What Are The First Stages Of Dementia

Difficulty Finding The Right Words

Another early symptom of dementia is struggling to communicate thoughts. A person with dementia may have difficulty explaining something or finding the right words to express themselves. Having a conversation with a person who has dementia can be difficult, and it may take longer than usual to conclude.

Using The Gds To Measure Dementia Progression

As the disease progresses, different signs and symptoms will become increasingly obvious. While there are several scales to measure the progression of dementia, the most common scale is the Global Deterioration Scale for Assessment of Primary Degenerative Dementia . The scale is also known as the Reisberg Scale. According to the GDS, there are seven different stages of Alzheimers disease correlating with four distinct categories: no Alzheimers, mild Alzheimers , moderate Alzheimers , and severe Alzheimers .

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.

Our dementia information is available to read or listen to online. You can also order a free printed copy of this factsheet and other dementia publications through the post.

STAGES OF DEMENTIA

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Loss Of Daily Life Skills

A home that may not be as well kept as usual may be a sign that the person living there has dementia. They may lose the ability to do many of the things they normally do themselves, such as preparing meals, household chores and eating and drinking properly.

They may also struggle to maintain their personal hygiene and getting dressed. Deciding what to wear, how to put things on and in the right order may become increasingly difficult. Getting around the house without walking into furniture and other items may also be a problem.

Key Points About Early

• Alzheimer disease commonly affects older people, but early-onset Alzheimer disease can affect people in their 30s or 40s.

• It affects memory, thinking, and behavior.

• Although there is no known cure, early diagnosis and treatment can lead to better quality of life.

• Stay healthy with a good diet and regular exercise.

• Avoid alcohol and other substances that may affect memory, thinking, and behavior.

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When To See A Doctor

Forgetfulness and memory problems dont automatically point to dementia. These are normal parts of aging and can also occur due to other factors, such as fatigue. Still, you shouldnt ignore the symptoms. If you or someone you know is experiencing a number of dementia symptoms that arent improving, talk with a doctor.

They can refer you to a neurologist who can examine you or your loved ones physical and mental health and determine whether the symptoms result from dementia or another cognitive problem. The doctor may order:

• a complete series of memory and mental tests
• a neurological exam
• brain imaging tests

If youre concerned about your forgetfulness and dont already have a neurologist, you can view doctors in your area through the Healthline FindCare tool.

Dementia is more common in people over the age of 65, but it can also affect younger people. Early onset of the disease can begin when people are in their 30s, 40s, or 50s. With treatment and early diagnosis, you can slow the progression of the disease and maintain mental function. The treatments may include medications, cognitive training, and therapy.

Possible causes of dementia include:

• Alzheimers disease, which is the leading cause of dementia
• brain damage due to injury or stroke

Sixth Dementia Stage: Severe Decline

The sixth stage of dementia is the second to last stage where patients may require constant supervision as well as around the clock or 24/7 medical care. If a person cannot receive proper care at home at this point, it is best to look for assisted living centers near you or nursing homes which also specializes in taking care of patients who have dementia . Symptoms that people usually showcase in the 6th stage of dementia include:

• Unawareness or confusion of surroundings and environment
• Wandering
• Need for assistance with day to day activities like bathing, dressing, toileting, eating and incontinence
• Potential behavioral problems as well as personality changes
• Inability to recall most details about their history
• Failure to recognize faces apart from very close relatives and friends
• Loss of bladder and bowel control
• Loss of willpower

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Other Types Of Dementia

Other progressive forms of dementia include frontotemporal dementia, Lewy body dementia, and vascular dementiaand it’s also possible to have a combination of dementia types.

Frontotemporal Dementia

With frontotemporal dementia, nerve cells in the parts of the brain involved in behavior, communication, and personality begin to degenerate. Thus, people with this condition typically have symptoms that impact how they behave, reason, or communicate. Movement is also affected.

Lewy Body Dementia

In Lewy body dementia, wads of protein accumulate in the brain. These proteins can also be found in patients with Parkinson’s and Alzheimer’s diseases. People with this form of dementia might hallucinate, have trouble concentrating, or experience difficulty with physical coordination and movement.

Vascular Dementia

Vascular dementia is second only to Alzheimers in its prevalence in people with dementia. It occurs as a result of problems with the blood vessels that involve the brain. While people with this form of dementia may have difficulty with recall, their most obvious symptoms are likely to be trouble with organization, reasoning, concentration, and thinking quickly.

How Are The Stages Of Dementia Diagnosed

During an evaluation process, doctors perform various tests to determine if a patient is suffering from dementia. These different tests include:

• Cognitive tests: Different cognitive tests are available, like the General Practitioner Assessment of Cognition screening and the Mini-Cog 3-minute test. Also available are the Eight-item Informant Interview to Differentiate Aging and Dementia and the Short Informant Questionnaire on Cognitive Decline in the Elderly .

