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If you are caring for someone with dementia, you may already know about the 7 Stages of Dementia Chart.
It was created by Dr. Barry Reisberg as a way to help healthcare professionals and caregivers better understand the progression of dementia.
Of course, every individual has a unique experience with dementia. Ultimately, however, there is a progressive decline. From the early stages of dementia to the final stage of dementia, a range of physical and cognitive changes will occur.
This post is designed to help you better understand what to expect during the various stages of dementia. I’ll discuss the distinct stages of each form of dementia, along with symptoms and personal care issues.
The Most Common Types of Dementia Explained
Dementia is actually an umbrella term to describe various types of cognitive impairment. While there are over 100 diseases that may cause dementia, the most common causes include:
Alzheimer’s Disease
When I was in my late teens in the 1980’s, concerns were raised about the potential association between aluminum exposure and Alzheimer’s disease. It was a bad time to be selling aluminum pans because people were throwing them away!
These days, there doesn’t seem to be any solid scientific evidence to support that theory. More recently, the National Institute on Aging suggests a combination of genetic, environmental, and lifestyle factors play a role in the development of the disease.
According to the Alzheimer’s Association, the lifetime risk for Alzheimer’s by age 45 is 1 in 5 for women and 1 in 10 for men! It’s no wonder we worry about a little short-term memory loss.
Early diagnosis is important, so if you are worried about a loved one, it’s important to understand the top 10 warning signs.Â
Top 10 Warning Signs of Dementia
If you notice your loved one experiencing one or more of the following symptoms, it may be time to seek a dementia diagnosis. Although there is no cure for Alzheimer’s disease, early diagnosis can allow for medical treatments to potentially slow the progression of the disease.
In addition, an early diagnosis allows individuals and their families to plan for the future. Signs to watch for include:
- Memory changes that affect daily life.
- Familiar tasks become difficult.
- Communication skills begin to change.
- Disorientation in time and place.
- Impaired judgment.
- Difficulty with abstract thinking.
- Misplacing things.
- Personality and behavioral changes.
- Loss of drive or initiative.
- Difficulty understanding visual and spatial information
Vascular Dementia
Vascular dementia can occur as a result of blocked or reduced blood flow to different parts of the brain. For example, changes in thinking may occur after a stroke.
Vascular dementia, or the more preferred term “vascular cognitive impairment,” involves changes to memory and thinking that can range from mild to severe.
Symptoms commonly seen after a stroke can include:
- confusion
- disorientation
- poor balance
- numbness or paralysis on one side of the body
- sudden headache
- trouble speaking
- trouble understanding speech
Symptoms may be similar to those of Alzheimer’s disease, depending on the specific brain areas where blood flow is reduced.
Lewy Body Dementia
Lewy-body dementia is the second-most common type of dementia. Alzheimer’s disease is the most common. It occurs when protein deposits called Lewy bodies develop in nerve cells in the brain.
As with Alzheimer’s disease, Lewy body dementia is a progressive condition. Symptoms can include:
- visual hallucinations
- changes in alertness and attention
- rigid muscles
- slow movements
- trouble walking
- tremors and other Parkinson-like movement disorders
- sleep problems
- cognitive problems
- depression
- loss of control over bodily functions
- apathy
Lewy body dementia can also affect the autonomic nervous system. The autonomic nervous system controls things like blood pressure and heart rate. Someone with Lewy body dementia could experience sudden drops in blood pressure, dizziness, and falls.
Frontotemporal dementia
Frontotemporal dementia (FTD) is a group of disorders that occur when nerve cells in the frontal and temporal lobes of the brain are lost.
When this happens, the lobes shrink. According to John Hopkins Medicine, frontotemporal dementia tends to strike at younger ages, with symptoms starting between the ages of 40 and 65. It can, however, strike younger or older individuals as well.
The two most common types of FTD are:
Frontal Variant
Affects behavior and personality.
Primary Progressive Aphasia
Affects the ability to communicate, speak, use, and understand language.
