Learn & Grow/Alzheimer's and Dementia/Understanding the Different Stages of Dementia
Alzheimer's and Dementia, Memory Care, Resources for Caregivers

Understanding the Different Stages of Dementia

Dementia is a general term for symptoms of cognitive decline leading to impaired memory or reasoning that interferes with day-to-day living. Many types of dementia exist, and many conditions cause it. Alzheimer’s disease is the most common type of dementia, accounting for between 60 to 80% of dementia diagnoses. It’s a degenerative brain disease that damages brain cells and leads to dementia symptoms that worsen over time.

The stages of dementia

If you have a loved one living with dementia, one of the most difficult things to hear is that, in most cases, dementia is incurable and  irreversible. Each person will experience dementia differently, but their symptoms will become more pronounced as the disease advances. Of all types of dementia, Alzheimer’s seems to have the slowest progression and can last more than a decade.

According to the Mayo Clinic, there are five stages of Alzheimer’s disease: preclinical, mild impairment, mild dementia, moderate dementia and severe dementia. Dementia.org identifies seven distinct stages of dementia. What these general classifications have in common is that they group symptoms into mild, moderate or severe categories. If someone you love is affected by memory loss, learning about these different stages of dementia may help you with early diagnosis and treatment. By being able to identify the symptoms, you’re also empowering yourself by knowing what to expect, so you can plan for the best care.

The early stage: Invisible changes.

It’s rare that you’ll notice any changes in your loved one’s behavior in this pre-dementia stage. Your loved one will function normally, and he or she may still be driving, working, and partaking in normal social activities. However, the diseases that cause dementia are already having an effect on the brain. The plaque that is a hallmark of Alzheimer’s disease is deposited in the brain long before symptoms surface.

The mild stage: Beginning signs.

At this stage, it’s clear that your loved one is not themself. They may feel like they’re having memory lapses, forgetting familiar names or words, or losing track of the location of everyday objects. These symptoms aren’t widely apparent, but may have an impact on their daily life.

This mild impairment in cognitive function may not be a sign of Alzheimer’s disease. For many people these symptoms are simply part of the normal forgetfulness that comes with age. If you’re concerned that they’re signs of early dementia, seek a doctor’s evaluation. A qualified doctor can recommend genetic tests and biomarker measures to see if there’s a higher risk of Alzheimer’s.

Through the different stages of dementia, you may notice that your loved one is having significant trouble with memory and thinking. They may forget information they usually easily remembered, such as a recent conversation or an appointment. Familiar names of friends and family members escape them. They might have trouble with the time needed for a particular task, or with the sequence of steps to complete it. They may not remember newly learned information and ask the same question again and again.

Everyday tasks that require problem-solving feel harder to someone with dementia. These could include familiar activities such as planning a family event, balancing their checkbook or arranging travel. Because they feel overwhelmed, they may lose the motivation to complete what they’ve started. Many people with dementia have lapses in judgment, especially when it comes to their finances.

You’ll notice your loved one’s frustration at not being able to organize or express their thoughts. They’ll be anxious about what’s happening and concerned that others notice. Often, people with dementia will deny or attempt to hide what’s happening. They may become subdued or withdrawn in social situations, so they don’t draw attention to themselves. You should be on the lookout for uncharacteristic changes in personality — anger, irritability, anxiety, confusion.

elderly woman and adult woman looking through a photo album together

The middle stage: Deepening changes.

As dementia takes hold, your loved one will likely become more confused and forgetful. You’ll  need to take extra care to be sure they don’t wander and become lost, even in a familiar environment, as they can easily lose track of time and place. They may confuse family members for strangers, and vice versa, and forget details such as their phone number or home address. These difficulties make it unsafe for your loved one to be left on their own.

As the disease progresses, your loved one may forget that they’ve told you something and repeat it over and over. Be aware that they may make up stories to fill gaps in their memory — other family members can react strongly to this, but it’s merely a symptom of their dementia. It’s not unusual for a loved one’s personality to undergo a dramatic change. For example, they may become aggressive, quiet or tearful. Some individuals develop unfounded suspicions of people they’ve trusted, believing that a family member is stealing from them or a spouse is having an affair. Others may see or hear things that aren’t really there.

Your loved one will also need help with self-care and other activities of daily living. This could include assistance with getting appropriately dressed for the occasion or the weather, grooming, eating, or using the bathroom. Because dementia throws off our internal circadian rhythms, they may have difficulty sleeping or grow restless and agitated at dusk, a behavior called sundown syndrome.

The later stage: What to expect.

When your loved one is in the later stages of dementia, they’re likely to be frail. As their memory problems become more severe, they’ll find it harder to communicate and will experience greater changes in behavior and more physical problems than before. If you’re the family caregiver, they’ll rely on you for full-time care. They may need total assistance with eating, dressing and using the bathroom. They’ll need your help to walk or hold their head up. Speaking and swallowing will become difficult as well.

memory care resident with a caregiver in a memory care facility

Coping with caregiving.

The speed at which dementia progresses will vary widely with each person. Many families feel that home is the best place for a loved one with dementia; however, as their condition changes, home often isn’t the safest place. Caring for a loved one through different stages of dementia can be rewarding, but the later stages often take a toll on family caregivers. Apart from being physically and emotionally exhausted, caregivers are also coping with feelings of loss. They wish to regain some of the relationship they once shared with their loved one — whether they’re a spouse, life partner, child, sibling or friend.

At Village on the Green, our memory care starts with getting to know your loved one. Once we understand the unique person they are, their story and personality, we design individual care that adds joy and peace of mind to their life and to yours. You and other family members will have the safety, support, and time to reconnect and rekindle in the way that’s best for you. Use the form below to find out how we can help.

Related Stories