• Neurological Evaluations: During this evaluation, doctors might perform a brain imaging study, like an MRI or CT scan. They will also check different functions including:

• Balance

• Cerebrospinal fluid analysis

• Analysis of thyroid

• Brain Scans: Cortisol atrophy is common in patients with dementia. This progressive loss of neurons causes the brain to appear thinner and wider as brain cells die and ventricles expand to fill the space. Doctors can identify this by performing computed tomographic and magnetic resonance imaging scans.

• Psychiatric Evaluation: Psychiatric evaluations are normally done to determine if a patient has depression or other psychiatric disorders that could be contributing to their symptoms of dementia.

A 2016 study has shown that:

• A majority of patients with dementia also experience mood, behavior, and perception disturbances.

• Patients with schizophrenia develop dementia later in life.

• Depression could be associated with cognitive decline.

• Alzheimers disease presents many psychiatric symptoms.

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Vascular Dementia: Early Signs And Symptoms

Vascular dementia occurs when blocked or damaged blood vessels in the brain deprive brain cells of the oxygen and vital nutrients they need. It is the second most common cause of dementia, after Alzheimers, accounting for an estimated 10 percent of all cases.

In the past, doctors used a diagnosis of vascular dementia to rule out Alzheimers, and vice versa. Now theres increasing awareness that both forms of dementia often coexist, a condition called mixed dementia.

Symptoms of vascular dementia may be most pronounced immediately after a person has a stroke that blocks a major blood vessel in the brain. These sudden changes can include these symptoms:

• Confusion
• Difficulty speaking or comprehending speech
• Loss of vision

Repeated small strokes or other damage to smaller blood vessels in the brain can lead to more subtle impairments that worsen over time. These symptoms can include the following:

• Difficulty making judgments and planning
• Uncontrolled laughing and crying
• Increasing inability to focus mentally
• Difficulty functioning in social situations
• Trouble finding the right words

Second Dementia Stage: Very Mild Decline

Older adults at the second stage of dementia may begin to notice that they are experiencing some minor memory issues. It is common for people at this stage to forget where they put things in the house. Memory lapses can also be seen when a person forgets the names that were at one time familiar. The memory loss patients experience during the second stage of dementia cannot be clearly distinguished from the ordinary age-related memory loss. It is to say that an individual may still do well when they go through memory tests.

It is also possible that physicians and loved ones may not be in a position to detect the disease at this stage. Studies reveal that almost half of the 65 and older generation report minor forgetfulness. It is also important to understand that the subtle changes could have nothing to do with dementia, but they might just be regular changes that come about as a person becomes older.

However, if a person has dementia, it may be severe enough to interfere with a persons ability to live independently or complete their daily chores. Life may go on normally at this point apart from occasional cases of slight memory loss.

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Watch For These 12 Early Signs Of Dementia

As you interact with an aging loved one, watch for these early signs of dementia and Alzheimers. One symptom doesnt necessarily mean that they are developing dementia. However, several may mean that your loved one needs to be seen by a neurologist. The top twelve early signs and symptoms of dementia include

Where To Find Help

When your loved one is displaying troubling symptoms, a trip to a primary care physician is often the first step. But to get a definitive diagnosis, youll need to see a specialist such as a neurologist, geriatrician or geriatric psychiatrist.

If you cant find one, the National Institute on Aging recommends contacting the neurology department of a nearby medical school. Some hospitals also have clinics that focus on dementia.

Ailments can mimic dementia

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What Diseases Or Conditions May Worsen Dementia

Treatable disorders revealed by the diagnostic evaluation should receive prompt attention.

• Common, treatable conditions that cause or worsen dementia include high blood pressure, high cholesterol, heart disease, diabetes, infections, head injuries, brain tumors, hydrocephalus, anemia, hypoxia, hormone imbalances, and nutritional deficiencies.
• Treatment varies by disorder, but some treatments may rapidly reverse the dementia symptoms.

A Person With Dementia Doesnt Always Fit Into One Stage

Dementia affects each person in a unique way and changes different parts of the brain at different points in the disease progression.

Plus, different types of dementia tend to have different symptoms.

For example, someone with frontotemporal dementia may first show extreme behavior and personality changes. But someone with Alzheimers disease would first experience short-term memory loss and struggle with everyday tasks.

Researchers and doctors still dont know enough about how these diseases work to predict exactly what will happen.

