Stages of Dementia – What You Need To Know

What Is Dementia

Dementia refers to a group of diseases that cause the decline of mental functions or the loss of memory. These conditions gradually progress over time, but their progression may be slow or rapid depending on the person or the type of dementia they’ve been diagnosed with. There is no clear way to prevent dementia, but spotting it early can help protect you or your loved one from harmful accidents, and provide you with plenty of time to consult a professional on the best long-term plan.

Types of Dementia

There are many different types of dementia, and the symptoms and progression will depend largely on which type a person is diagnosed with. Sometimes you’ll find a mixture of types of dementia in the same person, but there are a few basic types of dementia that are most commonly diagnosed.

Alzheimer’s Disease

Alzheimer’s Disease is often mistaken as the only form of dementia, as it is the most common, but it is actually only one type in this group of cognitive diseases. However, Alzheimer’s dementia alone accounts for anywhere from sixty to eighty percent of dementia occurrences.

Alzheimer’s disease generally progresses rather slowly, and those who have it usually live anywhere from four to eight years after diagnosis, but some have lived up to twenty years. This progressive brain disease is considered to begin long before symptoms start to surface, so early detection is difficult. Brain abnormalities that cause Alzheimer’s occur when pieces of protein called beta-amyloid start to gather and clump together inside the brain. This causes as plaque build-up, which can lead to blockage of cell-to-cell signaling and synopsis in the brain. It may also interfere with normal function of the immune system.   

There are many different symptoms tied to Alzheimer’s disease, but general symptoms include:

  • A struggle in recalling recent conversations, people’s names, or life events
  • Lack of motivation or depression
  • Difficulty walking
  • Impaired communication
  • Disorientation
  • Lack of good judgment
  • Frequent confusion
  • Behavioral changes
  • Difficulty speaking or swallowing

Vascular Dementia

Another type of dementia is referred to as Vascular Dementia. This type of dementia has also been known as multi-infarct or post-stroke dementia, and accounts for about 10 percent of dementia cases.  Vascular dementia is caused by physical conditions that decrease or obstruct the blood flow to the brain. The lack of necessary oxygen and nutrients that this blockage inflicts results in a decrease in mental faculties. This can be tied to strokes, or be a result of brain injury or bleeding in the brain.

Initial symptoms of Vascular Dementia often include:

  • Difficulty making clear decisions
  • Impaired judgment
  • Difficulty planning or organizing

Dementia with Lewy Bodies

Dementia with Lewy Bodies – or DLB – is the third most common type of dementia found today, and has many symptoms similar to those in Alzheimer’s. One clear factor that is unlike Alzheimer’s, however, is that symptoms of sleep disturbance and hallucinations are more prominent in the early stages of DLB.

This type of dementia is attributed to brain damages incurred by abnormal microscopic deposits over time. Other diseases that have included the presence of lewy bodies are Alzheimer’s disease as well as Parkinson’s Disease, and there are many similar symptoms that may be found between Parkinson’s and Dementia with Lewy Bodies.

Symptoms of DLB can include:

  • Decline in thinking
  • Decline in independent function        
  • Sleep disturbances
  • Rigid muscles
  • A shuffling walk
  • Difficulty initiating movement
  • Hallucinations
  • Hunched posture

Mixed Dementia

Mixed Dementia occurs when abnormalities of two or more memory diseases are found in the brain, and can also be referred to as “Dementia – Multifactorial.” This most commonly involves the combination of Alzheimer’s and Vascular Dementia, but can include other combinations of dementia as well. There may even be cases when all three of the aforementioned disorders coexist, with Alzheimer’s brain abnormalities, blood vessel dysfunction, and Lewy bodies all at work.

Symptoms of mixed Dementia may be hard to distinguish from one of the previously mentioned types of dementia, or may be a unique combination of several of them.

Parkinson’s Disease Dementia

Parkinson’s disease is not in itself a type of dementia, but as it progresses it often leads to dementia similar to Alzheimer’s or DLB. The abnormalities caused in Parkinson’s Disease Dementia are usually closely related to the affect of Lewy bodies, similar to what is found in DLB.

Symptoms often found in Parkinson’s Disease Dementia are:

  • Memory changes
  • Trouble concentrating
  • Difficulty understanding visual information
  • Muffled speech
  • Depression or anxiety
  • Hallucinations
  • Paranoia and delusions
  • Daytime drowsiness
  • REM sleep disorder

Frontotemporal Dementia

Frontotemporal Dementia (FTD) also known as Pick’s Disease, occurs when the brain’s frontal lobes or temporal lobes suffer nerve cell loss. Unlike DLB there is no sign of microscopic abnormality that links cases of FTD, and it generally affects people much younger than those with most other dementia disorders, often starting around the age of 60.

There are several variations of Frontotemporal Dementia, including Behavior Varient Frontotemporal Dementia (bvFTD), and Primary Progressive Aphasia (PPA). Depending on the type of FTD, symptoms may include:

  • Muscle weakness or wasting
  • Stiff limbs
  • Difficulty walking
  • Impaired speech
  • Impaired judgment
  • Personality changes

Rare Dementia Types

Much rarer types of dementia diseases include Creutzfeldt-Jakob Disease, Huntington’s Disease, Normal Pressure Hydrochephalus and Wernicke-Korsakoff Sydrome.

