The concept of “senile dementia” is used to refer to degenerative diseases that affect cognitive functioning, in particular memory, and which occur in old age. In contrast, we speak of precocious or presenile dementia when the symptoms appear earlier than expected, usually at maturity.
In this article we will describe the 7 phases of senile and precocious dementia indiscriminately, as the development of cognitive impairment follows the same rough general lines regardless of the age at which symptoms begin to appear.
The 7 phases of dementia
There are a large number of diseases that can cause dementia; some of the most common and well-known are Alzheimer’s disease, Lewy’s disease, and recurrent stroke. Each such disorder initially affects different regions of the brain, although the symptomatic differences are reduced in later stages.
Although the symptoms of dementia depend on the specific condition of each patient, the overall progress that these diseases follow has been divided into seven phases according to the degree of cognitive impairment that the person presents at any given time.
1. Lack of cognitive impairment
The first stage of cognitive impairment is its absence; therefore, most people find themselves in this phase, which can be grouped with the following two into the category of “pre-dementia”, characterized by normal or nearly normal cognitive functioning.
A person is considered to be in phase 1 when he has no significant cognitive symptoms that could be due to a brain impairment, such as memory loss greater than that which occurs due to lack of energy or attention, among other common factors.
2. Age-related memory deficits
Aging, and in particular the onset of old age, is naturally associated with small memory losses which are manifested mainly by forgetting the names or locations of objects. The second phase of cognitive impairment is characterized by the presence of these deficits more or less frequently.
While in many cases the occurrence of occasional forgetfulness is only a consequence of age, sometimes memory loss they may indicate a future serious impairment of cognition, Especially if the frequency of these is high and if the person is relatively young to have a forgetfulness typical of old age.
3. Mild cognitive impairment
The concept of “mild cognitive impairment” is used to describe cases in which visible signs of memory impairment appear and in the performance of daily tasks. At this point, the cognitive deficits are more pronounced than the person’s age would expect, even taking aging into account.
People with mild cognitive impairment they have a higher risk of developing dementia than those who do not, although often the progression of deficits stops at this stage. It is common for people with this type of impairment to have difficulty remembering information, remembering words, concentrating or orienting themselves.
4. Mild or early dementia
The fourth phase corresponds to the onset of dementia as such. At this point, which usually lasts about two years, personality and mood changes start to appear. Since social skills also deteriorate, it is very common for the frequency of social interactions to decline.
Cognitive problems become much more evident as soon as dementia first appears. Patients generally have some awareness of their disease when they reach this stage, although dementia also affects this recognition. They also tend to deny their symptoms as a defense mechanism.
5. Moderate dementia
During the middle stage of dementia, those affected begin to need help from other people with daily chores. As the disease progresses, skills deteriorate such as using money, telephone or cooking utensils, reading and writing, memorizing information about oneself and even dressing.
6. Moderately severe dementia
In this phase, the memory and cognition problems worsened to the point that they interfere with the performance of a large number of activities; this will continue to increase as the dementia progresses. The most common thing at this point is the person need constant supervision from one or more caregivers.
As for the most common symptoms and signs, in addition to the worsening of memory problems (which already include the recognition of loved ones) we find the appearance of feelings of anxiety and restlessness, sleep disturbances, walking, obsessive and repetitive, delusional, or aggressive behaviors.
7. Severe or advanced dementia
The average duration of the final stage of dementia is about two and a half years. Advanced dementia is characterized by generalized loss of psychomotor skills, Including those necessary to talk, walk, eat or use the bathroom.
Although the progression of each case of dementia depends on the disease causing it, they are all very similar during the final period due to the fact that the structural deterioration has spread to all regions of the brain.