3 Stages of Dementia: What to Expect

stages of dementia

Ease uncertainty by understanding the stages of dementia

One of the biggest challenges with Alzheimer’s and dementia is the uncertainty – not knowing what’s going to happen next with your older adult.

Experts say that changes in the brain start years before a person shows noticeable symptoms. When symptoms begin to affect everyday life and your older adult gets a proper diagnosis, 3 stages can be used as guidelines to help you plan for the future.

We explain the 3 stages of dementia, common symptoms in each stage, and why your older adult’s symptoms don’t always fit into these stages.



The 3 stages of dementia

In general, these stages apply to all forms of dementia, including Alzheimer’s. However, it’s essential to remember that someone with dementia may not always fit in a specific stage or go through every stage. The stages do have some overlap and the progression of dementia is different in each person.

Mild dementia
In the early stage, a person with dementia might still be able to live independently. They might still be able to drive, work, and socialize.

However, they will probably be having memory lapses, like forgetting familiar words or the location of everyday objects. Other people may start to notice that the person is having difficulty or that something “seems off.”

In a thorough medical exam, doctors might be able to detect problems in memory or concentration.

Symptoms may include:

  • Struggling to find the right word or name
  • Finding it difficult to do everyday tasks in social or work settings
  • Forgetting something that they just read
  • Frequently losing or misplacing things
  • Increasing trouble with planning or organizing
  • Making decisions with uncharacteristically poor judgement

Moderate dementia
The middle stage of dementia is usually the longest and can last for many years. As the disease progresses, the person will need an increasing level of care.

In this stage, you might notice that they get words mixed up, are often frustrated or angry, or act in unexpected ways, like refusing to bathe. Damage in the brain can make it difficult to express themselves and do everyday things.

Symptoms may include:

  • Forgetting things that happened recently or major events in their life
  • Being moody or withdrawn, especially in social situations or when something requires too much thought
  • Not being able remember significant things like their address, telephone number, high school, etc.
  • Getting confused about where they are or what day it is
  • Needing help choosing appropriate clothes for the season or occasion
  • For some, trouble with incontinence
  • Changing sleep patterns, like sleeping during the day and being restless at night
  • An increased risk of wandering and getting lost
  • Personality and behavior changes, including paranoia, delusions, and compulsive, repetitive behavior like hand-wringing

Late-stage dementia
In the final stage of dementia, people progressively lose the ability to engage in the world, to hold conversations, and to control their muscles.

They may still be able to talk, but communicating and expressing thoughts becomes difficult – even for something basic like pain. Their memory and cognitive skills continue to get worse and you might see significant personality changes or the fading of personality altogether.

At this stage, people with dementia typically:

  • Need 24/7 help with daily activities and personal care
  • Have increasing difficulty communicating
  • Lose awareness of recent experiences and their surroundings
  • Gradually and progressively lose physical abilities, including the ability to walk, sit, and swallow
  • Become more likely to develop infections, especially pneumonia


A person with dementia doesn’t always fit into one stage

Dementia affects each person differently and changes different parts of the brain at different times. Researchers and doctors still don’t know enough about how these diseases work to predict exactly what will happen.

Someone in the middle stages of dementia could suddenly have a great moment, hour, or day and seem like they’re back to their pre-dementia abilities. They could be sharp for a little while and later, go back to having obvious cognitive impairment.

When this happens, some caregivers may feel like their older adult is faking their symptoms or not trying hard enough. It’s important to know that this isn’t true, it’s truly the dementia that’s causing their declining abilities as well as those strange moments of clarity. They’re not doing it on purpose.


Knowing the stages of dementia helps you plan

Even if the stages aren’t exact and symptoms can be unpredictable, being able to plan ahead is essential.

The truth is that Alzheimer’s and dementia care is expensive and time-consuming. Being financially prepared for increasing care needs is a necessity.

On an emotional level, knowing what type of symptoms to expect helps you find ways to cope with challenging behaviors. It also gives you a chance to mentally prepare yourself for the inevitable changes in your older adult.


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By DailyCaring Editorial Team
Image: Bowman Dental


  • Reply August 1, 2019


    A very different Alzeheimers scenario where they were telling people his $100k cash, alleging he wins $10,00 to $20,000 from the lottery every year for over 20 year money from the lottery was stolen, however there was no lottery winnings. Because he was old they believed him we were unlawfully arrested. Fighting this dumb case in court, how can you be arrested for something that NEVER existed so a theft never happened
    Upset and said , never helping anyone again.

    • Reply August 3, 2019


      So sorry this happened 🙁 Hopefully the authorities will soon realize that he has Alzheimer’s.

  • Reply February 21, 2019


    My grandmother is 81 yrs old and is in the last stage of dimensia.. she’s has been battling this since 2014 and just gradually progressed and got worse. She does walk anymore she’s in bed all the time now and recently she’s been refusing to eat and is losing lots of weight and I can’t understand anything she says anymore. It’s soo heart breaking because that’s my mom she raised me. It’s hard to look at her and see all the memories and love we have and for her not to know me or anything that Wad there. From my age 23 to now 28 this is by far the hardest thing I’ve ever had to deal with especially when her kids are not there and I’m doing this on my own! I feel like I’m stuck in a room and can’t get out! I just want her with me and for her to tell me she loves me and it will be okay. I don’t know what to do

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