Understanding the Stages of Dementia: What to Expect as the Disease Progresses

Dementia is a clinical syndrome that impairs cognitive function by affecting memory, thinking skills, and behavior. It progresses through various stages, and the later stages of dementia before death can involve very severe cognitive decline.

Therefore, understanding how many stages of dementia are there and the differences between these stages will be helpful for those caring for patients, especially given its association with old age.

This article aims to discuss the 7 stages of dementia, highlighting what can be expected at different stages of dementia, life expectancy associated with it, and offering insights on how to manage these stages.

The Seven Stages of Dementia

The progression of disease is categorized into 7 stages of dementia , each with varying degrees of cognitive decline. They assist in explaining how dementia transforms over time, enabling patients and carers to expect variations and control it better.

Different phases provide a lucid interpretation of the way cognition and daily functioning of a person are affected by dementia. It is vital for planning the best care and support approach for each of the 7 stages of dementia.

Understanding the Stages of Dementia: What to Expect as the Disease Progresses — The Seven Stages of Dementia

Dementia progresses through distinct levels of cognitive and functional impairment, each stage ranging from asymptomatic to terminal cognitive dysfunction. Identification of 7 stages of dementia helps determine the onset of dementia, distinguishing it from other common age-related changes. It provides an early warning, allowing people to plan for the disease’s progression and ensure the necessary care and support are in place as the condition worsens.

By familiarizing oneself with the seven stages, caregivers can better support their loved ones and make informed decisions about treatments and lifestyle adjustments to improve the quality of life for those living with dementia.

Stage 1: No Cognitive Decline

There are no obvious signs of cognitive decline evident during the early stages of dementia symptoms. Memory and thinking skills are also intact, while the person continues to function normally in appearance. Thus, this stage is almost impossible to detect, as it serves as a benchmark against which possible variations will be measured later on.

During this phase, the individual is capable of performing his or her routine everyday duties without facing any difficulties. There are no occurrences of losing memory, and the mental faculties are whole.

The brain could possibly be undergoing fundamental alterations, though they are not visible as observable symptoms yet. Sophisticated neuroimaging methods together with biomarker evaluation tools may reveal a few early indications of alteration in structures or functionalities within the beginning stages of dementia.

Stage 2: Very Mild Cognitive Decline

In stage two, patients may find that they have a little difficulty recalling things they recently did. This is often perceived to be normal age-related forgetfulness. The symptoms include occasionally forgetting people’s names or the exact location where they left some of their things that you have used recently.

But even though these may be slight issues that most people just ignore, it could be an early sign of dementia. At the same time, such people can still manage their daily routines without anybody’s help, and the situation is not so serious that it hampers their working life or social interactions. Regular cognitive assessments and monitoring are recommended to track any progression.

Stage 3: Mild Cognitive Decline

The noticeable cognitive decline that could impact normal routines begins at the third stage, when things begin to go down. Some of its detailed symptoms include increased forgetfulness, difficulty concentrating such that it becomes hard to keep thoughts logical, as well as trouble finding appropriate words, which disrupts communication.

Along with other challenges, difficulties in executing plans and following well-structured schedules hinder the ability to manage money effectively, even when using result-oriented strategies.

These changes can now be noticed by friends and family. The individual may have issues preparing and managing duties. Even though they are able to stay on their own, this may result in much distress and worry. This is where the diagnosis of mild cognitive impairment often occurs, and this highlights the importance of distinguishing it from normal age-related changes.

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Stage 4: Moderate Cognitive Decline

At the fourth stage, cognitive decline begins to appear more. Some people may find it hard handling issues like managing finances, planning events, or following steps in activities. There are more frequent memory lapses at this point; personal hygiene and grooming may also decline.

Another common thing are shifts in moods, among which include withdrawing from social situations. A dementia diagnosis is typically confirmed medically during this time. Symptoms of the last stages of dementia become more pronounced. It becomes difficult for one to remember personal history or recent events, and patients rely more on other people due to the increased emphasis on support.

Stage 5: Moderately Severe Cognitive Decline

Stage five is related to the significant cognitive decline. Individuals will need assistance in performing their usual tasks, making it possible for them to remember their address or even telephone number. Recalling the identities of children becomes hard for them, while areas and time become confusing.

