onset dementia starting as early as 30 to 60 years old. Among those aged 65 and older, there were an estimated 5.0 million adults with dementia in 2014. This figure is projected to rise to nearly 14 million by 2060.

What Are The Seven Stages of Dementia?

1. No cognitive decline 
2. Very mild cognitive decline
3. Mild cognitive decline
4. Moderate cognitive decline
5. Moderately severe cognitive decline
6. Severe cognitive decline
7. Very severe cognitive decline

The seven stages of dementia are also known as the Reisberg scale, the first three stages of which are when there’s no dementia present. Some dementia experts prefer the three-stage scale: early (stage 4 in Reisberg), middle (stages 5-6), and late (stage 7). Let’s explore the seven stages and progression of dementia and talk about the dementia symptoms you might see in each. Remember, the only person who can determine the levels of dementia is a trained medical professional.

Stage 1: No Cognitive Decline

In this stage, there is no detectable impairment in cognitive function. This is an early stage of dementia in which the person usually operates in daily life and doesn’t experience any significant memory problems.

During this stage, individuals can benefit from adopting a brain-healthy lifestyle. This includes regular health check-ups, a balanced diet rich in omega-3 fatty acids and antioxidants, regular physical exercise, and engaging in mentally stimulating activities. Social engagement and learning new skills can also help maintain cognitive function.

Need help navigating dementia care options? Contact us for a free, no-obligation care assessment.

Stage 2: Very Mild Cognitive Decline

The second stage is characterised by normal forgetfulness associated with ageing. At this point, they show some very early signs of Dementia, but the changes are so subtle that they’re often indistinguishable from typical age-related memory loss. The person might occasionally forget names or misplace everyday objects like keys or glasses.

While these minor memory lapses can be frustrating, they generally don’t interfere with daily life or independent functioning. However, some individuals might start to notice these changes and feel concerned.

As a care provider, you can suggest memory aids such as notepads, smartphone apps, or strategically placed reminders around the home. Encourage the maintenance of social connections and participation in mentally stimulating activities like puzzles, reading, or learning a new hobby. These activities can help keep the brain active and potentially slow cognitive decline.

Stage 3: Mild Cognitive Decline

In the third stage, cognitive problems become more noticeable to friends and family. Mild Dementia often marks the beginning of mild cognitive impairment (MCI), which may or may not progress to dementia.

Symptoms may include: 

• Increased forgetfulness
• Slight difficulty concentrating
• Decreased work performance
• Getting lost more easily
• Trouble finding the right words in conversations

This stage requires a delicate balance of assistance and encouragement of independence. They need help establishing daily routines to reduce cognitive load and assist with organisation and planning. Encourage the use of calendars, to-do lists, and other organisational tools.

It’s also important to promote regular medical check-ups at this stage. Some causes of cognitive decline, such as vitamin deficiencies or medication side effects, can be reversible if caught early.

Stage 4: Moderate Cognitive Decline

Moderate Dementia often coincides with an early-stage Alzheimer’s diagnosis. Memory and reasoning problems become evident.

Symptoms may include:

• Difficulty with simple arithmetic
• Forgetting details of personal history
• Decreased ability to manage finances or plan complex tasks
• Mood changes, including withdrawal from social situations

In cases of moderate cognitive decline, provide assistance with managing finances and planning complex tasks. Support mood management and encourage participation in social activities to help with personal care and maintain some independence.

Stage 5: Moderately Severe Cognitive Decline

At this stage, significant confusion sets in, and individuals usually need help with many day-to-day activities. This comes under the middle stage of dementia. In this stage, the individual needs Dementia Care.

In this stage, patients show symptoms like:

• Confusion about time or place
• Trouble choosing appropriate clothing
• Difficulty recalling crucial personal information
• Increased need for assistance with personal care

During this dementia stage, offer them substantial support with daily activities and personal care. Ensure the environment is safe, and help the individual with tasks such as choosing appropriate clothing and recalling crucial personal information.

Don’t wait for symptoms to worsen. Contact us today to discuss how we can support you or your loved one.

