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Poll: stages of dementia 2009

What stage of Alzheimer's/dementia?

  • I don't want to think about this

    Votes: 2 2.8%
  • Stage 1

    Votes: 3 4.2%
  • Stage 2

    Votes: 1 1.4%
  • Stage 3

    Votes: 6 8.5%
  • Stage 4

    Votes: 9 12.7%
  • Stage 5

    Votes: 13 18.3%
  • Stage 6

    Votes: 23 32.4%
  • Stage 7

    Votes: 14 19.7%

  • Total voters
    71
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Brucie

Registered User
Jan 31, 2004
12,413
0
near London
I know this thread may be a sensitive one, but there are always posts about the stages of Alzheimer's.

The best definition I have seen of the seven stage theory as suggested by Dr Reisberg is on http://www.agelessdesign.com/Library...foType=Article

[this site tends to move the article about so I have attached an Adobe PDF version that will remain stable here]

stages plot.jpg

There are different ways that people try to categorise the stages and in truth none is wholly correct or wholly incorrect, because I think each tries to interpret a continuum.

Elsewhere on the forum is a great 5 stage model related to the MMSE [Mini Mental State Examination] scores http://www.alzheimers.org.uk/talkingpoint/discuss/showthread.php?t=9960

The results of the previous poll we had on this topic were:

View attachment Reisberg Stages of dementia.pdf
 
Last edited:

llamedos

Registered User
Apr 16, 2009
124
0
Where can i find the stages of az to answer these questions?

PLEASE enlighten me - I am not aware of how to decide what stage of az my wife is at - help would be appreciated.
 

Grannie G

Volunteer Moderator
Apr 3, 2006
74,625
0
Kent
Here are the Three Stages llamedos. They are not Gospel, just a guide.

THE THREE STAGE THEORY

Early Stages - Something Is Wrong
The early stages of AD might be described by saying that Alzheimer's is clearly present, but remains in
the background, not truly affecting or hindering everyday life. Symptoms may include forgetfulness,
misplacing items, or even occasional episodes of getting lost or failing to recognize people or places.
Though relatively minor in its impact on life, the disease is there, enough to convince the person, family
and friends that something is wrong.
Summing it up, the disease is in the background, but present, nonetheless.

The Middle Stages - The Battle
The middle stages of AD is best described as when the disease has now progressed to a point where
the patient is clearly battling it. They are aware that they are having problems and doing everything that
they can to survive. Life is a constant battle involving frustration, mishaps, and episodes of upset. The
question one may now be asking is who is winning - the person with AD or the disease?

The End Stages - the Disease Has Won
The end or late stages of AD are those periods when, during the course of the disease, it becomes
apparent that the disease has won and the patient can do nothing else but give in or succumb to the
overwhelming damage that has occurred in their brain. Now the person is in the background and the
disease is in the foreground.
 

jenniferpa

Registered User
Jun 27, 2006
39,446
0
And this is the 7 stage theory

THE SEVEN STAGE THEORY OF ALZHEIMER'S DISEASE

In 1982 Dr. Barry Reisberg published what was to become the best and most widely accepted
description of the stages of Alzheimer's disease. Even today, nine years later, when experts refer to a person being in stage 5 or stage 6, they are referring to Dr. Reisberg's scale of seven stages.
Stage 1
No cognitive decline. No subjective complaints of memory deficit. No memory deficit evident on clinical interviews.
Stage 2
Very mild cognitive decline (forgetfulness). Subjective complaints of memory deficit, most frequently in the following area:
1. forgetting where one has placed familiar objects;
2. forgetting names one formerly knew well.
No objective evidence of memory deficit on clinical interview. No objective deficits in employment or social situations. Appropriate concern regarding symptoms.
Stage 3
Mild cognitive decline (early confusional). Earliest clear-cut deficits. Manifestations in more than one of the following areas:
1. patient may have gotten lost when traveling to an unfamiliar location;
2. co-workers become aware of patient's relatively low performance;
3. word and name finding deficit becomes evident to intimates;
4. patient may read a passage of a book and retain relatively little material;
5. patient may demonstrate decreased facility in remembering names upon introduction to new
people;
6. patient may have lost or misplaced an object of value;
7. concentration deficit may be evident on clinical testing.
Objective evidence of memory deficit obtained only with an intensive interview. Denial begins to become manifest in patient. Mild to moderate anxiety accompanies symptoms.
Stage 4
Moderate cognitive decline (Late Confusional). Clear-cut deficit on careful clinical interview. Deficit manifest in following areas:
1. decreased knowledge of current and recent events;
2. may exhibit some deficit in memory of one's personal history;
3. concentration deficit elicited on serial subtractions;
4. decreased ability to travel, handle finances, etc.
Frequently no deficit in the following areas:
1. orientation to time and person;
2. recognition of familiar persons and faces;
3. ability to travel to familiar locations.
Inability to perform complex tasks. Denial is dominant defense mechanism. Flattening of affect and withdrawal from challenging situations occur.
Stage 5
Moderately severe cognitive decline (Early Dementia). Patient can no longer survive without some assistance. Patient is unable during interview to recall a major relevant aspect of their current lives, e.g., an address or telephone number of many years, the names of close family members (such as grandchildren), the name of the high school or college from which they graduated. Frequently some disorientation to time (date, day of week, season,etc.) or to place. An educated person may have difficulty counting back from 40 by 4s or from 20 by 2s. Persons at this stage retain knowledge of many major facts regarding themselves and others. They invariably know their own names and generally know their spouse's and children's names. They require no assistance with toileting and eating, but may have some difficulty choosing the proper clothing to wear.
Stage 6
Severe cognitive decline (Middle Dementia). May occasionally forget the name of the spouse upon whom they are entirely dependent for survival. Will be largely unaware of all recent events and experiences in their lives. Retain some knowledge of their past lives but this is very sketchy. Generally unaware of their surroundings, the year, the season, etc. May have difficulty counting from 10, both backward and sometimes forward. Will require some assistance with activities of daily living, e.g., may become incontinent, will require travel assistance but occasionally will display ability to familiar locations. Diurnal rhythm frequently disturbed. Almost always recall their own name. Frequently continue to be able to distinguish familiar from unfamiliar persons in their environment. Personality and emotional changes occur. These are quite variable and include:
1. delusional behavior, e.g., patients may accuse their spouse of being an impostor, may talk to
imaginary figures in the environment, or to their own reflection in the mirror;
2. obsessive symptoms, e.g., person may continually repeat simple cleaning activities;
3. anxiety agitation, and even previously nonexistent violent behavior may occur;
4. cognitive abulia, i.e., loss of willpower because an individual cannot carry a thought long
enough to determine a purposeful course of action.
Stage 7
Very severe cognitive decline (Late Dementia). All verbal abilities are lost. Frequently there is no speech at all - only grunting. Incontinent of urine, requires assistance toileting and feeding. Lose basic
psychomotor skills, e.g., ability to walk, sitting and head control. The brain appears to no longer be able to tell the body what to do. Generalized and cortical neurologic signs and symptoms are frequently present.
 