At this point, the patient is already in the last stages of dementia, so it becomes essential that people help with dressing, bathing, and managing personal hygiene. The behavior of such people is mostly characterized by increased anxiety or high levels of irritation; hence, they need careful monitoring under caregivers watch.

Individuals in late stages of dementia can also present instability in their sleep patterns, which may result in wandering around as well as having challenges following a consistent timetable, which also brings more worries to people taking care of them.

Stage 6: Severe Cognitive Decline

In stage six, severe cognitive decline affects nearly every aspect of the individual’s life. They may lose awareness of recent experiences and their surroundings, have trouble recognizing faces except for the closest friends and family, and require extensive assistance with daily activities.

Individuals may experience significant personality changes and could develop delusions, compulsions, or anxiety. They often need help with basic functions such as eating and using the toilet, and full-time care becomes necessary.

At these late stages of dementia, there is often a noticeable decline in verbal communication skills, leading to increased frustration and potential behavioral issues. Caregivers may need to manage feeding difficulties, incontinence, and increased risk of infections due to reduced mobility and overall physical health decline.

Stage 7: Very Severe Cognitive Decline

The final stage of dementia involves rather severe cognitive decline. Individuals lose the ability to respond to their environment, communicate, and control movement. They may still utter words or phrases, but communication is significantly impaired.

Physical abilities decline, and assistance is needed for all activities of daily living, including eating and using the toilet. The individual becomes bedridden, and their body becomes more vulnerable to infections and other complications.

At this late stage of dementia, individuals are at high risk for pressure ulcers, pneumonia, and other health complications due to immobility and weakened immune systems. Palliative care and hospice services are often introduced to ensure comfort and quality of life in the final stages of dementia.

Caregiving and Support for Dementia

Caregiving and Support Throughout the Stages of Dementia

Caregiving and support should vary significantly throughout the 7 stages of dementia. Providing care for someone with dementia requires understanding, patience, and a structured approach. As the disease progresses through the 7 stages of dementia, the level of care needed increases.

Understanding what to expect and how to manage the changes can help caregivers provide the best possible care for their loved ones. Here is a breakdown of care and support for each of the 7 stages of dementia:

Stage 1: No cognitive decline

Regular check-ups with a healthcare provider to monitor for any early signs of cognitive decline.
Learn about dementia, its progression, and early symptoms to be better prepared.
Encourage a healthy lifestyle, including a balanced diet, regular exercise, and mental stimulation, which can help maintain cognitive health.
Begin discussing legal and financial planning, even though symptoms are not yet present.

Stage 2: Very mild cognitive decline

Create a supportive environment that encourages the person to remain independent while being mindful of minor memory lapses.
Establish routines to help manage minor forgetfulness.
Use memory aids such as calendars, notes, and electronic reminders.
Continue with regular medical check-ups to monitor cognitive changes.
Provide emotional support and reassurance to alleviate any anxiety related to forgetfulness.

Stage 3: Mild cognitive decline

Provide increased supervision for complex tasks that the individual may find challenging, such as managing finances or planning events.
Engage in activities that stimulate cognitive function, such as puzzles, reading, and social interaction.
Implement safety measures at home to prevent accidents (e.g., removing tripping hazards, ensuring proper lighting).
Maintain clear and simple communication to help the individual express themselves and understand instructions.
Consider joining support groups for caregivers and individuals with dementia to share experiences and resources.

Stage 4: Moderate cognitive decline

Provide help with complex daily tasks such as cooking, managing finances, and following multi-step instructions.
Maintain a consistent daily routine to provide a sense of stability and reduce confusion.
Ensure regular medical evaluations to manage symptoms and receive appropriate treatments.
Encourage participation in social activities to prevent isolation and depression.
Seek support for yourself as a caregiver through respite care or counseling to manage stress and prevent burnout.

Stage 5: Moderately severe cognitive decline

Provide hands-on assistance with daily activities such as dressing, bathing, and grooming.
Continue using memory aids and cues to help with orientation and remembering important information.
Learn techniques to manage behavioral changes such as agitation and anxiety.
Increase supervision to ensure safety, particularly if the individual is prone to wandering.
Work closely with healthcare providers to manage symptoms and any co-existing medical conditions.

