7 Stages of Dementia and its Progression

Loss of cognitive functioning i.e. thinking, reasoning, and remembering and other behavioral activities in such a way that it affects the person’s daily activities is known as dementia. In many cases, dementia is irreversible and incurable. Early diagnosis can manage the progression of the disease by slowing it down. The progression of dementia is different in different people (rapid in some and slow in others), and it also depends on the underlying cause.

The symptoms of dementia do not appear all at once. The disease progresses in seven stages. The knowledge about the stages can help identify the disease early so that the treatment can start soon. It can also assist the caretakers and the sufferers to know what they can expect in the further stages of dementia.

In stage 1 of dementia, there is no memory or cognitive impairment. The patient gives a satisfactory result in the memory, language, and problem-solving test done by the health professional. It is basically a no impairment stage. A stage 1 to 3 is generally known as the pre-dementia stages.

This stage of dementia shows a very mild decline in cognitive function. It can be merely age-related decline of memory featuring the below-mentioned functions or can also be the early sign of dementia.

• Forgetting everyday phrases, dates, and names
• Forgetting the location of objects, or function done just a few hours ago
• Dementia is still undetectable at stage 2, but the presence of the symptoms can raise the concern about the disease.

3rd stage of dementia shows the manifestation of clear cognitive problems such as,

• Difficulty finding right word or phrase
• Forgetting names of friends, family members or the people recently introduced
• Poor performance at work
• Losing or misplacing important things
• Difficulty in remembering information
• Difficulty in concentration
• Anxiety in social or work settings

The appearance of these symptoms is not just noticeable to the family but also to the co-workers and the friends. Patient at this stage of dementia should visit a clinician for a proper diagnosis.

At this stage of dementia, the patient starts becoming socially withdrawn and might show changes in mood and personality. The people at the 4th stage of dementia might deny the symptoms as a defence mechanism. A healthcare provider can easily identify the cognitive decline in examination and interview of the patient. The average duration of this stage is approximately 2 years. The symptoms presented by the patient in stage 4 dementia are,

• Difficulty in problem-solving and managing finances
• Forgetting the personal history events
• Disorientation
• Difficulty in recalling current and recent events
• Challenges in traveling to unfamiliar places, familiar places seem to be of no problem
• Difficulty in organizing and expressing thoughts

The stage 4 dementia patient might hide symptoms to avoid stress and anxiety and might often avoid any challenging tasks.

This stage of dementia marks the beginning of mid-stage dementia. The patients start forgetting the familiar faces of friends and close family members. The patients at the 5th stage of dementia show the following symptoms:

• Disorientation of time and place
• Difficulty in recalling major details such as family members or address
• Trouble making decisions
• Forgetting basic information about self, such as telephone number or address

The stage 5 dementia lasts on an average till one and a half years. The dementia patient at this stage will be able to perform the daily basic functions such as preparing meals, bathing, and other daily functions. They might be able to recall their names or the name of their spouse and children.

People in the 6th stage of dementia require a full-time assistant to perform the day-to-day activities. They are unable to recall the recent events and even forget the names of close family and friends. The patients have very little memory of their earlier life and find completing tasks very difficult. A 6th stage dementia patient is generally unaware of the surroundings. The caretaker and the close family members should watch for the following symptoms:

• Anxiety, aggression, and agitation
• Loss of willpower
• Delusional behavior
• Major shifts in sleep and eating patterns

The patients might also experience incontinence in bowel and bladder and have diminished speech ability. The stage 6 of dementia lasts on an average for about two and a half years.

This is the last and the most difficult stage of dementia. The patient might completely lose the ability to respond to others in the 7th stage of dementia. They might not be able to smile or swallow and will no lager be able to carry on conversations. All the daily activities might require assistance, including eating, dressing, bathing, and toileting. There is a loss of psychomotor capabilities making walking difficult and the patient may require assistance with ambulation.

Dementia is a progressive disease and early identification can help delay the stages with medical help. Progression of dementia is different for every individual, but the caregivers and the family members should familiarize themselves with all the stages of dementia. The road through the different stages of dementia is challenging for the patients as well as for the loved ones, but the knowledge about the same can help ease the stress and uncertainty.

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