Creutzfeldt-Jakob Disease is the most common form of a group of diseases known as prion diseases, which cause rare and fatal brain disorders. This disease is caused when the prion protein in the body takes an abnormal shape, which triggers the same abnormality in the prion protein’s in the brain. This transformation causes brain damage with symptoms such as, decline in thinking,

involuntary muscle movement, confusion, and mood changes.

Huntington’s disease is caused by a defective gene on chromosome four, and may cause symptoms such as depression, decline in reasoning skills, irritability, and other mood changes.

Normal Pressure Hydrochephalus is caused by excess cerebrospinal fluid accumulation, and affects walking ability, clarity of thought, and bladdar control.

Dementia Tests

There are several ways that physicians may test a patient to ascertain whether they have a cognitive disease. Some of the most prominent tests used to assess dementia are:

  • Mini-mental state examination (MMSE)
  • Mini-Cog test

Once the test has been administered a physician will assign a Clinical Dementia Rating which defines what stage of dementia a person is in. The different scores include:

  • 0 for normal
  • 0.5 for very mild dementia
  • 1 for mild dementia
  • 2 for moderate dementia
  • 3 for severe dementia

Though there are only 5 scores in the Clinical Dementia Rating, most health professionals discuss the stages of dementia using the Global Deterioration Scale (GDS) (also known as the Reisberg Scale) which includes a total of seven stages of cognitive ability. Surprisingly the first three stages of symptoms that set the base for the scale don’t necessarily indicate dementia at all.

Stages of Dementia

Stage 1: No Cognitive Decline

This stage is the base where normal and healthy people fall in the scale categories. People in stage one have no memory loss and are considered to be mentally strong and healthy.

Stage 2: Very Mild Cognitive Decline

Most elderly people fall into this category, and there’s no reason to worry about being diagnosed with a type of dementia. Many people naturally lose a little speed and vigor in their mental capabilities as they age, and that’s normal. This stage may include some minor forgetfulness, or misplaced objects.

Stage 3: Mild Cognitive Decline

Those in stage three will discover that they have a little harder time concentrating, some difficulty in remembering little things throughout the day, and a decrease in work performance. In conversation, finding the words they want to use may be a little more of a chore, and those close to them may begin to notice a slight difference in their cognitive state. This stage may be an indicator that dementia could set in within seven years or so.

Stage 4: Moderate Cognitive Decline

Stage four is considered the early stages of dementia. In this stage people have a hard time recalling recent events, have difficulty concentrating, and may struggle with tasks that take a lot of thought. Travelling alone may become stressful, and they may start to withdraw from social activities because the interaction has become challenging. In this stage people are often resistant in acknowledging their symptoms, but a physician can usually spot cognitive problems even during a consultation. This stage may last about two years.

Stage 5: Moderately Severe Cognitive Decline

This mid-stage of dementia usually lasts around a year, and has many more obvious symptoms. At this point most people will begin to require some assistance with tasks throughout the day. Activities such as bathing, dressing, and preparing meals will necessitate some level of help, and memory loss may include important and common information such as their home address, the time of day, or even their current location.

Stage 6: Severe Cognitive Decline

This is also considered a mid-stage of dementia, and will usually last a little over two years. A greater amount of daily assistance will be necessary in this stage. People in stage six usually have difficulty counting, may forget names of close family members and friends, and will generally forget even recent events. Memory of their early lives is all but faded, and difficulty with bodily functions such as bladder control may set in. Ability to speak decreases, personality changes may also occur, and delusions and odd compulsions such as repeating simple behaviors may surface.

Stage 7: Very Severe Cognitive Decline

Those who reach stage seven have little ability to do anything on their own- even walking. Communication is nearly extinguished, and even activities such as eating and using the bathroom require constant assistance. This phase usually lasts a couple years or so.

Action Steps

There is currently no cure for dementia, but you and those you love can help prevent the risk of dementia by taking these action steps:

  • Stay active: This doesn’t have to consist of intense workouts, but consistent exercise throughout the week promotes brain health as much as overall physical well being.
  • Maintain a healthy diet: Eating foods that are high in antioxidants may prevent the effect of free radical chemicals that damage brain cells. Foods that are rich in antioxidants include green teas, blueberries, cranberries, and other vegetables and fruits.
  • Avoid activities that may risk head trauma: Avoid sports that may incur consistent impact to the head, and when engaging in high-intensity or higher-risk activities, always wear the necessary protective headgear.
  • Engage in mental games and activities: Activities such as crosswords puzzles, sudoku, board games, or learning a musical instrument all engage the brain and help keep it active and healthy.
  • Include social interactions in the weekly schedule: Seniors who isolate themselves may have a much higher risk of dementia, so keeping a consistent schedule of social activities can help prevent cognitive decline.

If you are already starting to recognize some symptoms of dementia in yourself or someone you love, there are some easy steps to get a better understanding of what you may be facing, and where to get the right care:

  • Self-monitor mental clarity by keeping a journal of the day’s events
  • Set up regular check ups with a personal physician
  • Follow doctor’s instructions if advised to see a neurologist or psychiatrist
  • Discuss the cognitive stage with family and make a care plan in advance

Conclusion

Thankfully healthcare has made great advancements over the years in the area of memory care, so there are many different options to choose from as you start to make your plans for the future. Whether it’s in-home care or an assisted living facility that is equipped for memory care residents, deciding early will make the process easier on everyone involved.

Because dementia takes very different courses with each person, it is very hard to know exactly how it will affect your life, but it’s always best to be prepared. Making a plan now will save you or your family money and stress, and make each year to come peaceful and meaningful as possible.