The Early Stages Of Dementia: Noticeable Cognitive Decline
A person is not typically diagnosed with dementia until theyre at stage 4 or beyond. This is when medical professionals and caregivers notice personality changes, as well as cognitive impairment.
Dementia stage 4: moderate cognitive decline
At this point, a person has clear, visible signs of mental impairment. While its considered mild or early stage dementia, the medical terminology for the fourth of the seven stages of dementia 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.
Stage 4 dementia symptoms
Your Guide To Understanding The 7 Stages Of Dementia
Dementia is a diagnosis that changes your life forever. Whether it is you or a loved one, its important that you understand the stages of dementia.
Dementia is a series of symptoms that affect memory, thinking, and reasoning. Doctors dont often refer to dementia as a whole. Instead, they talk about the seven stages of dementia.
There is no hard and fast line that signals a transition from one stage to another. Each patient will experience the stages in unique ways. But it is still helpful to know what the 7 stages of dementia are.
You want to guide your expectations and the level of care needed for your loved one. To do that, you must become familiar with the stages of dementia.
The 7 Stages Of Dementia: Early Middle Late Dementia Symptoms
Understand the 7 stages of dementia in the Reisberg scale and find out what to expect at each stage to better care for your loved one with dementia.
With Singapores ageing population, an increasing number of older adults are at risk of dementia. However, this is not a problem thats exclusive to Singapore, but a global phenomenon affecting countries around the world including Australia, Japan and Germany.
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What Are The Final Stages Of Dementia
As seniors progress to late stage dementia, full-time care may become necessary, whether you choose memory care or professional dementia care at home. The symptoms of the final stages of Alzheimers include behavioral and personality changes, inability to perform ADLs, and severe cognitive decline.
Dementia stage 6: severe cognitive decline
Stage 6 marks a need for caregiver help to perform basic daily activities such as dressing, eating, using the toilet, and other self-care. Seniors with late stage dementia may have difficulty regulating sleep, interacting with others, or behaving appropriately in public settings.
Fifth Dementia Stage: Moderately Severe Decline
At this point, the progression of the disease starts to take a downhill slope. Experts refer to it as mid-stage dementia. Patients start to need assistance with numerous activities of daily living. Individuals experiencing this stage may:
- Experience disorientation about the time or places
- Have trouble dressing properly
- Failure to perform simple math problems
- Not be able to recall simple information about themselves like personal phone numbers or home address
- Forgetfulness and confusion
If symptoms cannot be managed at home during this dementia stage, it may be a good idea at this point to start to look into dementia and Alzheimers care near you and find an appropriate facility that can properly manage the condition.
Some patients may, however, still maintain some level of functionality and may still be able to live at home with the help of their loved ones or hired caregivers. It is where they remain in a position to do some tasks independently which may include eating, taking a bath and properly using the toilet. Others may still know information about the people they love such as close family members and personal history especially their youth or childhood.
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Symptoms Specific To Dementia With Lewy Bodies
Dementia with Lewy bodies has many of the symptoms of Alzheimer’s disease, and people with the condition typically also experience:
- periods of being alert or drowsy, or fluctuating levels of confusion
- visual hallucinations
- becoming slower in their physical movements
- repeated falls and fainting
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Stage : Severe Cognitive Declinemoderately Severe Dementia
At this stage, the ability to perform basic activities of daily life becomes compromised. Functionally, five successive substages are identifiable. Persons initially in stage 6a, in addition to having lost the ability to choose their clothing without assistance, begin to require assistance in putting on their clothing properly. Unless supervised, the person with Alzheimers disease may put their clothing on backward, they may have difficulty putting their arm in the correct sleeve, or they may dress in the wrong sequence.
The total duration of the stage of moderately severe Alzheimers disease is approximately 2.5 years in otherwise healthy persons.
At approximately the same point in the evolution of AD, but generally just a little later in the temporal sequence, AD persons lose the ability to bathe without assistance . Characteristically, the earliest and most common deficit in bathing is difficulty adjusting the temperature of the bath water. Once the caregiver adjusts the temperature of the bath water, the AD person can still potentially otherwise bathe independently. As this stage evolves, additional deficits occur in bathing and dressing independently. In this 6b substage, AD persons generally develop deficits in other modalities of daily hygiene such as properly brushing their teeth.
Stages 6c, 6d, 6e
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Scales For Rating Dementia
Rather than simply using early stage,middle-stage, and late-stage dementia as descriptors, there are scales that provide a more comprehensive description. These scales help better understand the different stages of Alzheimers disease based on how well a person thinks and functions . These scales are the Global Deterioration Scale for Assessment of Primary Degenerative Dementia, the Functional Assessment Staging Test, and the Clinical Dementia Rating.
Did You Know?