Another common occurrence is for someone in the middle stages of dementia to suddenly have a clear moment, hour, or day and seem like theyre back to their pre-dementia abilities. They could be sharp for a little while and later, go back to having obvious cognitive impairment.

When this happens, some families may feel like their older adult is faking their symptoms or just isnt trying hard enough.

Its important to know that this isnt true, its truly the dementia thats causing their declining abilities as well as those strange moments of clarity theyre truly not doing it on purpose.

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What Is The Treatment For Symptoms And Complications Of Dementia

Some symptoms and complications of dementia can be relieved by medical treatment, even if no treatment exists for the underlying cause of the dementia.

• Behavioral disorders may improve with individualized therapy aimed at identifying and changing specific problem behaviors.
• Mood swings and emotional outbursts may be treated with mood-stabilizing drugs.
• Agitation and psychosis may be treated with antipsychotic medication or, in some cases, anticonvulsants.
• Seizures usually require anticonvulsant medication.
• Sleeplessness can be treated by changing certain habits and, in some cases, by taking medication.
• Bacterial infections require treatment with antibiotics.
• Dehydration and malnutrition may be treated with rehydration and supplements or with behavioral therapies.
• Aspiration, pressure sores, and injuries can be prevented with appropriate care.

How Dementia Causes Death

A person in the late stage of dementia is at risk for many medical complications, like a urinary tract infection and pneumonia . They’re at an even higher risk of certain conditions because they’re unable to move.

Trouble swallowing, eating, and drinking leads to weight loss, dehydration, and malnutrition. This further increases their risk of infection.

In the end, most people with late-stage dementia die of a medical complication related to their underlying dementia.

For example, a person may die from an infection like aspiration pneumonia. This type of pneumonia usually happens because of swallowing problems.

A person may also die from a blood clot in the lung because they are bedbound and not mobile.

It’s important to know that late-stage dementia is a terminal illness. This means that dementia itself can lead to death. Sometimes this is appropriately listed as the cause of death on a death certificate.

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Difficulties In Thinking Things Through And Planning

A person may get confused more easily and find it harder to plan, make complex decisions or solve problems.

Acting Out Of Character

We all change as we move through life, but a clear warning sign of dementia is abrupt changes in your loved ones personality. Dementia can cause changes in the brain that affect the ability to know what is appropriate.Someone who has always been careful with their words may start saying whatever pops into their head. This can include often quite rude or sexually inappropriate comments. When your loved one is behaving out of character, it is often because of changes in the brain.

What You Might Notice: Your mom has drilled into you since birth the importance of tact and politeness. Shes never spoken badly of anyone, but the last time you talked to her she said, Have you noticed how fat your sister has gotten?

How You Can Help: Try not to get upset. This is the changes in your moms brain causing the inappropriate comments. Dont respond and change the subject to a more appropriate one.

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Moderate Or Middle Stage

In this stage, individuals with Alzheimers disease are more likely to experience increased confusion, greater memory loss, and worsening judgment. Individuals in this stage of the disease may exhibit confusion about orientation, such as where they are or what day it is. They may also have difficulty recalling personal information, such as their address or phone number or important dates like birthdays or anniversaries. Some individuals may also be at increased risk for wandering. In the other types of dementia, the earlier symptoms will become more pronounced , but the diseases also start to resemble the moderate stage of Alzheimers disease.

During this stage, individuals with dementia are likely to begin to need more assistance. They may need help with some basic daily tasks, such as dressing, bathing, and grooming . You might also notice changes in sleep patterns, as well as in their personality and behavior. For example, individuals with dementia might experience increased paranoia or fear.

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Late stage of dementia

Knowing The Stages Of Dementia Helps You Plan

Even if the stages arent exact and symptoms can still be unpredictable, being able to plan ahead is essential.

The truth is that Alzheimers and dementia care is expensive and time-consuming. Being financially prepared for increasing care needs is a necessity.

On an emotional level, having an idea of what symptoms to expect helps you find ways to cope with challenging behaviors.

It also gives you a chance to mentally prepare yourself for the inevitable changes in your older adult.

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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.

Changes In Behaviour Judgement And Moods

Becoming quiet, withdrawn or restless or frustrated or angry can be early signs of dementia. Someone may develop repetitive behaviour for example, they ask the same question over and over again, do the same thing repeatedly or make multiple phone calls to the same person. They may become insecure and anxious or start hiding and losing items. They may withdraw from social activities or give up hobbies and interests they have enjoyed.

They may show poor judgement, for example putting summer clothes on in cold winter months, not knowing when a kettle is full or overfilling cups when making cold and hot drinks, putting a kettle on the hob or leaving a cooker on or tap running. Someone with dementia may become very emotional and experience rapid mood swings or become quieter and less emotional than usual.

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