The Seven Stages of Dementia — A Scale for Tracking Progression

The Seven Stages of Dementia — A Scale for Tracking Progression

In the medical and health science community, the progression of dementia is commonly measured using a scale developed by Dr. Barry Reisberg, a geriatric psychiatrist from the United States. As dementia worsens, various distinct signs and symptoms become increasingly apparent. According to this scale, known as the Global Deterioration Scale for Assessment of Primary Degenerative Dementia (GDS), or the Reisberg Scale, there are seven stages that correspond to four broader categories: no dementia, mild dementia (early stage), moderate dementia (middle stage), and severe dementia (late stage).

Stages 1–3: No Dementia

Stage 1

At stage 1 of this scale, there are no signs of dementia. The person functions normally and is mentally healthy. Someone showing no symptoms at all is considered to be at stage 1 — no signs, no symptoms, no memory loss, behavioral issues, or anything associated with the onset of dementia.

Stage 2

Stage 2 is known as very mild cognitive decline. At this stage, there is normal forgetfulness often associated with typical signs of aging (normal age-related memory loss). People around them may begin to notice occasional instances of forgetting something, but symptoms of dementia are still not apparent to medical professionals or those around them.

Stage 3

Stage 3 is commonly referred to as mild cognitive impairment. At this stage, those around the person may begin to notice signs of cognitive decline, such as increased forgetfulness, reduced performance at work, difficulty speaking, and difficulty focusing on everyday tasks. This stage is also known as the "pre-dementia" stage, and it's important for family members to recognize these signs in order to seek early diagnosis and intervention.

Symptoms of Mild Cognitive Decline:

• Declining performance at work
• Reduced memory
• Difficulty concentrating, solving problems, and managing complex tasks
• Difficulty driving
• Verbal repetition

Stage 4: Early-Stage Dementia

Early-stage dementia consists of a single stage — stage 4, moderate cognitive decline. Cognitive issues can be detected during interviews with a doctor and medical testing. People at this stage will experience difficulty concentrating, will forget events that just occurred, and will have trouble managing finances and traveling alone to new locations. They may also experience difficulty socializing and begin withdrawing from friends and family. In this situation, family members need to make a joint effort to actively involve the person with dementia in social activities. Family members and those around them will begin to take on a more important role at this stage and in later stages. Family members will need to create a daily care/support plan and set up a schedule to provide the necessary level of care, while also seeking physical and emotional support from other service providers.

Symptoms of Early-Stage Dementia:

• Misplacing items
• Forgetting recent conversations or events
• Difficulty finding the right words in conversation
• Not knowing the day, date, or time
• Losing interest in other people or activities
• Reluctance to try new things
• Increased anxiety, irritability, or depression
• Difficulty remembering names when meeting new people
• Difficulty planning or organizing things

Stages 5–6: Middle-Stage Dementia

Middle-stage dementia consists of two stages: stage 5, moderately severe cognitive decline, and stage 6, severe cognitive decline.

Stage 5

A person with middle-stage dementia now needs assistance to complete daily living activities. At this stage, the signs and symptoms of dementia become very easy to identify. Short-term memory will mostly be lost, and confusion and forgetfulness will be more apparent across all daily activities.

Stage 6

At stage 6, a person may begin forgetting the names of loved ones and retain little memory of recent events. Communication ability becomes quite limited, and delusions, compulsions, anxiety, and agitation may emerge.

Symptoms of Middle-Stage Dementia:

• Difficulty sleeping and confusion between day and night
• Inappropriate behavior in interactions with others
• Wandering or becoming lost
• Difficulty judging distance
• Delusions and/or hallucinations
• Becoming easily aggressive or angry
• Inability to recall personal history, address, and phone number
• Changes in sleep patterns may occur

Stage 7: Late-Stage Dementia

This final category of dementia consists of a single stage. At stage 7, very severe cognitive decline has occurred. A person at this stage typically no longer has the ability to speak or communicate, and requires assistance with most bodily functions, including walking. During this stage, caregivers will focus more on providing comfort and quality of life. Care needs may exceed what can be provided at home, as 24-hour monitoring is typically required.

Symptoms of Late-Stage Dementia:

• Difficulty eating and swallowing
• Significant weight changes (either loss or gain)
• Incontinence
• Gradual loss of speech ability
• Restlessness
• Anger outbursts due to confusion
• Increased vulnerability to infections, particularly pneumonia

While the GDS scale is available to help identify what stage of dementia a person has reached, it's important to recognize that this classification method only provides a general guideline. Every person with dementia can still display different symptoms and abilities even within the same stage; for example, one person at stage 6 may still be able to sing an entire song, while another person also at stage 6 may no longer be able to speak at all.

Because of this individual variation, the most important thing to remember when caring for someone with dementia is to adapt care to the behaviors and abilities they still have. The primary goal should always be to optimize their quality of life.

RUKUN Senior Care
Email: info@rukunseniorliving.com
Phone: 021 8795 1525

About RUKUN Senior Living

We believe that happiness and comfort in daily life are key to someone's quality of life. RUKUN Senior Living offers a range of residential facilities and services for seniors to support all their needs — whether they lead an independent, dynamic lifestyle or require more day-to-day support.

A variety of service options are available to suit residents' needs. For seniors living at home or with family, the following are available:

• RUKUN Senior Club, for independent seniors to take part in activities throughout the day.
• Dementia Day Program, a series of daily activities and social interaction for seniors with dementia to optimize their daily life. Available at Darmawan Park, Sentul, and the Dementia Support Center, Cipete.
• RUKUN Home Care, for seniors who need professional caregiver services at home (available in the greater Jakarta area).

For those wishing to reside at RUKUN Senior Living, Sentul, the Continuing Care Retirement Community (CCRC) concept offers an integrated set of facilities and services as a solution for every phase of a senior's life:

• The Villas, offering modern, functional private villas with HGB land title ownership. A worry-free lifestyle is available with a full range of additional facilities and services.
• RUKUN Senior Living Resort, with comprehensive facilities and a range of supporting services, including an activity program, wellness monitoring, food and beverage, housekeeping and laundry, and Assisted Living services. Full amenities also include an Activity Room, Game Room, Art Room, swimming pool, jacuzzi, lake, jogging path, and gazebo.
• RUKUN Senior Care, offering more intimate facilities and services for residents who require Dementia Support and Nursing Care, including an activity program, 24-hour monitoring by wellness staff, and a doctor on staff.

www.rukunseniorliving.com
Email: info@rukunseniorliving.com
Phone: 021 8795 1525
Facebook: @RUKUNSeniorLiving