What are the Stages of Dementia

When a person is diagnosed with dementia, it does not necessarily mean that they are an incapacitated person and in need of a guardian. Indeed, a person diagnosed with dementia may still have sufficient cognitive abilities to understand and execute legal documents, like a Power of Attorney or Health Care Directive.

The stages of dementia are somewhat fluid. A person may exhibit all or some symptoms depending on the environment they are in. The stages of dementia are typically defined as follows:

No impairment. At this stage, there are no obvious signs of dementia and people are still able to function independently.

Very mild. Dementia signs are barely noticeable and simply appear to be the kind of forgetfulness associated with aging, such as misplacing keys but finding them again after some searching.

Mild. At this stage, patients are usually able to do basic activities of daily living such as getting up, going to the bathroom, getting dressed, and so on, without difficulty. Symptoms of dementia at this stage may include some forgetfulness and memory loss, repetition, losing items without being able to retrace steps to find them, trouble balancing a checkbook or managing medications.

Moderate. At this stage patients have trouble doing routine tasks that they always did, such as cooking, laundry, or using the phone. Other dementia symptoms during this stage include increasing memory deficits, and inability to use or find the right words and phrases, difficulty doing challenging mental math exercises, such as counting backwards from 100 by 7 and increased social withdrawal.

Moderately severe. At this stage, dementia patients need some assistance with their day to day activities. Symptoms of moderately severe dementia include the inability to remember their home address, phone number, or other personal details, confusion about location or chain of events or even selecting appropriate clothing for the climate, season, or occasion.

Severe. When a patient has severe dementia, they are reliant on caregivers to help with many more day to day activities. Dementia signs at the severe stage include needing help to get dressed, toileting, wandering if there is no supervision, an inability to recall the names of family members or caregivers, but still being able to recognize familiar faces, and changes in sleep patterns. Often, there are also changes in personality or behavior, such as increased paranoia or even hallucinations.

Very severe. This is the final stage of the disease. Symptoms of dementia during this stage include a loss of language skills, loss of awareness of surroundings, and assistance with feeding oneself.

In order to determine the stage of dementia, a doctor may perform some mental tests. One frequently used screening tool is called the Mini Mental State Examination, an 11 question exam that can help pinpoint cognitive decline on a scale of 0 to 30. In general, a score between 14 and 26 points correlates to mild/moderate stage dementia and a score between 4 and 14 correlates with severe dementia. Doctors typically use the mental exams to help caregivers plan for future changes and to develop a treatment plan, which may include medications.