Brucie

Registered User
Jan 31, 2004
12,413
0
near London
You will find details of the 5 stage theory [yes, another variant!] in http://forum.alzheimers.org.uk/showthread.php?t=17497

You will need to get the document from the Australian web site. The interesting thing is that it equates the MMSE with the stages as they define them.

This is the one I use.

In reality, the stages are simply an attempt to quantify the effects of dementia. None are wholly correct, none wholly wrong. Just select the one that seems most appropriate for you.

That's all that matters. :)
 

jenniferpa

Registered User
Jun 27, 2006
39,446
0
I think the other thing to remember, particularly with the 7 stage theory, is that it really only relates to "pure" Alzheimer's. If there is a vascular component (as there so often is) then the stages can be way off.
 

Linda Mc

Registered User
Jul 3, 2005
1,881
0
Nr Mold
When I last voted July 2005 Vic was between 3/4 and today I have voted stage 6. So 4 years to progress this far.
 

sunray

Registered User
Sep 21, 2008
1,477
0
East Coast of Australia
what stage?

My husband Ray aged 67 (diagnosed 2005) is between 5 and 6. He relies on me for most things, doesn't make decisions, has frequent incontinence, can't initiate conversation but can still talk, cannot remember names, faces but still some distant memories.

My mum aged 91 is in stage seven and has been for a couple of years. She can walk, though has to be stood up to do so, has the mumbly sounds, doesn't recognise anyone, has to be shown how or got started to eat, but still likes her food. Not much quality of life at this stage.

I feel sad that the two people I love most in the world have dementia.:(

Sue.
 

Grannie G

Volunteer Moderator
Apr 3, 2006
74,625
0
Kent
In 2006, one year after diagnosis, Dhiren was at Stage 4 with signs of Stage 5. Now he too is at Stage 6.
 
Last edited:

lesmisralbles

Account Closed
Nov 23, 2007
5,543
0
I do not know what stage Ron is at, nor do I care

It will make no difference to us.
Why put a label on it.
He has dementia.

Will the calvalry come if he is at stage 5/6 NO

Ron does not attend the memory clinic.
Waste of time.
For us, I must stress. For others it is helpful.

Barb XX
 

Brucie

Registered User
Jan 31, 2004
12,413
0
near London
it will make no difference to us.

On the one hand it may be said that knowledge is of no use if it cannot be used to help matters in some practical way. When we were in the early stages, the knowledge of the length of time involved, and behaviours and symptoms and horrors to come might well have scared me witless.

For many people, identifying the present stage helps to gain some feeling as to how the things we see relate to the condition as a whole. This may well be of more use when the dementia is more advanced.
 

weeze

Registered User
Oct 4, 2006
121
0
nottingham
Mum is now at stage 6 and i think when I did the earlier poll about 2 years ago she was at stage 4. Before that she had been very stable for several years, now it appears to be a stage a year. thankfully mum has showed no signs of deterioration for about 6 months.
 

tre

Registered User
Sep 23, 2008
1,353
0
Herts
Wish I had seen this before

Found this thread a few days ago when I clicked on wrong bit in error. Then Saturday talking to my dad he was saying how he felt he had not done enough for mum who died Feb 05/2011 with Vascular Dementia. I printed out and showed him the stages and he said "why do the DRs not tell you this so you know ". I agree with him. He was irritated with mum when he was her carer about stuff we now know was a normal progression of the disease. We both agree for us to know what to expect would have helped. I told him all I could think was that once you have a child you know it hurts like nothing else and you do not have control, regardless what breathing or other techniques you employ, but no-one tells first time mothers this. At least in childbirth you have the baby at the end so the gain outweighs the pain but in dementia maybe the conspiracy of silence is because things only get worse, but I stll think it helps to know what to expect and to have an idea how close to the end your loved one might be. Both dad and I thought mum had years, we had no idea she was at end stage.
Tre
 
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