Dr Reisbergs 7 Stages of Dementia

Written by Active Minds on Thursday the 10th of January 2019.


Dr. Barry Reisberg, clinical director for New York University School of Medicine’s Silberstein Ageing and Dementia Research Centre, has determined seven stages of which someone living with dementia would be likely to go through. Having a clear guide of the progression of your loved ones dementia journey can make each transition easier for you and your family. Not every person living with dementia will follow these stages exactly but recognising the changes in behaviour can make it somewhat easier as they happen.

1. No Impairment

During this stage, dementia is not detectable and there are no signs of memory loss or cognitive impairment.


2. Very Mild Cognitive Decline

This stage is what would be considered normal aged forgetfulness. A lot of over 65s report not being able to recall names and events as well as they previously could. A person in this stage will most likely pass memory tests and changes may be unlikely to be detected by loved ones or doctors.


3. Mild Cognitive Decline

Changes at this stage, all though still subtle, may be more noticeable. Mild cognitive impairment (MCI) affects approximately 5-20% of over 65s, and people with MCI are more likely to develop dementia than those who do not have MCI.

A person with Mild Cognitive Decline may have one or more issues with memory, which differs from normal aged forgetfulness, and experience difficulty with cognitive skills. They may find it harder to remember names, sometimes struggle with problem-solving or become easily distracted.


4. Moderate Cognitive Decline

At this stage it can become more apparent that someone has dementia, and it is quite common that people will be diagnosed at this point. A person living with Moderate Cognitive Decline can have difficulty with simple arithmetic and experience poor short term memory. This can impact on the person’s ability to manage finances, go shopping or cook for themselves.


5. Moderately Severe Cognitive Decline

Day-to-day self-care may become more difficult for people at this stage of dementia. A significant loss of memory may be expected, and assistance completing daily tasks such as cooking and managing finances will be needed. Although cognitive decline will occur, the person may still be able to maintain functionality and some independence, such as when using the bathroom.


6. Severe Cognitive Decline

Some level of care will be required for someone living with Severe Cognitive Decline. A person at this stage of dementia will experience confusion and increased unawareness of surroundings, plus the inability to remember some names and faces. Major personality changes can also occur at this time, which can be difficult for loved ones to come to terms with. Care may be needed for activities such as cooking, using the bathroom and dressing at this point.


7. Very Severe Cognitive Decline

At this point in the dementia journey a person will need almost constant care as they may lose normal functionality. It is common at this stage that the person will have difficulty communicating, and may lose the ability to walk and swallow.


Whilst these seven stages of dementia have been set out as a guideline of what to expect, not every person living with dementia will experience every stage. Dementia can progress at different rates and affect people in different ways. It is important to consider the right level of care for your loved one depending on their abilities and where they are in their dementia journey.