Understanding the dementia timeline is key to making thoughtful medical and personal decisions regarding memory care. Learning the signs of early, moderate, and late stage dementia can help you know what you’re facing, prepare for the future, and determine when it’s time to reassess your family member’s care needs.
Dementia is a term for brain disorders that cause a loss of remembering, thinking, and reasoning skills. Alzheimer’s disease accounts for 60% to 80% of cases. The most common types of dementia, including Alzheimer’s, is progressive, meaning it worsens over time. Dementia is categorized as mild, moderate, or severe as well as early stage, middle stage, and late stage.
Health-care providers often use a more comprehensive seven-stage tool to assess dementia. It’s called the Global Deterioration Scale (GDS), or the Reisberg Scale, developed by Dr. Barry Reisberg, a geriatric psychiatrist and NYU Langone Health professor. It enables caregivers and health professionals to have a rough idea where someone is in the disease’s progression by observing and comparing their symptoms.
Someone in the first three stages of dementia does not usually exhibit enough symptoms to be diagnosed.
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Though it may seem odd, the lowest stage is normal mental functioning, or no cognitive impairment.
Where the heck did I put my keys? What was that person’s name?
At least half of the population 65 and older reports some minor age-related forgetfulness, according to the Fisher Center for Alzheimer’s Research. Caregivers or medical providers may not even notice such mild impairment, and it’s not considered to be dementia.
When memory and cognitive problems become more regular, as well as noticeable to caregivers and family members, a person is said to be suffering from mild cognitive impairment (MCI). It doesn’t generally have a major impact on day-to-day functioning.
Eight in 10 people with MCI will go on to develop Alzheimer’s disease within seven years, according to the National Institute on Aging. Since MCI can precede more severe stages of dementia, it’s important to recognize the signs of this stage and seek medical advice.
A person is not typically diagnosed with dementia until they are at stage 4 or beyond.
At this point, a person has clear visible signs of mental impairment. While it’s considered early stage or mild dementia, the medical terminology is moderate cognitive decline.
Doctors and caregivers will likely notice a worsening of stage 3 dementia symptoms, such as difficulties with language, problem-solving, and travel.
People require more intense care and supervision at this point. Someone with middle stage dementia often needs some caregiver assistance with regular day-to-day activities, such as dressing, eating, or bathing.
This stage marks the onset of what many professionals refer to as mid-stage dementia.
At this point, a person may no longer be able to carry out normal day-to-day activities, such as dressing or bathing, without some caregiver assistance. They know major facts about themselves — such as their name and their children’s names — but they may not remember grandchildren’s names, their longtime address, or where they went to high school.
Stage 6 marks a need for caregiver help to perform basic daily activities such as dressing, eating, using the toilet, and other self-care.
In severe Alzheimer’s or late stage dementia, people essentially can’t care for themselves.
All verbal ability is lost over the course of this final stage. Motor impairment occurs as well.
Memory care is specialized care for seniors who have Alzheimer’s disease, another type of dementia, and other forms of memory loss. It includes 24-hour supervision to prevent wandering, help with activities of daily living (ADLs), meal services, and health care as needed. Some carefully designed memory care facilities have layouts and therapies to reduce confusion and promote familiarity.
When to seek memory care will vary depending on a senior’s dementia symptoms, health status, living situation, and more. One of our Senior Living Advisors can discuss memory care thoroughly and share information on communities in your area.
Reisberg, B., Ferris, S.H., de Leon, M.J., and Crook, T. The global deterioration scale for assessment of primary degenerative dementia. American Journal of Psychiatry, 1982: https://www.fhca.org/members/qi/clinadmin/global.pdf
National Institute on Aging, “What is Mild Cognitive Impairment?”: https://www.nia.nih.gov/health/what-mild-cognitive-impairment
Kim Acosta is managing editor at A Place for Mom. She’s produced digital and print content for more than 20 years as an editorial leader at Shape magazine, P&G, Hallmark, and others. Her work has appeared in national media outlets including Family Circle, Parents, Lifescript, BuzzFeed, Living Fit, Natural Health, WorkingMother.com, and HomeCare.