What are the Stages of Dementia?

Written by Active Minds on Tuesday the 19th of July 2016.


Dementia can affect each person in a different way and someone’s experience of living with the condition can be prepared for, but not predicted. Dementia is a largely progressive disease and it tends to be viewed in terms of early, middle and late stages. It can be useful to research the stages and be mindful of what they can entail, but because of the different ways dementia affects each person, focusing on the present needs of someone living with a condition is recommended. It is also important to note that there are different types of dementia, which can affect when symptoms arise, the overlapping of stages and which symptoms are experienced.

Alzheimer’s, vascular dementia and frontotemporal dementia are some of the most common forms of dementia and they are all progressive, which we will cover in detail. Progressive symptoms affect the structure of the brain over time and mean more support will be required for someone as it progresses.

Early Stages

Alzheimer’s Disease – This type of dementia is often confused as stress, tiredness or the normal ageing process in its early stages. Alzheimer’s usually manifests itself as loss of memory and this is one of the most common early signs that someone can be living with it. Mislaying items around the house, forgetting conversations, losing track of time and becoming confused, indecisiveness and a loss of interest in activities are other symptoms that can arise in the early stages of Alzheimer’s. These symptoms can cause distress and frustration, so by providing emotional support, you can help someone to remain independent and positive.

Vascular Dementia – Vascular dementia shares many of its early symptoms with Alzheimer’s, but the frequency and intensity of symptoms can be different. Memory issues are also not as prominent early on, but rather making decisions, following instructions, concentration and speed of thought can be affected. The impact of these symptoms can cause frustration, as well as apathy, so changes in mood are common and being able to provide support is important. Breaking down tasks into manageable steps is also recommended.

Frontotemporal Dementia – Frontotemporal areas of the brain are responsible for regulating our behaviour, language and emotions. When these areas begin to change then someone living with dementia’s communication and behavioural skills can be affected. They may express themselves in ways that are not familiar and behave in selfish or emotionally unavailable ways. People living with this type of dementia can also get easily distracted or begin new routines, such as repeatedly tapping. Frontotemporal dementia has three forms; one type affects behaviour first and two types can affect speech and communication.

Middle Stages

Alzheimer ’s disease – As this type of dementia progresses, more support will be needed for someone living with the condition. General every day tasks such as eating, hygiene and going to the toilet can become difficult. Confusion is common, as people can start to forget names, places and become disorientated. It is understandable that people can become frustrated and upset when this happens to them, so being there to reassure and comfort someone is important. Wandering off, being socially inappropriate and hallucinating are all symptoms that are possible in the middle stages of Alzheimer’s.

Vascular Dementia – The middle stages of vascular dementia are very similar to Alzheimer’s. Whereas in the early stages of vascular dementia, memory loss is not a common symptom, memory problems start to arise as the disease progresses. Being able to communicate well and use reason to make decisions becomes more difficult. People living with vascular dementia may become disorientated and confused about their surroundings.

Frontotemporal Dementia – In the early stages, people with frontotemporal dementia can find themselves with either predominantly language based problems or behavioural based issues. As dementia progresses, the differences between the types of disease are less pronounced and both language and behavioural issues are experienced. Agitation and aggressive behaviour tends to develop at an earlier rate than other types of dementia, so being prepared for this is important.

Later Stages

For all types of dementia, the later stages share similarities. Someone living with dementia will become dependent on others to provide them with quality care and support. Their memory will be severely inhibited, but there can be moments of clarity and recognition and being soothing and affectionate can help to comfort someone. In the later stages, a person’s physical condition can deteriorate, so they may have trouble walking, mobility issues and need to use a wheelchair. Eating and swallowing can become difficult and can lead to weight loss. Communication skills and speech often decrease over time. People living with dementia can become restless and agitated, as they can become confused, frustrated and not understand what is happening to them. Finding ways to calm someone is important and also reviewing medication to ensure they are not in pain.

The most important message to take away is that dementia can affect people in a variety of different ways, at different times and not necessarily in the order that you may have prepared yourself for. It is good to have an awareness of potential issues, but aim to respond to issues when they arise and find ways to make someone living with dementia comfortable.