Dementia is a general term used for progressive mental or cognitive decline that has affected 47 million people globally; by 2050, this number is expected to increase to an estimated 131 million people.
Out of the various diseases that have dementia as one of their characteristics, Alzheimer’s disease is the most common. The progression of dementia (in Alzheimer’s disease) has been divided into seven stages as per the ‘Global Deterioration Scale (GDS)’ of primary degenerative dementia prepared by Dr. Riesberg and his team.
Stage 1 (No cognitive decline)
The imaging techniques such as computed tomography (CT) scan of the brain might show some changes but the patient does not exhibit any of the cognitive signs and symptoms.
Stage 2 (Very mild cognitive decline)
- The patient starts forgetting words or misplacing objects; this may go unnoticed by people around them.
- It should be remembered that this stage might also occur due to the normal aging process.
Stage 3 (Mild cognitive decline)
- The patient suffers from short-term memory loss—forgetting what they just read and the names of new acquaintances.
- They can’t make plans or organize things as earlier.
- They might frequently start misplacing and losing things.
Stage 4 (Moderate cognitive decline)
- The patient starts to lose interest in the things that they used to enjoy and avoids meeting people and, attending social events.
- Calculating simple expenses and adding up the financial bills becomes difficult.
- They become disoriented to time and place—they forget or figure out the present time, date and place
- The signs and symptoms of cognitive decline become clear to everyone around the patient.
- Clinical diagnosis of dementia is most likely to be made at this stage.
Stage 5 (Moderately severe cognitive decline)
- The patient experiences major memory disturbances such as forgetting their phone number and address.
- They may forget how to bath and face trouble while choosing and wearing clothes.
Stage 6 (Severe cognitive decline):
- The patient loses his memory as much as that they fail to remember the names of closed ones and might mistake one person for another.
- They suffer from severe confusion and anxiety.
- As dementia worsens, they might need help to go to the bathroom.
Stage 7 (Very severe cognitive decline):
- This is the final stage or end-stage of dementia.
- The patient becomes completely dependent on other patients to carry even basic activities like eating, drinking, walking, and sitting.
- There is loss of bladder and bowel control.
- Their ability to communicate is hampered drastically as they speak too little struggling with words.
It should be noted that the speed of progression through the stages of Alzheimer’s disease differs amongst patients. Not all patients will experience the same changes at each stage and the cognitive decline that occurs may overlap stages.
How is dementia treated?
Treatment of dementia depends on its cause. For example, dementia that has developed due to vitamin deficiency can be treated with vitamin supplements and hence is reversible. Other causes of dementia such as depression, thyroid problems can also be treated.
For progressive dementias, including Alzheimer's disease, no treatment can halt its progression, and research is still going on to find out the same. But, some medications may temporarily help relieve its symptoms such as memory loss and confusion. These are:
Patients should ask their doctor about which medicine can be used at the stage of dementia they are currently in.
Some of the non-drug approaches can be adopted by the patient’s family, friends, or caregivers. This helps improve the quality of life of patients with dementia. Some of the non-drug therapies include:
- Monitoring the patient’s comfort
- Being gentle in arguing or explaining certain facts
- Learning how to cope with the patient’s agitation
- Diverting the patient’s attention
- Creating a calm atmosphere
- Creating a safe and secure environment (such as Install safety switches throughout the home)
- Helping the patient join a dementia support group
Can dementia be prevented?
Some risk factors such as genes and age cannot be avoided. Research suggests that patients with dementia can follow a healthy lifestyle to reduce their risk of dementia. Suggestive healthy practices include:
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Reisberg B et al. The Global Deterioration Scale for assessment of primary degenerative dementia. Am J Psychiatry. 1982;139(9):1136-1139.
7 stages of Alzheimer’s disease. Available at: https://www.webmd.com/alzheimers/guide/alzheimers-disease-stages#1
Dementia. Available at: https://emedicine.medscape.com/article/2003174
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