Four Stages of Dementia. Don’t Miss the Symptoms!
I’ll be honest: this material was especially difficult to prepare. I have seen the beginning of the symptoms with my own eyes.
And for many people, reading it will not be easy either. For some, because it is already familiar from someone close. For others, on the contrary, because it is unknown — and therefore unsettling. I understand both.
This chapter is about the most subtle and the latest symptoms that appear across the four stages of dementia.
Let’s just agree on one thing: if you read something that feels familiar, before trying this “suit” on yourself, read the next chapter about pseudodementia.
In any case, only a doctor can make a diagnosis. Your task is simply to know the basics, so you can understand the quality of their recommendations and prescriptions.
There is also an important chapter on diagnostic methods. Knowing this information will help you ask the doctor the right questions.
For the Sake of Order, Scientists Divided Dementia by Age
The First Group
When dementia appears before the age of 65.
Presenile dementia. The Latin prefix “prae-” means “before,” and “senilis” means “senile” or “old-age.”
Unfortunately, it tends to progress more aggressively, literally destroying the entire psyche within just a few years — often 3–4 years.
The Second Group
Senile dementia is diagnosed after the age of 65.
About one in five people over this age shows signs of cognitive impairment, which may be a transitional stage before dementia.
At present, in the absence of a widespread culture of prevention and care for brain health, by the age of 85 almost 35% of people may be diagnosed with one of the stages of dementia.
In General, Dementia Is Characterized by the Following Symptoms
Aphasia
Impaired ability to speak, including difficulty finding words or understanding other people’s speech.
Apraxia
Rapid loss of skills, or praxis — the ability to perform even simple actions despite preserved physical ability to carry them out.
Agnosia
Reduced ability to recognize objects and identify people or sounds while sensory functions remain intact.
Amnesia
Loss or impairment of memory.
So, the 4 Stages of Dementia
In medical practice, a four-stage classification is often used:
- PREDementia
- MCI — mild cognitive impairment
- Moderate cognitive impairment
- Dementia
At the same time, there are broader specialized classifications.
For example, the Global Deterioration Scale, GDS, includes seven stages of dementia. It allows specialists to account for changes at each stage in more detail.
We do not need that level of detail here. Let’s leave it to the specialists.
For a general understanding, it is enough to understand the drama in four acts.
The first signs of dementia may appear several years before the diagnosis is made.
Important: these signs may resemble predementia, but they do not necessarily mean that it is actually predementia. The causes of the symptoms described may be different — do not scare yourself ahead of time.
So. At first, everything may seem not that serious.
- Minor memory problems… well, you forgot where you put your keys / glasses.
- The title of a book, a film, an actor’s name, or something you had planned for the day — it just “slipped your mind.” It happens to everyone.
- At this stage, memory problems are subjective: people around you do not notice them yet, and neuropsychological tests will most likely not show negative results.
Only the person themselves realizes that everyday forgetfulness, concentration, and mental quickness are getting worse.
At the stage of mild cognitive impairment, or MCI, the symptoms become more noticeable, and harder to ignore.
- The verbal parade of phrases like “that thing” and “what’s it called again” appears more and more often, when even simple words become harder to recall.
- Clearer signs of aphasia appear — difficulty expressing thoughts.
- Simple actions that used to happen automatically become harder: getting ready for work or a walk without forgetting your phone, glasses, keys, documents, or money.
- It becomes harder to concentrate, plan, and switch from one task to another.
People close to the person already begin to look more carefully and notice something…
The manifestations of cognitive impairment expand.
They become obvious not only to loved ones, but also to other people.
Keys end up in the fridge, or a cup is placed on the shoe shelf.
At the stage of moderate cognitive impairment, a person may still be able to read books, watch videos, and understand their meaning while watching.
But if you ask them what it was about, they will not be able to reproduce the meaning.
The ease of conversation disappears. So does wit, if it was there.
By the way, there is also a “classic” pattern of psychological change.
- Some people become more egocentric, as if they have returned to adolescence.
- Somehow, almost unnoticed, all the sharp edges of character that seemed to have softened with age start showing again.
- In some cases, there is a tendency to lecture everyone on life, moralize, become aggressive, hostile, and quick-tempered.
- Sometimes disinhibition appears. Some people suddenly become ravenous, start eating everything in sight, or develop an interest in alcohol.
- In the presenile, or younger, form, disinhibition in the form of sexual preoccupation can also become a shocking new feature of behavior.
- Sometimes, for example in Alzheimer’s disease, memory breaks down according to a special pattern known as Ribot’s law.
Recent or current events are forgotten first. But distant youth — you could almost write a dissertation about it today.
Though, of course, there are nuances here: many memories may turn out to be invented — so-called confabulations.
Not on purpose. That is how the brain tries to fill in the gaps and stitch together a story that is no longer there.
At this stage, the person you knew is already hard to find.
In the final stages, they can barely speak.
They often fall into apathy and become completely indifferent to those around them.
They do not recognize their relatives: grandchildren become abstract beings, children become brothers — or even ghosts of relatives who have long passed away.
In the mirror, they see anyone but themselves.
Gradually, the physical state catches up with the mental one: the muscles weaken, the hands tremble, the gait becomes small and shuffling.
Speech becomes unclear. Everything blends into an indistinct mumble.
At the last stage, there is exhaustion. The person lies in a fetal position, whispering something — but no longer to anyone.
Curtain….
