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Alzheimer's Alliance: Stages of Dementia

There are seven stages of dementia you should know.
Credit: Alzheimer's Alliance

Stage 1: No Impairment

  • Memory and cognitive abilities appear normal.

Stage 2: Minimal Impairment/Normal Forgetfulness

  • Memory lapses and changes in thinking are rarely detected by friends, family, or medical professionals.

Stage 3: Mild Cognitive Impairment

Duration: 2 to 7 years

  • While subtle difficulties begin to impact function, the person may consciously or subconsciously try to cover up their problems.
  • There is some difficulty with retrieving words, planning, organization, misplacing objects, and forgetting recently learned information, which can affect life at home and work.
  • Depression and other changes in mood can also occur.

Stage 4: Late Confusional/Mild Alzheimer's Disease

Duration: approximately 2 years

  • Problems handling finances result from mathematical challenges are present.
  • Recent events and conversations are increasingly forgotten, although most people in this stage still know themselves and their families.
  • They may also experience problems carrying out sequential tasks, including cooking, driving, ordering food at restaurants, and shopping.
  • They often withdraw from social situations, become defensive, and deny problems.

Stage 5: Early Dementia/Moderate Alzheimer's Disease

Duration: approximately 1.5 years

  • Decline is more severe and requires assistance. They are frequently disoriented regarding place and/or time.
  • They are no longer able to manage independently or unable to recall personal history details and contact information.
  • People in this stage experience a severe decline in numerical abilities and judgment skills.
  • Basic daily living tasks like feeding and dressing require increased supervision.

Stage 6: Middle Dementia/Moderately Severe Alzheimer's Disease

Duration: approximately 2.5 years

  • Total lack of awareness of present events and inability to accurately remember the past. Many can't remember close family members, but they know they are familiar.
  • People in this stage progressively lose the ability to take care of daily living activities like dressing, toileting, and eating but are still able to respond to nonverbal stimuli and communicate pleasure and pain via behavior.
  • Agitation and hallucinations often show up late in the afternoon or evening. Dramatic personality changes such as wandering or suspicion of family members are common.

Stage 7: Late Dementia/Severe Alzheimer's Disease

Duration: approximately 1 to 2.5 years, depending on quality of care

  • In this final stage, speech becomes severely limited, as well as the ability to walk or sit.
  • Total support around the clock is needed for all functions of daily living and care.

Adapted from the Reisberg Scales: 7 Stages of Cognitive Deterioration

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