Dementia is a progressive condition that gets worse over time. While every individual with dementia is unique, their journey through the seven stages of dementia typically follows a specific path. Each of the different levels of dementia comes with new symptoms or a worsening of existing symptoms. Knowing what to look for through dementia’s stages and phases will help you determine when it’s time to reassess your family member’s care needs. Read on to learn how to recognize warning signs during the early stages of dementia, plus common symptoms of middle- and late-stage dementia.
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Dementia is a general term for a decline in cognitive function that affects memory, problem-solving skills, language, and functions that affect daily living. Specific types of dementias — including Alzheimer’s disease and vascular, Lewy body, and frontotemporal dementia — advance at unique rates and differ from person to person.
The seven stages are separated into three progressive phases of dementia:
Health care providers use a comprehensive tool to assess the seven stages of dementia in elderly patients: the Global Deterioration Scale.[01] Also known as the GDS, this trusted method enables caregivers and health professionals to determine how quickly dementia progresses in elderly patients and which symptoms to expect during each of the seven stages of dementia. A dementia stages chart can help caregivers track and monitor their loved one’s health status against stage-related symptoms.
The seven stages of dementia are:
Though it may sound odd, stage 1 dementia often looks like normal mental functioning without any cognitive decline. Someone in the first three dementia stages doesn’t usually exhibit enough symptoms to be diagnosed. However, it’s important to note that changes in the brain are still taking place. While some cognitive impairment may be present, stages 1, 2, and 3 on the GDS are recognized as pre-dementia stages.
Stage 2 dementia includes simple memory mistakes like a loved one wondering “Where did I put my keys?” or, “What was that person’s name?”
A significant amount of the senior population experiences age-related forgetfulness, and caregivers or medical providers may not even notice such mild impairment. This explains why stage 2 is also known as “age-associated memory impairment” on the GDS.
“About 40% of people aged 65 or older have age-associated memory impairment — in the United States, about 16 million people,” said Professor Gary W. Small [02] in research published by the British Medical Association. “Only about 1% of them will progress to dementia each year.”
Stage 2 dementia symptoms:
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When memory and cognitive problems become more regular, as well as noticeable to caregivers and family members, a person is said to be suffering from mild cognitive decline, which is also known as mild cognitive impairment (MCI). Stage 3 dementia doesn’t generally have a major impact on day-to-day functioning.
How quickly does this dementia stage progress in the elderly? An estimated 10 to 20 percent of people age 65 or older with MCI will develop recognizable or diagnosable dementia within a year, according to the National Institute on Aging.[03] Since MCI often precedes more severe dementia stages, it’s important to recognize the signs of this stage and seek medical advice.
Stage 3 dementia symptoms:
Stage 4 dementia is when a person has clear, visible signs of cognitive impairment and exhibits personality changes — both of which are significant dementia symptoms. A person is not typically diagnosed with dementia until they’re at stage 4 or beyond. While the medical terminology for stage 4 dementia is moderate cognitive decline, this stage is officially diagnosed by the GDS as mild dementia.
At this stage, doctors and caregivers will likely observe hallmark signs that dementia is getting worse, including difficulties with language and reduced problem-solving skills.
Stage 4 dementia symptoms:
This stage marks the onset of what many professionals refer to as “mid-stage” in the seven stages of dementia. At this point, a person may no longer be able to carry out normal activities of daily living (ADLs), such as dressing or bathing, or Instrumental activities of daily living (IADLs) without some caregiver assistance. Middle-stage dementia often lasts between two and four years,[04] though every dementia patient will progress at a unique rate.
In stage 5 dementia, your loved one will likely require more intense support and supervision. They know major facts about themselves — such as their name and their children’s names — but they may not remember grandchildren’s names, their longtime address, or where they went to high school.
Stage 5 dementia symptoms:
Stage 6 dementia marks a need for caregiver help to perform basic daily activities, such as eating, using the toilet, and other self-care. Seniors experiencing this stage of moderately severe dementia may have difficulty regulating sleep, interacting with others, or behaving appropriately in public settings.
At stage 6 of dementia, you may find yourself wondering if full-time care is necessary as symptoms become more complex. You can stay prepared by tracking symptoms, monitoring your loved one’s ability to perform ADLs and IADLs, and exploring care options like memory care or home care.
Stage 6 dementia symptoms:
In stage 7, which is considered late-stage dementia, people can no longer care for themselves. Generally, for patients with severe dementia, all verbal ability is lost and movement becomes severely impaired. Symptoms of late-onset dementia disrupt bodily functions like the ability to chew, swallow, and breathe.
Stage 7 dementia symptoms:
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There’s no real way to know how long it will take for a loved one to progress through all the stages of dementia. Dementia gets worse with time, but some people stay in the early stages of dementia longer and can remain independent for years. However, others experience rapid dementia symptoms and will require more immediate support. End-stage dementia, which is the most aggressive stage of dementia, typically lasts between one and two years.
The average person with a dementia diagnosis will live between four to eight years.[05] Some people, however, live up to 20 years after their diagnosis. Different types of dementias, like Alzheimer’s disease and vascular dementia, follow a similar seven-step progression.
Life expectancies vary slightly for different dementias, according to the Alzheimer’s Society[06]:
Accepting a loved one’s dementia diagnosis and understanding what to expect can help you feel empowered. It can also help you build opportunities to make the most of this time together. Remember that caregivers have a variety of ways to provide support to a loved one through the progression of dementia.
If the idea of navigating a dementia diagnosis alone seems overwhelming, A Place for Mom is here for you. Explore our library of caregiver resources, which contains many articles on dementia therapies and memory care.
Memory care is specialized support for seniors with dementia or other forms of debilitating mental illness. It includes 24-hour supervision to prevent wandering, assist with ADLs, provide meal services, and administer health care as needed. Memory care can be beneficial from the early stages of dementia through the end of life. Specially designed memory care activities, dining plans, and exercise programs address all types of dementia symptoms in elderly loved ones.
Understanding when to seek memory care will vary depending on a senior’s dementia symptoms, health status, living situation, and more. Our Senior Living Advisors offer free guidance and are ready to discuss local memory care and dementia home care options with your family.
The information contained in this article is for informational purposes only and is not intended to constitute medical, legal, or financial advice or to create a professional relationship between A Place for Mom and the reader. Always seek the advice of your health care provider, attorney, or financial advisor with respect to any particular matter, and do not act or refrain from acting on the basis of anything you have read on this site. Links to third-party websites are only for the convenience of the reader; A Place for Mom does not endorse the contents of the third-party sites.
Levels of dementia: What to expect in pre-, middle-, and late-stage dementia
Reisberg, B. Ferris, S. de Leon, M., & Crook, T. (1982). The global deterioration scale for assessment of primary degenerative dementia. American Journal of Psychiatry.
Small G. (2002, June 22). What we need to know about age related memory loss. The BMJ.
National Institute on Aging. National Institutes of Health. (2021, April 12). What is mild cognitive impairment?
Alzheimer’s Society. (2021, February 24). The middle stage of dementia.
Alzheimer’s Association. Stages of Alzheimer’s.
Alzheimer’s Society. The later stage of dementia.
The information contained on this page is for informational purposes only and is not intended to constitute medical, legal or financial advice or create a professional relationship between A Place for Mom and the reader. Always seek the advice of your health care provider, attorney or financial advisor with respect to any particular matter, and do not act or refrain from acting on the basis of anything you have read on this site. Links to third-party websites are only for the convenience of the reader; A Place for Mom does not endorse the contents of the third-party sites.
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