Dementia

Stages of Dementia

Dementia can be divided into seven stages which are similar to those in Alzheimer’s disease. The seven stages of dementia include:

I. No impairment of normal function: No signs of memory loss are visible to a medical professional nor does the patient experience any symptoms.

II. Very mild cognitive decline: People may experience some loss of memory such as forgetting familiar words, names, or location of their wristwatch, eyeglasses or any similar objects of daily use. Family, friends or colleagues may observe these signs.

III. Mild cognitive decline: Early stage dementia can be diagnosed only in some individuals with the following symptoms:

• The patient has trouble remembering words or names.

• The patient loses the ability to remember names of individuals newly introduced to him or her.

• Difference in performance can be easily noticeable in work environment, social environment by family, friends or colleagues.

• Less retention from articles or stories read in a magazine or book.

• The patient misplaces or loses valuable objects.

• Decreased ability to plan or organize.

V. Moderately severe cognitive decline: Moderate or mid-stage dementia stage involves major gaps in memory and deficits in cognitive function. Assistance with daily activities may be required and the following symptoms are observed:

• The patient fails to recall their home address, telephone number and name of the college or school from which they graduated.

• The patient is in a confused state of mind with regards to their current location, date, day of the week, season etc.,

• The patient fails to perform even lesser challenging mental arithmetic such as counting backwards from 40 by 5s.

• The patient requires help in choosing the appropriate clothing for a particular season or occasion.

• Generally, the patient retains substantial knowledge and can tell his/her own name, names of their spouse or children.

• The patient does NOT require any assistance for eating or using toilet.

VI. Severe cognitive decline: This is the next to the last stage and is also called moderately severe or mid-stage dementia and includes memory difficulties continuing to worsen, personality changes emerging substantially, and the patient requiring a considerable amount of help for carrying out their day-to-day activities. The following symptoms are observed in patients with this stage of dementia:

• The patient loses track of some of the most recent experiences, events and even their surroundings. The patient cannot recall personal history exactly, though she/he can recall her/his name perfectly. The patient can distinguish familiar faces from unfamiliar faces.

• The patient requires help to dress appropriately, since they tend to create errors such as wearing shoes on the wrong feet etc.,

• The patient experiences a disturbance in normal sleep/waking cycle.

• The patient would require the help for handling details of toileting such as flushing toilet, wiping and proper disposal of tissue paper.

• There are increasing episodes of urinary or fecal incontinence.

• Changes in behavior including suspicion and delusions such as suspecting the care giver as an impostor, hallucinations, repetitive behavior such as hand wringing etc.,

• The patient tends to wander and become lost.

VII. Very severe cognitive decline: This is the last stage of dementia and is called Severe or late-stage dementia and includes symptoms such as: the patient losing the ability to respond to the environment, unable to communicate orally, and unable to control movements.

• Often, patients in this stage lose the ability to communicate in a recognizable speech though they utter phrases occasionally.

• Patients need assistance in eating and toileting with general incontinence of urine being common. (9)

Patients gradually lose the ability to walk without support, to sit, to smile and hold their head up. Muscles become rigid and reflexes abnormal with swallowing becoming impaired. (9)

Article by Kona Vishnu, MS
Medical Writer,
OmniMedicalSearch.com

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