Sadly nearly all of us will know someone affected by dementia, but most people don’t know the stages of dementia (UK).
We know that it tends to affect older people and that it is most likely to progress over time. But many of us don’t know that there are actually seven stages of dementia.
Let’s take a closer look at the different dementia stages, their symptoms and how much care your loved one will need with each one.
Here’s what we’ll cover in this article:
- Dementia is a term that covers many brain conditions, including Alzheimer’s, Lewy Body and Vascular dementias, amongst others.
- There are seven stages of dementia and these fall within four main phases.
- Dementia, in all of its forms, can affect people in a variety of ways. Everyone’s dementia journey is different and there is no set time for people to progress through the different stages.
- What is dementia?
- What are the 7 stages of dementia?
- What are the phases of dementia?
- Pre-Dementia - Stages 1-3
- Early-Stage Dementia - Stage 4
- Mid-Stage Dementia - Stages 5- 6
- Mid-stage dementia stage six
- Emotional impact on family and friends
- Late-Stage Dementia - Stage 7
- What support is needed at each stage?
What is dementia?
Dementia is the collective name for a series of conditions that affect the brain, in particular memory and cognition.
There are many different types of dementia, including Alzheimer’s disease, Lewy Body dementia, and Vascular dementia, amongst others.
Dementia is a progressive condition, which means that as time goes on, the disease inevitably gets worse.
That progression happens in stages. Over time the severity of symptoms increase and it becomes harder for the individual with dementia to live independently.
Full time specialist dementia care will be needed in the latter stages.
What are the 7 stages of dementia?
The seven stages of dementia are outlined in the Global Deterioration Scale (GDS), used by Doctors and health care providers to assess elderly patients. It acts as a guide for families to understand what symptoms to expect, and what levels of care may or may not be needed in each of the different stages.
The seven stages of dementia are:
- Stage 1: No cognitive impairment
- Stage 2: Very mild cognitive decline
- Stage 3: Mild cognitive decline
- Stage 4: Moderate cognitive decline
- Stage 5: Moderately severe cognitive decline
- Stage 6: Severe cognitive decline
- Stage 7: Very severe cognitive decline
What are the phases of dementia?
The seven stages of dementia can then be put into four, or sometimes three categories or phases.
These are often called: pre dementia, early, middle and late stage dementia.
They can also be referred to as: mild, moderate and severe dementia.
Depending on which medical practitioner or which information source you are using, both sets of categorisation may be used.
Helping you prepare
Knowing about these three or four categories can help people with dementia, and their loved ones, prepare for the future.
It is important to note that not everybody gets the symptoms listed, in the order listed.
Some symptoms may also come and go, particularly those relating to behaviour changes.
How long does each phase last?
There is also no definite time scale to be applied to the stages. The transition from mild to moderate may take years, or be significantly faster.
Unfortunately there is no way to predict how quickly it will progress. There is an average time scale shown on some of the stages, however this may not be applicable to everyone.
Every person, and their experience of dementia, is different.
Please seek medical advice for your doctor or GP if you have any immediate concerns.
Pre-Dementia - Stages 1-3
Stage one – No cognitive impairment
In this stage there is no outward sign of dementia. A brain scan would reveal changes in the brain, but they have not impacted the person’s life yet. Stage one shows a person living normally for them.
Stage two – Very mild cognitive decline/forgetfulness
Mild forgetfulness might be seen in stage two. This stage is usually dismissed as a normal sign of ageing. A doctor or nurse may not notice anything out of the ordinary about their patient. The person would still be able to operate as usual. The mild forgetfulness would not impact their life in any significant way.
Stage three – Mild cognitive decline
Family and friends may begin to notice forgetfulness. The person may miss, or nearly miss appointments or events.
They may mislay their keys or other household items frequently. Forgetfulness may be paired with some difficulty thinking or concentrating.
Sometimes speech may begin to be very mildly affected in this stage. All of these symptoms can be easily explained away at this point.
Being tired, not eating properly, sitting too long, being bored, dehydration etc can cause similar effects. It is also part of what we see as ‘normal’ age related memory loss.
This stage can last for a long time, up to seven years in some cases.
Early-Stage Dementia - Stage 4
Stage 4 – Moderate cognitive decline
This is the stage where dementia can be diagnosed by medical professionals. It is commonly called early-stage dementia at this point.
Memory issues are likely to have increased, cognition may be reduced.
Activities like crossword puzzles or word searches may become more challenging at this stage. Reading a knitting pattern or instruction manuals may be more challenging than before.
Some normal activities like paying for items in a shop may also become challenging as money becomes confusing.
The person will likely still be able to live quite normally. They will be the same person they always were, just more forgetful and easily confused than before.
Stage four can last for around two years, on average.
Mid-Stage Dementia - Stages 5- 6
Stage 5 – moderately severe cognitive decline.
During this stage it’s likely that the person with dementia will need some help with their day to day activities.
They are still likely to be able to eat, drink, and use the loo by themselves. They may now need reminders to bathe themselves, however.
Also, they may need assistance in dressing appropriately for the weather and their activities.They will also need support to attend appointments and events.
Dementia symptoms become present
In this stage it will become obvious that the person has symptoms of dementia. Their long term memory will start to be affected.
During this stage, the use of music from the past can be soothing, and help to bring back happy memories.
Stage five takes an average of one and a half years.
Mid-stage dementia stage six
Stage 6 – severe cognitive decline
The person affected is likely to experience profound changes to their personality and behaviour at this point. It can be extremely difficult for the loved ones of a person suffering from dementia.
Anger and aggression are commonly displayed during stage 6. Often this is a result of not fully understanding what is going on.
Recognising loved ones
They may no longer recognise the people around them or their environment, and this can be profoundly upsetting.
Perhaps they may begin to experience severe anxiety, and bladder control issues.
Continence issues can be very upsetting, as a person can’t understand what is happening to them. They may feel infantilised or trapped.
Emotional impact on family and friends
Stage six dementia can be a very distressing period for family and friends, as the person they love may no longer recognise them.
Their behaviour and personality may be completely different from before they developed dementia.
However hard it may be, try not to take it personally. Remember that the disease is causing these changes and the person can’t stop it from happening.
Dementia care and support
Individuals are likely to need a good deal of support in this stage, perhaps day and night care, depending on their needs.
Families often utilise specialist dementia care at home or in a residential setting to assist during this stage of dementia.
Stage six takes an average of two and a half years.
Late-Stage Dementia - Stage 7
Stage seven – Very severe cognitive decline
The final stage of dementia is late stage dementia. At this stage the person affected will usually need 24 hour care.
They are unlikely to be able to perform tasks independently, and will require support with eating, drinking and personal care.
Often the individual will experience difficulty with communication and may have mobility issues.
What support is needed at each stage?
What support is needed will vary according to the person, and how severely they experience each stage. It will also depend on how they live their life.
Someone who is fit and healthy, with a large support network, may not need additional care for some time.
Support from family and friends during stages 1-5, helping with shopping or cooking meals, taking them to appointments and so on, may be sufficient.
This may mean there is only a need to introduce some external support such as personal care in stage six.
Additional care and support
However, a person in poor health, with mobility issues, who lives alone, may need assistance and support earlier.
For example, they may feel that support from carers is beneficial from the onset of stage three.
Dementia stage 6 onwards
Individuals entering stage six and onward will almost all require a good deal of care.
This is often more than a modern family is able to provide.
It is also beneficial to have dementia specialist care at this stage, for the safety and wellbeing of the person.
Find the care you need
Whatever your care needs you can find additional care guides on our dedicated dementia care section.