Stages of dementia
There are three known stages of dementia progression:
| Stages of dementia | Characteristics |
|---|---|
| Mild stage | • This stage can last from 3-5 years. • The person is able to live and function independently: work, drive, selfcare. • In the beginning the symptoms are mild memory interferences, problems with thinking and learning. • The symptoms are mild attention deficit, when a person cannot follow the conversation, especially in a larger group of people. Person starts avoiding the crowd and is losing interest in things that he/she liked until recently. • Then they start forgetting things, they become emotionally distant. In a lot of cases they appear sad and numb. • It continues with memory interferences, when a patient is forgetting and therefore repeats things. When people point that out, the patient sometimes becomes angry and distrustful. • Complaining over memory interferences: person forgets where he/she puts things, forgets the names he/she knew very well. • Denial and mild anxiety. Signs, when there are misfunctions on more than one area: o The person can easily get lost when traveling at unknown locations. o Co-workers and people around become suspicious about the problems. o The person might read a book, watch a movie, see a show and not remember much. o Not remembering names when meeting new people. o Losing or misplacing things. o Clinical testing can show problems with concentration. The objective indicator of memory loss can be confirmed only with formal tests. |
| Moderate stage | • This stage can last from 3-12 years. • Memory interferences of recent important topics (who is the president, which is the capital city, who is the famous poet, etc.) • Communication problems (person doesn’t find appropriate words, has troubles with the conversation flow). • Problems with everyday chores, hygiene, usage of different utensils (kitchen, electrical devices, TV, telephone). • The person is unable to recall the important information from life, like address or phone number, the names of family members, … Very common occurrence is disorientation for date, day, space, time of the year and backward counting (from 40 or 20). • The person can recognize family members and has preserved memories from personal history (episodic memory). • Still able to do some things on his/her own. • Attention deficit on multiple areas. • Not able to travel or handle money. • Not able to do complex tasks. • Emotional instability and avoidance: denial is a dominant defense mechanism, jealousy, delusions, aggression or apathy, anger, impulsiveness. • Unable to function on his/her own: the person needs help and cannot live on his/her own anymore. |
| Severe stage | • Plaques and tangles are seen on the larger part of the brain. • The person forgets the names of the relatives. He/she can remember his/her name, but has problems with other family members- don’t distinguish between relatives and strangers. • Memory fades on the recent events and experiences. • The person is able to recall only few events and gained knowledge. • Problems with counting forward and backward with larger numbers than 10. • Distractions in every day’s rhythm: sleeping disorder. • Changes in personality and emotional perceiving: the person can have delusional experiences, apathy, obsessive symptoms, fear, loss of appropriate behavior. • All verbal skills are lost. Often the speech is gone, what is left is mumbling. • Person needs help with daily chores, getting dressed, being fed, going to the bathroom. • Loss of psycho- motoric functions: the brain loses the ability to communicate with the body; slowly losing ability to walk. • In the end the person obtains only vegetative functions. |
Measures:
| Stages of dementia | Measures |
|---|---|
| Mild stage | • The biggest effect on the decrease of cognitive actions are preliminary precaution activities: cognitive exercises (attention, memory, problem solving, etc.), exercises for sensory, physical activities, healthy diet and corresponding lifestyle. • We have to help the person with the plan for daily chores and activities: diary of activities, taking medicine, finance plan, planning important events, daily plan (meals, free time, etc.). • Planning the future: legal formalities, conversations about care and staying at the nursing home, etc. |
| Moderate stage | • Lead activities with the person so they can strengthen cognitive and other functions. • Recommended activities are those, that stimulate memory of the past, that strengthen motoric and sensor functions, activities that stimulate all kinds of memory areas (episodic, semantic, implicit-procedural memory). • Lead activities, that stimulate movement. • Care for communication and socializing. |
| Severe stage | • Complete care. • Activities that strengthen sensory perception, that are soothing and relaxing. • Lead activities with the person so they can strengthen cognitive and other functions that are left. |