Stage 6: Severe cognitive decline—one of the stages of dementia before death

Provide 24-hour supervision and care, as the individual will need help with nearly all activities of daily living.
Assist with personal care tasks, including eating, toileting, and maintaining hygiene.
Offer comfort and reassurance, as individuals may experience significant confusion and distress.
Use strategies to manage severe behavioral changes and personality shifts, including creating a calm and soothing environment.
Consider professional care services or a memory care facility for specialized support.

Stage 7: Very Severe Cognitive Decline

Provide total care, including feeding, toileting, and turning to prevent bedsores.
Focus on comfort measures to enhance the individual’s quality of life, as communication and physical abilities are severely impaired.
Work closely with healthcare providers to manage pain, prevent infections, and address other medical needs.
Offer emotional support and presence, even if verbal communication is not possible.
Consider palliative care or hospice services to ensure comfort and dignity in the final stages of dementia.

Caregiving for the different 7 stages of dementia, especially the stages of dementia before death, involves addressing both the physical and emotional needs of the individual.

Strategies for Providing Care and Support to Individuals During 7 stages of Dementia

Effective caregiving for individuals with dementia stages at the end of life involves a combination of practical strategies, emotional support, and access to appropriate medical care. Here are some key strategies for providing care and support for the 7 stages of dementia:

Establishing routines

Creating a structured daily routine can help reduce confusion and provide a sense of stability. Regular schedules for meals, activities, and bedtime can make the day more predictable and less stressful for individuals with dementia stages at the end of life.
Communication techniques

Use clear, simple language and maintain eye contact when communicating. Break down tasks into smaller steps and provide one instruction at a time to patients. Be patient and give the person ample time to respond.
Creating a safe environment

Ensure the living environment is safe and free of hazards. Install grab bars in the bathroom, remove tripping hazards, and use locks on cabinets containing dangerous items. Consider using GPS tracking devices for individuals in the last stages of dementia who are prone to wandering.
Engaging activities

Engage the individual with dementia stages at the end of life in activities that they enjoy and that stimulate their cognitive and physical abilities. This can include puzzles, music therapy, gardening, and gentle exercises.
Support networks

Join support groups for caregivers and individuals with dementia. These groups provide a platform to share experiences, seek advice, and find emotional support from others in similar situations, such as stages of dementia before death.
Respite care

Take advantage of respite care services to give yourself a break and prevent caregiver burnout. Respite care can be provided by family members, professional caregivers, or adult daycare centers.
Education and training

Educate yourself about dementia, the 7 stages of dementia, and caregiving techniques. Attend workshops, read books, and seek advice from healthcare professionals to improve your caregiving skills.

Maintaining a calm and supportive attitude helps in managing behavioral changes and reducing anxiety for both the patient and the caregiver, especially at the stages of dementia before death.

Treatment with Stem Cells for Dementia

Dementia can be managed with stem cell therapy, which is a relatively new field. Swiss Medica uses adult multipotent mesenchymal stromal cells (MSCs), well-known for their anti-inflammatory as well as immunomodulating features, which help to decelerate the progression of dementia and boost memory in patients suffering from this disorder.

Stem cell therapy aims to repair and regenerate damaged brain tissue, potentially improving symptoms and quality of life. Clinical trials and research are ongoing to determine the efficacy and safety of this treatment. While not yet a cure, stem cell therapy offers hope for future advancements in dementia care.

Conclusion

Caregivers and patients must know how many stages of dementia are there, and also comprehend effective disease management at each of the 7 stages of dementia.

From mild cognitive decline symptoms to the late stages of dementia when the person needs round-the-clock attention, knowing what to expect can significantly help you offer the correct assistance. Although no cure exists for dementia, therapies such as stem cell therapy provide a basis for optimism towards enhancing the lives of its victims.

For more information on stem cell therapy for dementia, visit Swiss Medica’s stem cell therapy for dementia.

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Dr. Aleksandra Fetyukhina, MD

Medical Advisor, Swiss Medica doctor