Dementia is a progressive condition that gradually affects memory, language, motor skills, and problem-solving abilities. Over time, it becomes harder for individuals to manage daily tasks independently. While each person’s experience with dementia is unique, the condition often progresses through distinct stages. Understanding the stages of dementia before death can provide valuable insight into what lies ahead, helping families and caregivers prepare for the journey.
In this blog, we’ll walk you through the 7 stages of Dementia, offering a clear and compassionate guide to understanding the progression of dementia.
What are the 7 Stages of Dementia?
Health professionals use a detailed tool – Global Deterioration Scale (GDS), to analyze the seven stages of dementia. This widely used method helps caregivers and medical experts understand how quickly dementia advances in a patient. It also guides families and caregivers by explaining the symptoms expected at each stage of dementia.
The Seven Stages of Dementia are as Follows:
- No cognitive impairment – No signs of memory or thinking difficulties
- Very mild cognitive decline – Slight changes in memory or thinking
- Mild cognitive decline – Noticeable memory or thinking problems
- Moderate cognitive decline – Significant difficulties with memory and thinking
- Moderately severe cognitive decline – Serious memory and thinking challenges
- Severe cognitive decline – Major memory and thinking impairments
- Very severe cognitive decline – Extreme memory and thinking loss
Learning about the stages of dementia before death can offer caregivers valuable insights to support their loved ones during this challenging journey.
How Does Dementia Progress?
Dementia typically advances through seven stages, which are grouped into three main phases:
-
Early-Stage or Pre-dementia (Stages 1, 2, and 3):
In these initial stages, individuals can often live independently. Memory problems or task difficulties may not yet be noticeable. Symptoms are generally mild and can resemble normal age-related forgetfulness.
How to Help Early-Stage Dementia Patients?
If you are seeing signs of early stage or pre-dementia in your loved one, you should start documenting their lifestyle, their values, and priorities. Doing so will help them keep tabs on their daily tasks if the disease progresses.
-
Middle-stage or Moderate Dementia (Stages 4 and 5):
During this phase, symptoms begin to affect personality and behavior significantly. Individuals may require support from a part-time or full-time caregiver to manage daily activities. Moderate dementia includes noticeable cognitive decline and emotional changes such as mood swings.
How to Help Middle-Stage Dementia Patients?
If the condition of dementia worsens and he/she starts showing signs of moderate dementia, it is time to seek serious medical attention. Tell the doctor everything and plan the perfect medical plan to stop the symptoms from advancing.
-
Late-Stage or Severe Dementia (Stages 6 and 7):
The final stages of dementia are marked by severe cognitive and physical impairments. Common symptoms include profound memory loss, loss of bladder and bowel control, and difficulty moving without assistance.
How to Help Last-Stage Dementia Patients?
The last stage of dementia is the level of disease where you can no longer rely on simple medications or your personal care. You must now get in touch with a trusted assisted living center in your area to give your loved ones with dementia the care they deserve.
It’s important to note that the progression of dementia varies for each individual and depends on the specific type, such as Alzheimer’s, vascular dementia, Lewy body dementia, or frontotemporal dementia. Recognizing the signs and symptoms in each phase, particularly the later stages of dementia before death, can help caregivers respond effectively as the condition advances.
Dementia Stage 1: No Cognitive Impairment
Stage 1 of dementia might seem unusual because it typically resembles normal mental function with no noticeable decline. People in the first three stages of dementia usually don’t show enough symptoms for a diagnosis.
Although mild cognitive impairment might exist, stages 1, 2, and 3 on the Global Deterioration Scale (GDS) are considered pre-dementia stages. However, it’s important to understand that changes in the brain are already happening during these early stages, which could progress to a dementia diagnosis by stage 4.
Dementia Stage 2: Mild Memory Lapses
Stage 2 dementia, also referred to as “very mild cognitive decline,” involves occasional memory slips, such as misplacing keys or forgetting someone’s name. This stage is often considered a pre-dementia phase and does not qualify for an official dementia diagnosis.
Many seniors experience this level of forgetfulness as part of normal aging. The changes are usually so minor that caregivers or healthcare providers may overlook them. Stage 2 is also called “age-associated memory impairment” on the Global Deterioration Scale (GDS). It is a standard part of aging that many older adults face at some point.
According to research by Professor Gary W. Small, published by the British Medical Association, “About 40% of people aged 65 or older have age-associated memory impairment — in the United States, that’s about 16 million people. Only about 1% of them will progress to dementia each year.”
For most people, this pre-dementia phase does not advance to a dementia diagnosis. With healthy lifestyle adjustments supporting brain function, seniors can remain in Stage 2 for a long time or indefinitely.
Stage 2 dementia symptoms include:
- Misplacing familiar items
- Difficulty remembering names of friends, family, or past acquaintances
Dementia Stage 3: Mild Cognitive Decline
Stage 3 dementia, often referred to as mild cognitive impairment (MCI) or mild decline, usually does not significantly disrupt daily activities. At this stage, individuals may not yet receive a formal dementia diagnosis, but memory and thinking issues become more apparent to family and caregivers.
