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