Stage 6: Severe Cognitive Decline

This stage is characterised by severe cognitive decline and extensive need for help with daily living.

Signs and Symptoms may include:

• Unawareness of surroundings and recent experiences
• Difficulty recognising family and friends
• Wandering and getting lost
• Personality changes, including delusions or compulsive behaviours
• Loss of bladder and bowel control
• Sleep disturbances

For severe cognitive decline, they should be provided extensive assistance with daily living and ensure the individual’s safety. Support them through increased need for help with personal care and address issues such as wandering or confusion about time and place.

Stage 7: Very Severe Cognitive Decline

In the final stage, individuals lose the ability to respond to their environment or communicate verbally. This is the late stage of dementia, where they may still say words or phrases, but communicating pain becomes difficult. As memory and cognitive skills continue to worsen, significant personality changes may take place, and individuals need extensive care.

Symptoms may include:

• Loss of ability to speak or communicate
• Requiring 24/7 assistance with personal care
• Loss of physical abilities (walking, sitting, swallowing)
• Increased vulnerability to infections

In this stage of dementia, they need 24/7 care and support. They need assistance with all aspects of private home care, including mobility and feeding, and manage any physical and cognitive challenges, including loss of communication abilities and increased vulnerability to infections.

How Long Do the 7 Stages of Dementia Last?

The life expectancy of a person with dementia can vary widely depending on several factors, including the type of dementia, age at diagnosis, overall health, and access to medical care. On average, individuals with dementia live approximately 4 to 8 years after the onset of symptoms. However, some people may live longer, while others may have a shorter life expectancy.

For example:

Alzheimer’s disease: Around 8-10 years.
Vascular dementia: About 5 years.
Lewy body dementia: Approximately 6 years.
Frontotemporal dementia: Around 6-8 years

The approximate duration of the seven stages of dementia is as follows:

• Stage 1: Not applicable
• Stage 2: Unknown
• Stage 3: 2 to 7 years
• Stage 4: 2 years
• Stage 5: 1.5 years
• Stage 6: 2.5 years
• Stage 7: 1.5 to 2.5 years

How quickly does dementia disease progress?

There are many types of dementia, all of which are progressive. This means that symptoms may appear modest at first, but symptoms become worse with time, typically over several years.

You may also like: Questions about dementia

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Causes and Risk Factors Of Dementia

Dementia is a broad term that refers to a deterioration in cognitive function severe enough to impede daily activities. Understanding the origins and risk factors of dementia is critical for prevention and early treatment. Here, we look at the fundamental causes and risk factors for this illness.

Causes of Dementia

1. Alzheimer’s Disease: It is the leading cause of dementia. It is characterised by the accumulation of amyloid plaques and tau tangles in the brain.
2. Vascular dementia: It is caused by disorders that block or limit blood flow to the brain, resulting in brain damage.
3. Lewy Body Dementia: It is linked to aberrant deposits of alpha-synuclein in the brain.
4. Frontotemporal Dementia: Results from progressive damage to the frontal and temporal lobes of the brain.
5. Mixed Dementia: A combination of two or more types of dementia, such as Alzheimer’s disease and vascular dementia.
6. Other Causes: Includes Parkinson’s disease, Huntington’s disease, and conditions like Creutzfeldt-Jakob disease.

Risk factors

• Age
• Genetics (inherited risk)
• Other long-term health conditions
• Lifestyle – for example, smoking and excessive alcohol use
• Sex and Gender
• Cognitive Reserve – the brain’s ability to keep working despite having the disease

How to Treat Dementia Patients?

Caring for individuals with dementia requires patience, understanding, and adaptability. While there’s no cure for most types of dementia, including Alzheimer’s disease, there are many ways to improve the quality of life for those affected. Here are some critical strategies for treating and caring for dementia patients: 

1. Establish a Positive Environment
2. Maintain Routines
3. Encourage Independence
4. Communicate Effectively
5. Promote Physical Health

Also read: 101 things to do with dementia patients

Takeaway