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Behaviors at Each Stage of Dementia

While many disorders may cause dementia, the most common cause is Alzheimer's disease, a progressive degenerative brain disorder in which the electrical charges and neurotransmitters (chemicals) that carry messages between nerve cells are damaged. The brain begins to shrink, especially in the area that controls short-term memory (the hippocampus), and plaques and tangles of protein develop. However, people go through similar stages of dementia regardless of the cause.

  1. Stage 1 (Pre-Clinical)

    • During this very early stage, people show no obvious signs of dementia. They are unaware of any loss of memory and function normally. However, according to the National Institute of Aging, damage to the brain may begin up to 20 years before onset of symptoms, affecting areas where learning, memory and reasoning take place.

    Stage 2 (Mild)

    • The onset of dementia is often very subtle. People may realize that they are becoming more forgetful, misplacing items and having difficulty recalling names, but their intellect is intact, and family and friends notice no signs of dementia. These changes may be dismissed as part of the normal aging process.

    Stage 3 (Early Stage)

    • This is the first stage where testing may diagnose dementia. People experience increased memory loss, often obvious to family and friends. Typical signs of dementia include difficulty remembering names, inability to handle financial affairs, losing valuable items, difficulty planning and executing, decreased reading comprehension and confusion regarding work and social roles.

    Stage 4 (Moderate)

    • Dementia is more obvious, and people begin forgetting family history and show little knowledge of current affairs. They may increasingly withdraw from social situations. They can usually attend to simple activities of daily living, such as preparing meals and bathing, but become confused with complex tasks. They will have difficulty with mental arithmetic.

    Stage 5 (Mid-Stage)

    • People are no longer able to completely take care of themselves and require supervision as they may have disorientation, forgetting their address, the date or their telephone number although they usually still know their name and recognize family and close friends. People may sometimes dress inappropriately for temperature.

    Stage 6 (Severe)

    • People usually require full-time care and need assistance with most activities of daily living, such as dressing, eating and bathing. They usually have extensive memory loss and confusion and may recognize family but confuse the relationship. Language ability may be impaired, and the person may be unable to read or read with little comprehension. People may become incontinent and may have disruption of sleep-wake cycles, begin to wander away and get lost and exhibit unusual behavior, such as pacing back and forth, tearing paper or moving belongings about. People may become confused about reality; for example, they may believe events in a movie are real.

    Stage 7 (End-Stage)

    • According to the National Institute of Aging, in the final stage damage occurs throughout the brain. People are completely dependent, usually becoming bedridden and unable to stand, walk, talk or eat. They are incontinent and have increasing trouble swallowing and controlling muscles, which often become rigid.

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