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Dementia Overview (cont.)

What is dementia?

Dementia is a decline or loss of reasoning, memory, and other mental abilities (the cognitive functions such as judgment, thinking, behavior, and language) and is not a normal part of aging. This decline is progressive and eventually impairs the ability to carry out everyday activities such as driving; household chores; and even personal care such as bathing, dressing, and feeding (often called activities of daily living).

According to World Health Organization (WHO) statistics, about 47.5 million people worldwide have dementia, with a projected increase to 75.6 million by 2030 with about 7.7 newly diagnosed each year.

Are dementia, senility, and Alzheimer's disease the same things?

  • Dementia occurs most commonly in elderly people; it used to be called senility and/or senile dementia, and was considered a normal part of aging. Affected people were labeled as demented. The term "senile dementia" is infrequently used in the current medical literature and has been replaced by the term "dementia."
  • "Senile dementia," "senility," and "demented" are older outdated terms that incorrectly label people with memory loss, confusion and other symptoms as a normal part of aging.
  • Dementia, as defined above, is a constellation of ongoing symptoms that are not part of normal aging (even though it occurs most often in older individuals) that have a large number of different causes, for example, Alzheimer's disease is the major cause of dementia in individuals (about 60%-70%) but it is only one of many problems that can cause dementia.

What are the 7 stages of dementia?

Global Deterioration Scale for Assessment of Primary Degenerative Dementia (GDS) (also known as the Reisberg Scale)

Global Deterioration Scale for Assessment of Primary Degenerative Dementia (GDS)
Stage Diagnosis Dementia Symptoms and Signs
Stage 1: No cognitive decline No dementia In stage 1, the person functions normally, has no memory loss, and is mentally healthy. People with no dementia would be considered to be in Stage 1.
Stage 2: Very mild cognitive decline No dementia Stage 2 is used to describe normal forgetfulness associated with aging; for example, forgetfulness of names and where familiar objects like keys were left. Symptoms are not evident to loved ones, family or the patient's physician.
Stage 3: Mild cognitive decline no dementia This stage includes increased forgetfulness, slight difficulty concentrating and some decreased work performance. People may get lost more often or have difficulty finding the right words. At this stage, a person's loved ones and family will begin to notice a decline in problem solving and traveling to new places. Note that other researchers may include this stage in either early stage or stage 1 of 3 stages (early, moderate or severe staging systems).
Stage 4: Moderate cognitive decline Early-stage dementia Stage 4 includes difficulty concentrating, decreased memory of recent events, and difficulties managing finances and/or traveling alone to new locations. People have trouble completing complex tasks and may be in denial about their mental abilities. They may also start withdrawing from family or friends because socialization becomes difficult. A physician can detect clear cognitive problems during a patient interview, physical exam and dementia testing.
Stage 6: Moderately severe cognitive decline Mid-stage dementia People in stage 5 have major memory deficiencies and need some assistance to complete their daily activities (for example, dressing, bathing, preparing meals). Memory loss is prominent and may include major relevant ongoing memory problems; for example, people may not remember their address or phone number and may not know the time or day or where they are currently.
Stage 6: Severe cognitive decline (middle dementia) Mid-stage dementia People in stage 6 require extensive assistance to carry out daily activities like dressing themselves. They start to forget names of close family members and have little memory of recent events. Many patients can remember only some details of earlier life. They also have difficulty counting down from 10 and finishing tasks. Incontinence (loss of bladder or bowel control) is a problem in this stage. Ability to speak declines. Personality changes, such as delusions (believing something to be true that is not), compulsions (repeating a simple behavior, such as cleaning), or anxiety and agitation may occur.
Stage 7: Very severe cognitive decline Late-stage dementia People in this stage have essentially no ability to speak or communicate. They require assistance with most common daily activities (e.g., using the toilet, eating). They often lose psychomotor skills, for example, the ability to walk or to sit in a chair.
Medically Reviewed by a Doctor on 6/20/2016

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Read What Your Physician is Reading on Medscape

Delirium, Dementia, and Amnesia »

Delirium, dementia, amnesia, and certain other alterations in cognition are subsumed under more general terms such as mental status change (MSC), acute confusional state (ACS), or organic brain syndrome (OBS).

Read More on Medscape Reference »


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