Memory Care

The Stages of Dementia: Early, Middle & Late Symptoms

Dementia — which refers to any condition that causes a general decline in memory, language, and problem-solving — typically follows three stages: early, middle and late. 

During these stages of dementia, adults will gradually start to lose cognitive function, including memory, thinking, problem-solving, language and perception. The exact timing of progression and related symptoms vary according to the individual, as well as the type of dementia. 

To help you detect if your loved one is showing signs of dementia, let’s take a deep-dive into the progression, symptoms, and care expectations at every stage.

Jump Ahead

Early-Stage Dementia

Early in dementia, adults may still be able to function independently. Damage to neurons and communication pathways has just begun, causing individuals to experience mild memory lapses. 

Early-stage dementia lasts an average of two years and individuals may continue to lead relatively normal lives during this time.

Symptoms of early-stage dementia

  • Mild memory lapses, such as forgetting a familiar word or having difficulty following a conversation
  • Trouble remembering new names
  • Losing items or getting lost with some frequency
  • Difficulty retaining what was just read
  • Difficulty expressing thoughts
  • Often repeating questions
  • Trouble planning or organizing, especially with complex tasks
  • May become more withdrawn or experience other mood changes
  • May experience lapses in judgment
  • May blame others for “stealing” misplaced items
  • Visual-perceptual difficulties, such as judging staircase distance

Care needs for early-stage dementia 

In early stage dementia, individuals typically can function independently with little assistance. In fact, most can live independently or with some help of family caregivers. This is the time where families should begin to:

  • Discuss future care priorities with your loved one (such as advanced health directives, finances, etc.).
  • Create coping strategies so loved ones can stay independent, such as setting up reminders, making daily to-do lists, utilizing technology and putting together a family scrapbook.
  • Consider safety features at home, such as a monitoring device.

Middle-Stage Dementia

In the middle stage of dementia, symptoms become progressively worse. Damage to neurons may now be affecting the cerebral cortex, which is responsible for language, logic and behavior. 

Middle-stage dementia lasts an average of four years and the majority of diagnosed adults will require assistance with daily tasks at some level.

Symptoms of middle-stage dementia 

  • Experience general confusion and/or poor judgment
  • Unable to remember personal information
  • Disoriented about where they are and what time/day it is
  • Confuse family members’ names
  • Forget what they’re saying mid-sentence
  • Loss of more long-term memory
  • Experience changes in personality, including moodiness, agitation, aggression and suspicion and compulsive behaviors
  • May experience shifts in sleep patterns, such as restlessness at night
  • May experience incontinence
  • May wander and become lost
  • May lose inhibitions and say/do socially inappropriate things
  • May experience depression and anxiety

Care needs for middle-stage dementia 

In middle-stage dementia, individuals will require assistance with a variety of tasks. Most individuals with middle-stage dementia can’t live alone and may require 24/7 help. 

Depending on the severity of this stage, families may need to be more hands-on with this assistance and consider senior living communities such as assisted living or memory care. 

Some key care tasks that families should plan for include:

  • Provide assistance with self-care tasks, such as bathing, dressing, eating, toileting, etc.
  • Ensure that their loved one’s living arrangements are safe (whether at home or in a community) through adaptations such as grab bars, remote front door lock, night lights, an emergency response system, etc.
  • Consider quality of life factors, such as establishing a routine, planning social interaction and providing entertainment that enriches the daily experience.
  • Communicate slowly and clearly, so that a loved one may better understand. 
  • Discuss the potential of assisted living or memory care if it’s unsafe to leave a loved one alone, or the current arrangements lack opportunities for cognitive stimulation. 

In addition, adults with greater cognitive decline would benefit from highly specialized care from trained dementia professionals in memory care communities. Either type of community may be right, as the choice between assisted living and memory care will depend on your loved one’s level of care and care goals.

Late-Stage Dementia

During late-stage dementia, whole networks of neurons are breaking down, causing brain regions to shrink and symptoms to become severe. 

This impacts individuals’ ability to interact with their environment and even control movement. It’s common for communication to be negligible, perception to be altered and significant changes in personality to occur. 

Late-stage dementia lasts an average of two years and individuals require extensive care at a memory care community as their symptoms progress.

Symptoms of late-stage dementia 

  • Extensive care needs, including 24/7 total assistance with personal care
  • Loss of awareness of surroundings and recent experiences
  • Loss of physical abilities, including walking, sitting, holding up head and swallowing 
  • Unable to recognize family members or themselves in a mirror
  • Difficulty communicating, but may say some words or use non-verbal gestures
  • May experience significant behavioral changes, such as agitation, aggression, paranoia and hallucinations
  • May experience significant depression and apathy
  • May experience “time shifting” where they think they’re at an earlier period of life
  • May experience bladder and bowel incontinence
  • May experience loss of appetite and weight loss 
  • Vulnerable to falls and infections, especially pneumonia

Care needs for late-stage dementia 

In late stage dementia, individuals have extensive round-the-clock care needs and depend completely on caregivers. 

Full-time personal care at this point is very hands-on and includes tasks such as basic mobility and feeding. Often families are unable to provide 24/7 supervised care and choose a memory care community for their loved one.

A memory care community for late stages of dementia offers specialized care within a comfortable and safe setting. Not only do communities like Varenita offer assistance with daily tasks and other key amenities, but also memory-enhancing programming that maximizes abilities and sparks moments of joy. Learn more about how Varenita West Cobb’s memory care residents live full lives here.

How Fast Do the Stages of Dementia Progress?

The progression of dementia varies widely depending on the individual. On average, adults with dementia live for 4-8 years, though some will reach up to 20 years. 

Some factors that may influence the speed of progression include:

  • The type of dementia
  • Other serious health problems
  • Individual’s age
  • Individual’s care plan, including medications
  • Individual’s support network

How Long Does Each Dementia Stage Last?

Early StageAverage 2 years
Middle StageAverage 4 years
Late StageAverage 2 years

There’s no set timeline for the progression of dementia, though on average the early and late stages last two years and the middle stage four years. That said, the rate of decline depends greatly on the individual and the factors mentioned above. 

What Are Signs That Dementia is Progressing?

Dementia is a progressive condition, which means that symptoms advance over time. Key signs that dementia is progressing quickly include:

  • Sudden onset of new symptoms 
  • Limited speech to a few words
  • Experiencing frequent falls or infections
  • Losing weight due to problems eating and drinking
  • Becoming less mobile and bed-bound
  • Experiencing bladder and bowel incontinence 

Of course, exact signs are unique to every individual. You should get in touch with your loved one’s doctor and their caregivers if you believe their dementia symptoms are worsening. 

Next Steps: Detect the Signs of Dementia and Get Help

Now that you better understand the stages of dementia, you can detect potential signs and get help for your loved one. If your parent isn’t yet diagnosed, you should contact their primary physician as soon as possible. 

Depending on your loved one’s care needs, you should also reach out to senior living communities like Varenita about the benefits of memory care. At Varenita, we provide compassionate-driven care in a vibrant community that aims to elevate every adult’s whole-person wellness. Get in touch to learn more about our West Cobb assisted living, assisted living plus and memory care programs on our online form today.