Global Deterioration Scale / Reisberg Scale
The most commonly used scale is often referred to simply as GDS, or by its more formal name, the Reisberg Scale . The GDS divides into seven stages based on the amount of cognitive decline. This test is most relevant for people who have Alzheimers disease because some other types of dementia do not always include memory loss.
Someone in stages 1-3 does not typically exhibit enough symptoms for a dementia diagnosis. By the time a diagnosis has been made, a dementia patient is typically in stage 4 or beyond. Stage 4 is considered early dementia, stages 5 and 6 are considered middle dementia, and stage 7 is considered late dementia.
|Global Deterioration Scale / Reisberg Scale|
Clinical Dementia Rating
|Clinical Dementia Rating Scale|
|Average duration is 1 year to 2.5 years.|
How Many Stages Of Dementia Are There
There are several different types of Dementia, with Alzheimers disease being the most common. Though when it comes to the different stages of Dementia, we can typically categorise the trajectory of the disease as mild, moderate or severe.
Although this three stage model is useful for providing an overview of early, middle and final stages of Dementia, most people prefer a seven stage model that breaks cognitive decline down into seven specific categories. The progression of Dementia will be different for everyone, but knowing where a loved one falls on this scale can help to identify signs and symptoms, whilst also determining the most appropriate care needs. So, what are the 7 stages of Dementia?
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Fourth Dementia Stage: Moderate Decline
Dementia symptoms are clear-cut at this point. Patients who at the fourth stage of dementia showcase some issues such as:
- Difficulties solving simple arithmetic
- Short-term memory loss, for instance, one may not remember what they had for lunch in the afternoon
- Forgetting information about their life history
- Reduced knowledge of recent or current events
- Inability to pay bills or even manage finances
- Trouble with routine chores or tasks
- Challenges recognizing people and faces
- Trouble with traveling to a new location alone
To help efficiently deal with this dementia stage, loved ones can help out with daily tasks and make sure that the patient is safe at all times. Be on the lookout to make sure that they do not fall victim to unscrupulous individuals who may want to take advantage of the patient financially. For many patients, the fourth dementia stage usually lasts about two years.
Many patients at this time also tend to withdraw from the society mainly because they feel like what they are going through is embarrassing them. They could also face adverse changes in their moods and personality. Many patients also deny that they have any symptoms as a defense mechanism, even though the symptoms may be quite evident.
Stage : Moderate Dementia
Patients in stage 5 need some assistance in order to carry out their daily lives. The main sign for stage 5 dementia is the inability to remember major details such as the name of a close family member or a home address. Patients may become disoriented about the time and place, have trouble making decisions, and forget basic information about themselves, such as a telephone number or address.
While moderate dementia can interfere with basic functioning, patients at this stage do not need assistance with basic functions such as using the bathroom or eating. Patients also still have the ability to remember their own names and generally the names of spouses and children.
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What Is Mixed Dementia
It is common for people with dementia to have more than one form of dementia. For example, many people with dementia have both Alzheimer’s disease and vascular dementia.
Researchers who have conducted autopsy studies have looked at the brains of people who had dementia, and have suggested that most people age 80 and older probably have mixed dementia caused by a combination of brain changes related to Alzheimer’s disease,vascular disease-related processes, or another condition that involves the loss of nerve cell function or structure and nerve cell death .
Scientists are investigating how the underlying disease processes in mixed dementia start and influence each other. Further knowledge gains in this area will help researchers better understand these conditions and develop more personalized prevention and treatment strategies.
Other conditions that cause dementia-like symptoms can be halted or even reversed with treatment. For example, normal pressure hydrocephalus, an abnormal buildup of cerebrospinal fluid in the brain, often resolves with treatment.
Researchers have also identified many other conditions that can cause dementia or dementia-like symptoms. These conditions include:
Tips For Managing Dementia End
Because individuals with advanced dementia will often have difficulty communicating, it is important that caregivers keep a close eye on their loved one for signs of pain or discomfort. These signs may include moaning or yelling, restlessness or an inability to sleep, grimacing, or sweating. This may also signal that its time to call hospice or a palliative care team to help with the pain management.
If an individual with end-stage dementia is having trouble sitting up without assistance, hospice can provide a hospital bed or other equipment to lift their head.
Perhaps the hardest thing for families is when a loved one with dementia is no longer able to eat or swallow. Because an individual with dementia is unable to understand the benefits of feeding tubes or IV drips, they will often be incredibly distressed and attempt to remove them, causing added pain and risk of infection. Instead, focusing on keeping the individual comfortable. Supporting them with mouth care to prevent their mouth from becoming dry will allow them to make their final transition in peace.
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What Are The Signs And Symptoms Of Dementia
Signs and symptoms of dementia result when once-healthy neurons, or nerve cells, in the brain stop working, lose connections with other brain cells, and die. While everyone loses some neurons as they age, people with dementia experience far greater loss.
