Stages and Symptoms


Not everyone experiencing dementia will have all of these symptoms.


I. EARLY STAGE—FORGETFULNESS

Memory Loss Causes Small Problems

  • Memory problems affect job performance
  • Word loss can become noticeable
  • Problems telling time, relaying messages
  • Items are misplaced and others are blamed

Cognitive Loss Impairs Thinking

  • Abstract thought and math skills may be impaired
  • Money management and paying bills can be difficult
  • There may be challenges in learning new things
  • Tasks are left unfinished and hobbies drop away
  • Decisions may become erratic and unreliable
  • Judgment may become noticeably impaired

Personality Changes

  • Person can lose his/her sparkle, spontaneity, ambition
  • Mild depression may become noticeable
  • May withdraw from social activities
  • Mood swings may become alarming
  • Person may anger easily and may lose impulse control
  • May try to conceal changes in his/her abilities


II. MIDDLE STAGE—CONFUSION

Memory Loss Increases—Both Short Term and Long Term

  • May forget to take medications or turn off appliances
  • Often repeats the same question many times within a short period
  • May get lost in familiar surroundings
  • Person may recognize close family members but may have more difficulty recognizing friends & acquaintances

Cognitive Loss Increases

  • Attention span may decrease
  • Calculation skills can be lost
  • Speech and understanding become slower—difficulty following conversations
  • Reading and comprehension may become difficult

Personality Changes Become a Problem

  • Frustration may lead to increased agitation
  • Sleep disturbances may lower the agitation threshold
  • The person can seem self‐centered, insensitive, jealous
  • As depression increases, self‐esteem may decrease
  • May refuse to wash or bathe, may not change clothes
  • Social skills may become strained
  • Repetition may become an annoyance to caregivers


III. ADVANCED STAGE—DISORIENTATION

Memory Loss Becomes Severe

  • Person may become disoriented to time and place
  • May not remember personal information such as address and phone number
  • Person may not recognize family members and daily caregivers
  • May become unaware of recent events with a sketchy recall of his/her own life

Cognitive Losses

  • Can no longer manage the most simple tasks without assistance
  • Invents and uses inappropriate words; uses gibberish
  • Needs assistance with dressing and bathing

Personality Changes

  • Person may not respond to affection
  • Person may be emotional—cries easily or may become aggressive
  • Person may become suspicious and fearful
  • Delusions and hallucinations can be common
  • May engage in different sexual behavior
  • There is a loss of most social skills

Physical Changes

  • Stooped appearance and shuffling gait
  • Walks with hands slightly extended, palms down
  • Incontinence of bladder and sometimes bowel
  • Hyper‐motor phase; incessant walking
  • Sleep disturbances


IV. FINAL STAGE—ABSENCE

Memory Loss Complete

  • Complete disorientation
  • Recognition of family can be lost

Cognition Absent

  • Complete disorientation
  • May compulsively touch things and/or put things in his/her mouth
  • Requires total care

Personality and Physical Changes

  • Facial expressions are often absent
  • May be unable to speak and/or walk
  • Chewing and swallowing can become difficult
  • The person may develop seizures
  • Constant chewing and smacking lips may occur
  • May become bedridden and/or lapse into a coma

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