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The 7 phases of senile and early dementia

The 7 phases of senile and early dementia

November 25, 2022

The concept "senile dementia" is used to refer to degenerative diseases that affect cognitive functioning, particularly memory, and that occur at advanced ages. Conversely, we speak of early or presenile dementia when symptoms occur earlier than expected, usually at maturity.

In this article we will describe the 7 phases of senile dementia and premature dementia indistinctly, since the development of cognitive deterioration follows the same approximate general lines regardless of the age at which the symptoms begin to manifest.

  • Related article: "Types of dementia: forms of cognition loss"

The 7 phases of dementia

There are a large number of diseases that can cause dementia; Some of the most common and known are Alzheimer's, Lewy and recurrent strokes. Each disorder of this type initially affects different regions of the brain, although symptomatic differences are reduced in advanced stages.


Although the symptoms of dementia depend on the specific alteration of each patient, the overall progress of these diseases has been divided into seven phases depending on the degree of cognitive deterioration that the person presents at a given moment.

1. Absence of cognitive impairment

The first stage of cognitive deterioration corresponds to the absence of it; therefore, most people are in this phase, which can be included along with the next two in the category "pre-dementia", characterized by a normal or almost normal cognitive functioning.

A person is considered to be in phase 1 when does not present significant cognitive symptoms that may be attributable to brain deterioration, as memory losses more relevant than those that occur due to lack of energy or attention, among other common factors.


2. Memory deficits associated with age

Aging, and in particular the arrival of old age, is naturally associated with small memory losses that are manifested mainly in forgetting names or locations of objects. The second phase of cognitive deterioration is characterized by the presence of these deficits in a more or less usual way.

Although in many cases the appearance of occasional forgetfulness is only a consequence of age, in some cases the memory losses may indicate a future severe impairment of cognition , especially if the frequency of these is high and if the person is relatively young so as to have typical forgetfulness of old age.

3. Mild cognitive impairment

The concept of "mild cognitive impairment" is used to describe cases in which there are notable signs of memory impairment and in the performance of daily tasks. In this phase, the cognitive deficits are more marked than would be expected for the age of the person, even taking into account aging.


People with mild cognitive impairment have a greater risk of developing dementia that those that do not present it, although frequently the progress of the deficits stops at this stage. It is usual that those who suffer this type of deterioration have problems to retain information, to remember words, to concentrate or to orient themselves.

  • Related article: "Mild Cognitive Impairment (MCI): concept, causes and symptoms"

4. Mild or early dementia

The fourth phase corresponds to the onset of dementia as such. In this stage, which usually lasts approximately two years, changes in personality and mood begin to appear . Since social skills also deteriorate, the frequency of social interaction is often reduced.

Cognitive problems become much more evident from the onset of dementia. Patients usually 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 intermediate stage of dementia, the affected people begin to need the help of other people to carry out daily tasks . As the disease progresses, capacities such as using money, telephones or kitchen tools, reading and writing, remembering information about oneself and even dressing up deteriorate.

6. Moderately severe dementia

In this phase the problems of memory and cognition have worsened to the point that they interfere in the realization of a large number of activities; it will continue to increase as dementia progresses. The most frequent when reaching this stage is that the person need constant supervision of 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 close people) we find the appearance of feelings of anxiety and agitation, problems sleeping, ambulation, obsessive and repetitive behaviors, delusions or aggressiveness.

7. Severe or advanced dementia

The average duration of the final stage of dementia is approximately two and a half years. Advanced dementia is characterized by Generalized loss of psychomotor skills , including those that are necessary to talk, walk, eat or use the bathroom.

Although the progress of each case of dementia depends on the disease that causes it, they are all very similar during the final period because structural deterioration has spread to all regions of the brain.


Caregiver Training: Refusal to Bathe | UCLA Alzheimer's and Dementia Care (November 2022).


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