Common symptoms of FTD include:
- dramatic behavioral and personality changes
- impulsive, inappropriate, or repetitive behaviors
- impaired judgment
- apathy
- lack of empathy
- less interest in self
- uninterested in daily activities
- may become emotionally withdrawn
- experiences loss of energy or motivation
- has trouble expressing words or understanding the meaning of words
- difficulty naming objects
- becomes hesitant to speak
- easily distracted
- becomes easily agitated
- becomes increasingly dependent
Some people with FTD may also have physical symptoms (tremors, muscle spasms, weakness, etc.) or psychiatric symptoms, including hallucinations or delusions.
Communicating with Dementia Patients
If you’re the caregiver or loved one of someone with dementia (regardless of the type) you may find yourself having difficulty communicating with the individual.
Read: 7 Things Not to Say to Someone With Dementia to guide you through the difficult phases of dementia.
The 7 Stages of Dementia
There are seven different stages of dementia that can be hard to detect in the beginning. As the disease progresses, new symptoms develop or there is a worsening of existing symptoms.
In order to best help patients with dementia, healthcare professionals often use the Global Deterioration Scale (also known as the Reisberg Scale) to determine the stages of cognitive function.
The seven stages of dementia are broken down into pre-dementia stages (the first three) and dementia stages (four to seven).
Stage 1
No cognitive decline.
Stage 2
Very mild cognitive impairment.
Stage 3
Mild cognitive decline.
Stage 4
Moderate cognitive decline.
Stage 5
Moderately severe cognitive decline.
Stage 6
Severe cognitive decline.
Stage 7
Very severe cognitive decline. Considered late-stage dementia. Read the infographic below to see examples of what each stage can involve.
Infographic to Share
Image Caption
Diagnosis of Dementia
Diagnosing dementia involves medical and cognitive assessments. It begins with a thorough medical history review to understand the patient’s symptoms and any underlying health conditions.
Cognitive tests and neuropsychological assessments are used to evaluate memory, attention, language, and problem-solving abilities.
MRI or CT scans may be used to identify structural abnormalities. In addition, blood tests can help rule out other potential reasons for cognitive decline.
Living with Dementia
Dementia presents unique challenges for individuals and their caregivers. In the early stages, dementia patients may experience normal forgetfulness. Daily tasks, however, are still manageable. As the illness progresses, help from a caregiver may become more of a necessity and less of an option.
Every person’s experience of dementia is different.
However, it’s common to gradually find the activities of daily living more difficult. Early-stage dementia may involve mild memory issues. In the later stages, however, it’s not unusual for the person to experience emotional changes and cognitive issues.
Family members might be comfortable enough to help the person manage everyday tasks. However, as the disease progresses to the middle and late stages, healthcare providers may need to step in to help with round-the-clock care.
Life Expectancy of Someone with Alzheimer’s Disease
The life expectancy of someone with Alzheimer’s disease can vary from person to person. On average, people with Alzheimer’s disease live between three and 11 years after diagnosis.
However, some people can live 20 years or more! Things that may impact the lifespan of someone with this type of dementia include the following:
- The level of impairment at the time of diagnosis
- Whether the person has untreated vascular risk factors
- Health background
- Age and race
- Genetics
- Socioeconomic status
- Education
Summary
Dementia is a general term to describe a decline in mental ability that is severe enough to interfere with a person’s daily life. Although the terms “dementia” and “Alzheimer’s disease” tend to be used interchangeably, they are not the same thing.
Alzheimer’s disease is progressive and cannot be cured. It occurs as the result of complex brain changes that occur following cell damage. The damaged brain cells lead to dementia symptoms that worsen over time.
The clinical stages of Alzheimer’s disease progress slowly from the early, middle, and late stages of the disease.
To better help health professionals and care-givers, a 7 stages of dementia chart was created. Although every individual experiences dementia in a unique way, the chart is a useful tool in determining how far the disease has progressed and what is yet to come.
Resources
https://www.alzheimers.org.uk/about-dementia/types-dementia
https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/vascular-dementia
https://www.mayoclinic.org/diseases-conditions/lewy-body-dementia/symptoms-causes/syc-20352025
https://www.aplaceformom.com/caregiver-resources/articles/dementia-stages
