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