The symptoms of dementia can vary and may include:
- Experiencing memory loss, poor judgment, and confusion
- Difficulty speaking, understanding and expressing thoughts, or reading and writing
- Wandering and getting lost in a familiar neighborhood
- Trouble handling money responsibly and paying bills
- Repeating questions
- Not caring about other peoples feelings
- Losing balance and problems with movement
People with intellectual and developmental disabilities can also develop dementia as they age, and recognizing their symptoms can be particularly difficult. Its important to consider a persons current abilities and to monitor for changes over time that could signal dementia.
What Are The Different Types Of Dementia
Various disorders and factors contribute to the development of dementia. Neurodegenerative disorders result in a progressive and irreversible loss of neurons and brain functioning. Currently, there are no cures for these diseases.
The five most common forms of dementia are:
- Alzheimers disease, the most common dementia diagnosis among older adults. It is caused by changes in the brain, including abnormal buildups of proteins, known as amyloid plaques and tau tangles.
- Frontotemporal dementia, a rare form of dementia that tends to occur in people younger than 60. It is associated with abnormal amounts or forms of the proteins tau and TDP-43.
- Lewy body dementia, a form of dementia caused by abnormal deposits of the protein alpha-synuclein, called Lewy bodies.
- Vascular dementia, a form of dementia caused by conditions that damage blood vessels in the brain or interrupt the flow of blood and oxygen to the brain.
- Mixed dementia, a combination of two or more types of dementia.
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Common Early Symptoms Of Dementia
Different types of dementia can affect people differently, and everyone will experience symptoms in their own way.
However, there are some common early symptoms that may appear some time before a diagnosis of dementia. These include:
- memory loss
- difficulty concentrating
- finding it hard to carry out familiar daily tasks, such as getting confused over the correct change when shopping
- struggling to follow a conversation or find the right word
- being confused about time and place
- mood changes
These symptoms are often mild and may get worse only very gradually. It’s often termed “mild cognitive impairment” as the symptoms are not severe enough to be diagnosed as dementia.
You might not notice these symptoms if you have them, and family and friends may not notice or take them seriously for some time. In some people, these symptoms will remain the same and not worsen. But some people with MCI will go on to develop dementia.
Dementia is not a natural part of ageing. This is why it’s important to talk to a GP sooner rather than later if you’re worried about memory problems or other symptoms.
What Is Dementia Symptoms Types And Diagnosis
Dementia is the loss of cognitive functioning thinking, remembering, and reasoning to such an extent that it interferes with a person’s daily life and activities. Some people with dementia cannot control their emotions, and their personalities may change. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person’s functioning, to the most severe stage, when the person must depend completely on others for basic activities of living.
Dementia is more common as people grow older but it is not a normal part of aging. Many people live into their 90s and beyond without any signs of dementia.
There are several different forms of dementia, including Alzheimers disease. A persons symptoms can vary depending on the type.
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Phases Of The Condition
Some of the features of dementia are commonly classified into three stages or phases. It is important to remember that not all of these features will be present in every person, nor will every person go through every stage. However, it remains a useful description of the general progression of dementia.
- Early Dementia
- Advanced Dementia
Stage : Slight Cognitive Decline
For Stage 2, signs of mild cognitive decline, also known as Age Associated Memory Impairment, are common. Caregivers and family members may notice slight forgetfulness from time to time, but memory issues may go undetected. For instance, familiar names may slip the persons mind, or the individual may forget where he or she left an object. During this period, lost keys or misplaced cell phones could become a common occurrence. This stage does not warrant a dementia diagnosis and signs of the disease would not be seen during any memory tests. The person would still be able to have a job and participate in normal social activities. Not all individuals with these signs will move on to the later stages of dementia.
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The Progression And Stages Of Dementia
Dementia is progressive. This means symptoms may be relatively mild at first but they get worse with time. Dementia affects everyone differently, however it can be helpful to think of dementia progressing in ‘three stages’.
The progression and stages of dementia
How Long Does The Final Stage Of Dementia Last
We wish we could give you a firm answer. The final stages of dementia can last anywhere from a few weeks to a few years.
The intensive end-of-life care required to mitigate the symptoms of end-stage dementia, when provided by professional care staff, can allow caregivers space and emotional energy to spend quality time with your loved one.
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How Can Healthcare Professionals Help At This Stage
Healthcare professionals can explain these changes so you understand what is happening.
Healthcare professionals can also take steps to reduce the persons pain or distress, often using medication.
If the person cant swallow, then medication can be provided through patches on the skin, small injections or syringe pumps that provide a steady flow of medication through a small needle under the persons skin. Speak to a GP or another health professional about this.