WHAT ARE THE STAGES OF DEMENTIA? The 3 stage and 7 stage models explained

Hi there Careblazer!  I am often asked about the different stages of dementia. In this video, I describe the 2 most popular dementia staging models. But before I get into the details, it’s important to know a few things when it comes to dementia stages.

#1- No matter what type of dementia or what staging model is used, it’s important to think of dementia on a continuum. With 'no cognitive impairment' on one end and 'severe cognitive impairment' on the other.  Think of these stages as fluid with the ability for some slight changes, rather than a true stage that doesn’t change.

In many cases, it can seem like your loved one is stuck in between stages and that is okay too. Also factors such as daily environment, and daily schedules can help keep someone in a stage longer than others with similar dementia. You might notice that someone with dementia who takes a trip or does something out of the ordinary, may seem to struggle more because they are out of their comfort zone or out of their element and it may look like they progressed to a new stage. However, once they return to their normal routine, they may return to their prior level of functioning, or they may stay in their new stage.

#2- Stages don’t happen suddenly or over a specified period of time. Everyone is different and everyone’s progression may be different. There are many types of dementia and not all of them progress the same. There is no expected length of time someone spends in a certain stage before progressing to another stage.  The different stages aren’t so simple as to think that someone easily ends one stage and moves on to the next. Again, It is more of a continuum and people can go back and forth and seem to be almost stuck in between stages.

#3- It’s important that you don't only look at one symptom as a sign of a stage. You have to lok at the bigger picture of multiple behaviors, functioning, and thinking to see what seems to fit best. For example, Just because a person doesn’t remember a neighbor’s name doesn’t tell you what stage they are in...it could be mild, moderate, or severe. You have to know what other symptoms are also happening to give you a better idea of the current stage.  

3 STAGE MODEL OF DEMENTIA

Let’s talk about the 3 stage model of dementia.  the stages are broken down into early/mild, middle/moderate, and late/severe.

EARLY/MILD STAGE

In the mild stage, people start to have some memory loss and small changes in their personality. They may forget recent events or names of familiar people or things. They also start to slowly lose the ability to plan and organize. In this stage, it may be possible for people really close to the person with dementia to not even realize there is true impairment happening. It is easy for close family members and friends to think that the person is just having a bad day, or is under a lot of stress which is causing the difficulty, or to just assume that their struggles are normal given their age.

Some specific examples someone may show in this stage include:

Difficulty making a grocery list and finding items in a store.  

They might start losing things

Getting lost while driving.

In some cases in this stage it is very easy for people to cover up their problems or for family members (especially spouses to cover up these problems).

In some cases no one even realizes these problems are occurring until they start to advance to the moderate stage or when a family member who isn’t around as much comes around for a visit and starts to notice the changes. Sometimes when we are too close to something, it easier to miss the changes.

MODERATE/MIDDLE STAGE

In this stage, memory loss, confusion and personality changes become more obvious Some things you may notice in this stage include:

-changes in sleep

-wandering

-difficulty with hygiene

-not making it to the toilet on time

-possibly behaviors such as kicking, screaming, hitting, or accusing people stealing or cheating.

SEVERE/LATE STAGE

In the severe or late stages of dementia, the person is no longer able to do any of their basic daily tasks. They cannot:

-use the toilet

-clean themselves

-eat on their own

-walk

-talk

-recognize some family members.

- may even stop eating and start to having difficulty swallowing.

This last stage of dementia ends in death.  

That is the simple 3 staging model of dementia. I tend to prefer this 3 stage mode as do most other professionals and organizations.

7 STAGE MODEL OF DEMENTIA

This next 7 step model is a bit more complicated, has many more steps, and many of the symptoms overlap. It is a staging model that many caregivers like, because it seems to help them track in more detail, their loved one’s decline.  Here are the seven steps of dementia.

Stage 1: No Impairment – No memory loss

Stage 2: Very Mild Cognitive Decline – Normal memory loss associated with aging

Stage 3: Mild Cognitive Decline – Friends and family members begin to notice cognitive problem.

Stage 4: Moderate Cognitive Decline – This is typically where the disease gets diagnosed.  The person has poor short-term memory, may forget personal details, and has difficulty with simple math.

Stage 5: Moderately Severe Cognitive Decline – Begins to need help with daily activities, significant confusion, disorientation, may no longer be possible to live alone. 

Stage 6: Severe Cognitive Decline – Worsened memory loss, difficulty recognizing family members, some personality changes. 

Stage 7: Very Severe Cognitive Decline – Final stage; communication is limited, basic body functions start to decline.

To recap, think of dementia stage on a continuum.  

The amount of time spent in any particular stage varies greatly from person to person.

It is possible for people to move between stages, even sometimes looking like they are improving when they have good days.

No one symptom can tell you exactly what stage someone is in. You need to look at multiple symptoms.

I hope that this video has been helpful to you in some way. 

Keep up the great work!

P.S. If you haven't downloaded your Careblazer Survival Guide with tips and strategies for caring for someone with dementia, you can do so right here.  

- Natali Edmonds