What Are the Stages of Dementia?

There are seven stages of dementia, each with different symptoms and behavioral characteristics. The first stage is characterized by no cognitive decline, while the seventh and last stage describes very severe cognitive decline. These stages help healthcare providers measure the progression of dementia symptoms.

The stages of dementia also help family caregivers understand how their loved one’s dementia is likely to progress. This can be useful when making long-term care decisions, such as when to transition to a nursing home or a memory care facility.

Doctors and other healthcare providers use the Global Deterioration Scale (GDS) to measure cognitive impairment in various types of dementia, including vascular dementia, frontotemporal dementia and Alzheimer’s disease. This scale has seven stages:

• No cognitive decline. Stage one describes a person with normal, healthy cognitive function.
• Very mild cognitive decline. Also known as age-associated memory impairment, people at this stage may occasionally misplace their keys or forget familiar names.
• Mild cognitive decline. This early stage of dementia is characterized by memory problems that affect a person’s work or social life, such as forgetting words or having trouble concentrating.
• Moderate cognitive decline. Also known as mild dementia, people in this stage may forget recent events or have trouble handling their finances.
• Moderately severe cognitive decline. People in this stage of dementia forget important details about their lives, such as their address or phone number, and may become disoriented and wander.
• Severe cognitive decline. At this stage, people tend to become unaware of their surroundings, develop personality changes and even occasionally forget their spouse’s name.
• Very severe cognitive decline. At this advanced stage, people with dementia lose their ability to speak and walk, and generally need assistance to eat.

The progression of dementia symptoms varies from one person to another, but understanding the stages of dementia can help give caregivers a general idea of the type of care their loved one is likely to need in the future. People in the early stages of dementia can often live independently with little or no assistance, but as the disease advances, they may start needing help with day-to-day tasks such as transportation or managing finances.People in the moderate to severe stages of dementia need ongoing assistance with basic activities of daily living, such as dressing, eating or toileting. Individuals who wander may require round-the-clock supervision to help ensure safety. Depending on each individual’s needs and preferences, this assistance could be provided at home by loved ones or professional caregivers, or in a nursing home or a memory care facility.