7 Stages of Dementia explained

This guide aims to help families better understand what to expect and when they can expect it.

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Alzheimer’s disease and other common forms of dementia including vascular dementia, dementia with Lewy bodies, and frontotemporal dementia are progressive conditions, with symptoms worsening over time as the disease progresses. Dementia does not affect every person in the same way. It presents itself differently in each individual and progresses at different rates. Some people will stay in a state of mild decline for an extended period, while others may develop multiple symptoms quickly. Understanding the seven stages of dementia can make these transitions a little easier for you and your loved one.

Although the two terms are often used interchangeably, Alzheimer’s disease and dementia are two different terms.

Dementia is an umbrella term used to describe several conditions and it includes Alzheimer’s, as well as other conditions with shared symptoms. An individual must have trouble with at least two of the following cognitive areas to be diagnosed with dementia:

  • Memory
  • Communication and speech
  • Focus and concentration
  • Reasoning and judgment
  • Visual perception (including trouble detecting movement, differentiating colours, or experiencing hallucinations)

Some symptoms may occur later than others, others may appear in a different order and some may not appear at all. Some symptoms may appear and then vanish, while others will continue to worsen over time. Because every person is different and so is their dementia journey, the speed at which dementia progresses varies widely. On average, a person with Alzheimer’s disease lives 4 to 8 years after a diagnosis, but some have been seen to live as long as 20 years.

How is Dementia Diagnosed?

No single test can determine if your loved one has dementia. A doctor will examine several factors to come up with a diagnosis, including a full medical history, physical exam, blood tests, and recognizing a pattern of loss of function and skills. With a high level of certainty, doctors can diagnose a person with dementia, but it’s more challenging to define the exact type of dementia.


Stage 1
In Stage 1 of dementia, there are no signs of dementia, the person functions normally, and is mentally healthy. People with no dementia diagnosis are considered stage 1. There are no signs or symptoms, no memory loss, behavioural problems, or anything else associated with the onset of dementia.


Stage 2
The next stage is stage 2, known as very mild cognitive decline. In this stage, there is normal forgetfulness that often attributed to normal signs of ageing. In this stage, carers may start to notice some level of forgetfulness, but symptoms of dementia are still not apparent to doctors or often loved ones. At this early stage, support is about finding a balance between independence and assistance. When in doubt, assume your loved one can accomplish a given task on his or her own unless there is an immediate risk to safety.


Stage 3
Stage 3 is also known as mild cognitive decline. Family and friends may begin to notice signs of cognitive decline as their loved one experiences increased forgetfulness, decreased performance at work, speech difficulty, and difficulty focusing on everyday tasks. It is important to recognise the signs of this stage for early diagnosis and intervention.


  • Diminished work performance
  • Increased memory loss and forgetfulness
  • Trouble concentrating, problem-solving and managing complex tasks
  • Driving difficulties and getting lost.
  • Asking the same questions repeatedly.


Stage 4
At Stage 4 there is moderate cognitive decline and this stage is commonly defined as early dementia or Alzheimer’s disease. Symptoms of cognitive decline are apparent, and your loved one should be consulting with a health care professional. This stage lasts an average of 2 years and cognitive issues can be detected during a medical interview and test. People in this stage will have difficulty concentrating, will forget recent events, and will have difficulty managing finances and travelling alone to new locations. Additionally, they may experience difficulty socializing and begin withdrawing from friends and family. It is important to actively engage with the person with dementia. Family and carers will have a more involved role in this stage and subsequent stages. It is a good idea to have a daily care plan in order that the necessary level of care is provided. If you are caring for a loved one alone it may be you need additional support both physically and emotionally.


  • Misplacing items
  • Forgetting recent conversations or events
  • Struggling to find the right words in a conversation
  • Losing track of the day, date, or time
  • Social withdrawal with the loss of interest in other people or activities
  • Unwilling to try new things
  • Increased feelings of anxiety, irritability, or depression
  • Trouble remembering names when meeting new people
  • Increased trouble planning or organizing


Stage 5
Mid-stage dementia is comprised of two stages. Stage 5, moderately severe cognitive decline and stage 6, severe cognitive decline, or middle dementia.

Stage 5 lasts an average of 4 years, a person in mid-stage dementia now needs assistance to complete activities of daily living like dressing and washing. In this stage, signs and symptoms of dementia will be very easy to identify. Short-term memory will be mostly lost and confusion and forgetfulness will be more pronounced throughout activities of daily living.


Stage 6
In stage 6 of dementia, there is severe cognitive decline. A person may start forgetting the names of close loved ones and have little memory of recent events. Communication is severely disabled and delusions, compulsions, anxiety, and agitation may occur.


  • Problems sleeping and confusing day and night with some changes in sleep patterns
  • Difficult behaviour in social settings
  • Wandering or becoming lost
  • Difficulty with recognising loved ones.
  • Delusions and/or hallucinations
  • Increased aggression and irritability
  • Inability to recall personal history, address, and phone number


Stage 7
In Stage 7 there is very severe cognitive decline lasting an average of 2.5 years. A person in this stage usually has no ability to speak or communicate and requires assistance with most activities, including walking. During this stage, carers will focus mostly on providing comfort and quality of life. Care options may become too difficult at home.


  • Difficulty eating and swallowing
  • Considerable changes in weight (both loss and gain)
  • Incontinence
  • Gradual loss of speech
  • Restlessness
  • Angry outbursts due to confusion
  • Increasingly vulnerable to infections, especially pneumonia

The progression of dementia in your loved one is as individual as the person who has it. There is no specific roadmap or timeline to transition through the seven stages. But all types of dementia are progressive and damaging over time. While the exact symptoms displayed in each stage can differ from person to person, this is only here as a guide to help families to know what to expect and when to expect it.


At TrustonTap we realise how difficult changes to your loved one can be. Whatever support you need, we’re here to help. Give us a call on 0808 278 1112

Dementia Support

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What is Dementia and what are the different types?

Dementia is caused by diseases which lead to the loss or death of nerve cells in the brain. The most common causes are Alzheimer’s disease, Vascular Dementia and Dementia with Lewy Bodies.

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