Global Deterioration Scale

FACTS

  • The Global Deterioration Scale (GDS) is a tool for health professionals to assess the level of cognitive function in a person with a primary degenerative dementia, such as Alzheimer’s disease.
  • It determines the current level of functioning, which is useful for determining strategies to use to provide a calm, clean, safe, and loving environment.
  • Although useful, it is important to remember that no two people with dementia experience the disease the same way and the stages are used as a guide.

STAGE 1: NO COGNITIVE DECLINE

  • Normal cognitive function with no memory loss

STAGE 2: AGE-APPROPRIATE MEMORY LOSS

  • May start to misplace objects
  • No objective deficits noticed in employment or social situations
  • Symptoms are not evident to loved ones

STAGE 3: MILD COGNITIVE IMPAIRMENT

  • Mild cognitive decline
  • Increased forgetfulness
  • Some difficulty concentrating
  • May have trouble finding the right words
  • May start to get lost when traveling to unfamiliar locations
  • Coworkers may start to notice a change in performance
  • May have some trouble retaining information when reading a book
  • Lack of concentration may be evident upon clinical testing

STAGE 4: MILD DEMENTIA

  • Average stage duration of two years
  • Difficulty concentrating
  • Decreased knowledge and memory of current/recent events
  • Trouble managing finances
  • Difficulty completing tasks
  • May withdraw from family and friends
  • Reduced ability to show emotions with facial expressions
  • Denial about symptoms

STAGE 5: MODERATE COGNITIVE DECLINE

  • Average stage duration of 1.5 years
  • Person can no longer survive without some assistance
  • Major memory deficiencies
  • May forget details of their phone number, address, names of close family members, or schools they attended
  • Frequent disorientation regarding time or place
  • Inability to perform some activities of daily living, such as dressing, but do not need assistance with eating or toileting

STAGE 6: MODERATELY SEVERE COGNITIVE DECLINE

  • Average stage duration of 2.5 years
  • May occasionally forget the name of the spouse or close relatives
  • Forgets major past and recent events
  • May have difficulty speaking
  • Cannot perform any activities of daily living without assistance
  • Bowel/bladder incontinence
  • May experience personality and emotional changes, including delusions, compulsions, and anxiety
  • Sleep disturbances

STAGE 7: SEVERE DEMENTIA

  • Average stage duration of 1.5-2.5 years
  • May occasionally forget the name of the spouse or close relatives
  • The brain appears no longer able to tell the body what to do
  • Cannot speak or communicate
  • Requires help with most activities
  • Needs assistance with feeding
  • Loss of motor skills
  • Cannot walk
  • Generalized rigidity