Stages of dementia

It is useful to know about the stages of dementia to help inform plans for treatment and care. Understanding the stage of dementia can also help guide care needs as the disease progresses. In the earlier stages of dementia, individuals can still function relatively independently, however in the middle stages they will begin to need more assistance. During these later stages, the caregiver’s goals often shift to focusing on preserving the person’s comfort and quality of life. Although individuals may lose the ability to communicate, research suggests that aspects of the person and their former self still remain, so you are still able to have meaningful interactions even in the later stages of the disease. 

To identify a stage, the Clinical Dementia Rating Scale (CDR) is designed to evaluate the stages of dementia. It uses a 5-point scale to assess the severity of symptoms as they affect the person’s ability to function in six different cognitive categories (memory, orientation, judgement and problem solving, community affairs involvement, home life and hobbies, and personal care).

Stage 1 

No impairment: No memory loss

Stage 2

Very Mild Cognitive Decline: Normal memory loss associated with aging 

Stage 3

Mild Cognitive Decline: Friends and family members begin to notice cognitive problems 

Stage 4

Moderate Cognitive Decline: Poor short term memory, may forget personal details, difficulty with simple arithmetic 

Stage 5

Moderately Severe Cognitive Decline: Begins to need help with daily activities, significant confusion, disorientation

Stage 6

Severe Cognitive Decline: Worsened memory loss, difficulty recognising family members, possible personality changes 

Stage 7

Very Severe Cognitive Decline: Communication is limited, physical systems also decline