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Stages of Dementia

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Dementia is loss of cognitive abilities like memory, thinking, reasoning which further leads to changes in behaviour mood and personality. It’s not a disease (should not be confused with Alzheimer’s disease), rather a cluster of symptoms which are outcome of certain diseases (like Alzheimer’s disease, Parkinson’s disease, brain injury, etc.) or normal aging process.

It’s a progressive disorder, i.e. becomes worse with age and as per Clinical Dementia Rating (CDR), 5 stages of dementia have been proposed with different independent scores.

The 5 Stages of Dementia

Stage 1- No Impairment

In this stage no evidence of dementia is found and the CDR score is 0. Individuals do not have any memory problems and they are completely functional in every aspect of living. They have normal reasoning abilities, can maintain family and take care of himself/herself without any assistance.

Stage 2- Questionable Impairment

A bit of memory complications are noted in the second stage. The CDR score is 0.5 in this stage. Although they can take care of their personal needs, they face difficulties in dealing with complex situations and judgment. The problem pertains to timing. Slight forgetfulness is observed which could be forgetting to do some work and social engagement.

Stage 3- Impairment

Substantial memory impairment is observed in the third stage and the CDR score rises to 1. Loss of memory would clearly reflect while doing any outdoor as well as indoor activities and they would need reminders for their tasks. A person might face difficulty in tracking directions while commuting from one place to another and would need assistance. At home, they often forget to take care of personal hygiene. Family members can help them to recall things. The stage 3 is characterized by short term memory loss.

Stage 4- Moderate Impairment

Moderate impairment means they face substantial difficulty in remembering the recent things, which include faces, names, relationships and events. Short term memory loss gets more severe than Stage 3 and the CDR score is 2 in this state. Old people need personal assistance for carrying out daily chores like personal hygiene, engaging in social activities, going out for walk or any other purpose. This is because they face a great deal of challenge when it comes to orientation with time, space and movement.

Stage 5- Severe Impairment

The last stage of dementia is characterized by extreme form of memory loss, wherein they cannot function with the help of a caretaker. The CDR score is 3 for stage 5. Going out in public places and social engagement even in the company of caregiver is not advisable as they get utterly confused and cannot understand or communicate anything. At home, they become completely non-functional in carrying out any task and need a caregiver 24/7 for personal help.

The stages of dementia are diagnosed thoroughly by doctor in order to know whether it has resulted from aging or any other disorder. However, your doctor will suggest several strategies that will help coping with dementia in a wonderful way.

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Written by: Saptakee sengupta
Date last updated: January 17, 2015