The 4 Stages of Dementia

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How quickly dementia progresses can vary widely from person to person, depending not only on the individual but the specific cause of their dementia. Some people will only have dementia for a few short years near the end of their life, while others could have it for decades. Symptoms can also vary depending on the cause of dementia. That said, most people with dementia will pass through each of these stages at some point.

Stage 1: Mild cognitive impairment (MCI)

This stage is actually pre-dementia. It’s when a person has forgetfulness that goes beyond what’s expected with normal aging but hasn’t yet veered into clinical dementia. During this phase, forgetfulness will become more frequent. So while misplacing your keys or where you parked the car is nothing to worry about when it happens occasionally, with mild cognitive impairment, you’ll notice these mental lapses begin happening with concerning frequency. The good news: Those with MCI are typically able to function independently and still complete routine, everyday tasks. While some people with mild cognitive impairment will go on to develop dementia, many won’t. Symptoms include:

  • Forgetting things more often, such as appointments or the names of new people
  • Losing your train of thought more frequently
  • Starting to have trouble navigating familiar environments
  • Feeling overwhelmed by more complicated tasks and needing to break things into smaller tasks in order to complete them
  • Greater apathy or anxiety than normal

Stage 2: Mild dementia

With mild dementia, most people can still function on their own and won’t need round-the-clock care. That said, as memory lapses become more frequent, people might grow increasingly agitated and confused, which can, in turn, lead to withdrawal from social situations out of shame and even depression. People with mild dementia are also more likely to get lost, and everyday responsibilities, like paying bills or caring for pets, may begin to slip. Loved ones will certainly notice a change in someone with mild dementia, and will want to start watching for patterns in behavior. Other symptoms include:

  • Difficulty finding the right word during conversation
  • Getting disoriented more often, even in familiar environments
  • Not being able to find misplaced items, even when retracing steps
  • Feeling confused or anxious with greater frequency
  • Memory loss that’s noticeable by a spouse or loved one

Stage 3: Moderate dementia

As dementia progresses, so will the difficulties associated with memory lapses, especially if the person has Alzheimer’s disease. At this stage, people also lose cognitive function and longer-term memories, which may lead to increased confusion. More supervision will be necessary during this phase, but exactly how much oversight and care is required will depend mostly on how quickly the condition progresses. Other symptoms include:

  • Difficulty communicating or speaking
  • Increased difficulty with recalling information, like names and places
  • Irregular sleep patterns, such as sleeping more during the day but being awake and active at night
  • Getting lost, even in very familiar spaces, such as a family member’s home
  • Difficulty with motor activities, such as securing buttons or walking in a straight line
  • Not recognizing neighbors, coworkers or family friends
  • Increased depression, anxiety, and apathy

Stage 4: Severe dementia

As mental function continues to diminish, people with dementia may lose their ability to communicate verbally and will require full-time care for their own safety and well-being. Eating and using the bathroom independently may become impossible. Infections, like pneumonia, will also become more likely. This stage is incredibly difficult on caregivers, so support groups are a good idea. Symptoms include:

  • Wandering off and becoming lost, if unsupervised
  • Difficulty eating, swallowing, and handling utensils
  • Difficulty using the bathroom unassisted and/or incontinence
  • Difficulty speaking or communicating in any way
  • Heightened agitation in new or less-familiar environments
  • Behavior changes and frequent, severe mood swings
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