Stages Of Dementia

Global Deterioration Scale for Assessment of Primary Degenerative Dementia (GDS)

(also known as the Reisberg Scale1)

Stage 1: No Dementia; No Cognitive Decline

● In this stage, the person functions normally. He has no memory loss and is mentally healthy. People with NO dementia would be considered to be in Stage 1.

Stage 2: No Dementia; No Cognitive Decline

● This stage is used to describe normal forgetfulness associated with aging. For example, the person experiences forgetfulness of names and where familiar objects were left. Symptoms are not evident to loved ones or the physician.

Stage 3: No Dementia; Mild Cognitive Decline

● This stage includes increased forgetfulness, slight difficulty concentrating and decreased work performance. The individual may get lost more often or have difficulty finding the right words. At this stage, his loved ones will begin to notice a cognitive decline. Average duration: 7 years before onset of dementia.

Stage 4: Early Stages; Moderate Cognitive Decline

● This stage includes difficulty concentrating, decreased memory of recent events, and difficulties managing finances or traveling alone to new locations. People affected with the early stage of dementia have trouble completing complex tasks efficiently or accurately. But they may deny about their symptoms. They may also start withdrawing from family or friends because socialization becomes difficult for them. At this stage, a physician can detect clear cognitive problems during a patient interview and exam. Average duration: 2 years

Stage 5: Mid Stage; Moderately – Severe Cognitive Decline

● People in this stage have major memory deficiencies and need some assistance to complete their daily activities (dressing, bathing, preparing meals). Memory loss is more prominent and may include major relevant aspects of current lives. For example, they may not remember their address or phone number and may not know the time or day or where they are. Average duration: 1.5 years.

Stage 6: Mid Stage; Severe Cognitive Decline (Middle Dementia)

● People in Stage 6 of dementia require extensive assistance to carry out daily activities. They start to forget names of close family members and have little memory of recent events. Many of them can remember only some details of earlier life. They also have difficulty counting from 10 and in finishing their tasks. Incontinence (loss of bladder or bowel control) is a problem in this stage. Ability to speak declines. Personality changes, such as delusions (believing something to be true that is not), compulsions (repeating a simple behavior, such as cleaning), or anxiety and agitation may occur. Average duration: 2.5 years.

Stage 7: Late Stage; Very Severe Cognitive Decline (Late Dementia)

● People in this stage have essentially have lost their ability to speak or communicate. They require assistance with most activities (e.g., using the toilet, eating). Most of them have lost their psychomotor skills, like the ability to walk. Average duration: 2.5 years.

1 Reisberg, et al., 1982; DeLeon and Reisberg, 1999