Stages of dementia

The most common type of dementia is called Progressive Dementia, which means the dementia gets worse over time. Patients coping with dementia have their progression evaluated using the five stages of progressive dementia outline in the The Clinical Dementia Rating (CDR).

This system allows professionals to monitor the patient’s cognition and functioning across six key areas. These areas include memory, orientation, personal care, judgement, community and home and hobbies.

Stage 1: CDR-0 or No Impairment

Stage one of the CDR signifies no diminishing in a person’s capabilities. An individual who gets a score of 0 will likely have no significant issues with their memory and will retain a full comprehension of time and place. They will remain able to function day to day in the world, have normal judgment and will be capable of taking care of their personal needs and have a well maintained home life.

Stage 2: CDR-0.5 or Questionable Impairment

A score of 0.5 on the CDR scale signifies very minor impairments. An individual who gets a score 0.5 may have slight inconsistencies with their memory. They may have difficulty in solving challenging problems and have some issue with timing. In addition they may be slipping at work or when involved in social activities. They can however still maintain their own personal care without any support.

Stage 3: CDR-1 or Mild Impairment

An individual with a score of 1 will show noticeable impairment in each of the six key areas. Changes are still mild but issues with short-term memory will be noticeable and may impact some aspects of their day. Individuals will start to become disorientated and may experience difficulty with directions or getting from one place to another. There may be some impact on their ability to care for themselves at home with chores and personal hygiene becoming neglected. Outside the home they may experience trouble functioning independently.

Stage 4: CDR-2 or Moderate Impairment

An individual with a score of 2 means they are moderately impaired. At this stage they will need assistance with day to day activities and personal hygiene. Short term memory will be severely impaired with particular difficulty in remembering recent events and people they just met. There are more obvious signs of disorientation with individuals getting lost easily and a difficulty in comprehending time and space. They remain well enough to take part in social activities but will now need to be accompanied.

Stage 5: CDR-3 or Severe Impairment

Stage five of the CDR scale signifies the most severe stage of dementia. An individual who gets a score of 3 will no longer be able to function without support. Their memory will be severely impaired with signs of extreme memory loss. In addition, they will have very little or no understanding of time, place or geography. Full time help is required in the home to assist with personal care and they will no longer be able to engage in every day and social activities even with assistance.