How Quickly Does Early Dementia Progress?
According to the National Institute on Aging, around 10–20% of older adults with MCI, aged 65 or above, may develop detectable dementia within a year.
Because MCI can lead to more advanced dementia stages, identifying the signs early and seeking medical advice is vital. Proactive care can help maintain brain health and potentially slow the progression of dementia.
Common signs of this stage include:
- Frequently missing appointments or forgetting events.
- Misplacing items often.
- Getting lost in familiar areas.
- Declining performance at work.
- Struggling to find the right words.
- Repeating statements or questions.
- Difficulty staying organized or focusing.
- Trouble handling complex tasks or solving problems.
- Driving challenges or unsafe driving behaviors.
Recognizing these symptoms early can help families plan for care and better manage the later stages of dementia before death becomes a concern.
Dementia Stage 4: Moderate Cognitive Decline
At stage 4 of dementia, a person shows clear and noticeable signs of mental decline. Their personality may change, and they often display significant dementia-related behaviors. The severe symptoms from stage 3 become more prominent at this stage. Dementia is usually not diagnosed until a person reaches stage 4 or later.
Medically, stage 4 is called “moderate cognitive decline,” but the Global Deterioration Scale (GDS) also classifies it as “mild dementia.” At this point, doctors and caregivers notice clear signs that the Dementia is progressing and requires memory care. These include problems with language and a reduced ability to solve problems.
Symptoms of stage 4 dementia include:
- Withdrawing from social interactions
- Emotional instability or mood swings
- Lack of responsiveness to others
- Decline in intellectual abilities
- Difficulty completing everyday tasks
- Forgetting recent events
- Denying that symptoms are present
If you are in the moderate stage of dementia and want to improve, here are 7 ways to create a daily routine for seniors with dementia.
Dementia Stage 5: Moderately severe cognitive decline
This stage, often referred to as middle-stage dementia or “mid-stage” in the seven stages of dementia, represents a significant shift. At this point, individuals may need help with daily tasks (ADLs), such as dressing and bathing, as well as more complex activities (IADLs), like managing finances or preparing meals.
Stage 5 typically lasts between two to four years, but the progression of dementia varies for each person.
During this phase, your loved one will likely need closer supervision and increased care. While they may still remember important facts about themselves — like their names and children’s names — they might forget details such as their grandchildren’s names, their former addresses, or where they went to high school.
Common Symptoms of Stage 5 Dementia:
- Significant memory loss, including personal details and recent events
- Wandering
- Confusion and forgetfulness
- Disorientation, especially later in the day (sundown syndrome)
- Noticeable decline in mental sharpness and problem-solving skills
Understanding these changes can help you prepare for the stages of dementia before death and provide the support your loved one needs during this challenging time.
Dementia Stage 6: Severe Cognitive Decline
Stage 6 of dementia involves significant cognitive decline, requiring a caregiver to assist with basic daily tasks such as eating, using the bathroom, and personal care. Seniors at this stage may struggle with sleep regulation, interacting with others, and behaving appropriately in public.
As dementia symptoms become more complex in stage 6, you might question whether full-time care is needed. To stay prepared, keep track of symptoms, observe your loved one’s ability to handle daily activities (ADLs) and more complex tasks (IADLs), and consider care options like memory care or home care.
Stage 6 Dementia Symptoms include:
- Difficulty sleeping
- Incontinence (urinary or fecal)
- Aggression and anxiety
- Personality changes, such as paranoia or delusions
- Inability to carry out daily activities (ADLs)
- Severe memory loss
- Inability to recognize family members and caregivers
Dementia Stage 7: Severe Cognitive Decline
Stage 7 is the final stage of dementia, often called the end stage. At this point, individuals can no longer care for themselves and become very unresponsive, with both verbal and physical abilities severely declining. Speech is lost, movement is minimal, and essential body functions start to fail.
Symptoms of Stage 7 dementia include:
- Inability to speak
- Failure to recognize loved ones or caregivers
- Lack of physical movement without assistance
- Difficulty chewing or swallowing
- Impaired bodily functions, including breathing problems and organ failure
- Excessive sleeping
- Loss of bladder and bowel control
This stage marks the final stages of dementia before death, where the person’s health deteriorates rapidly.
Wrapping Up
Understanding the stages of dementia before death can provide important insight into the challenges ahead. As the condition progresses, it’s essential to stay informed and seek support to ensure your loved one’s comfort and well-being.
Whether you’re coping with dementia yourself or caring for a loved one, knowledge is a powerful tool in managing the journey. If you’re considering additional care options, contact communities like Quail Crest for memory care in Eugene Oregon, for compassionate and professional support. Offering services such as hospice respite care can also provide relief for caregivers during this difficult time.
