Dementia is a chronic, progressive condition. It comes on slowly and gradually gets worse over time. It is not possible to reverse dementia, but it may be delayed, slowed and managed with the proper care and treatment.
There are seven dementia stages. Knowing what to expect at each stage can help you plan for your loved one’s care and feel more empowered as their caregiver.
Stage 1: Normal behavior, no dementia
The first stage of dementia doesn’t cause any noticeable symptoms. During this stage, changes are starting to take place in the brain, such as the buildup of harmful plaques and severed connections between neurons.1
Stage 1 dementia can often last for years without symptoms before progressing to stage 2.
How caregivers can help
In the early stages of dementia, the best thing you can do as a caregiver is be aware of the disease and find out whether your loved one has any risk factors. Dementia is not a regular part of aging, and certain factors may increase the risk of the disease.
Known risk factors for dementia include2, 3:
- Lack of exercise
- Uncontrolled diabetes
- High blood pressure
- Hearing loss
- Smoking
- Alcohol use
- Family history of dementia
Now is a great time to meet with your loved one’s provider to discuss prevention, care and treatment options for dementia.
Stage 2: Mild changes, no dementia
The second stage of dementia has symptoms that are highly similar to those associated with the normal aging process. For instance, your loved one may become forgetful more frequently and make small mistakes, such as forgetting to pay a bill. Mild confusion, slowed thinking and difficulty with finding the right words are other common symptoms of stage 2 dementia.
How caregivers can help
During stage 2, keep an eye out for new symptoms of dementia and monitor current symptoms. Ask your provider about brain scans, cognitive tests and other diagnostic tests that can be used as helpful baselines when the disease starts to progress.3
Stage 3: Mild, more noticeable changes
The third stage of dementia is similar to stage 2, but with more noticeable lapses in memory, thinking and reasoning. Your loved one may feel as though something isn’t quite right with their brain health and have concerns about dementia. This is also the stage when dementia becomes more noticeable to friends and family.
Signs of stage 3 dementia include:
- Forgetfulness
- Emerging problems at work
- Increased difficulty with focus and paying attention
How caregivers can help
Stage 3 dementia is a good time to help your loved one adjust to living with their condition. Some ways to help include:
- Helping your loved one understand dementia
- Scheduling doctors’ appointments for your loved one
- Driving your loved one to appointments
- Making sure bills are paid on time
- Organizing and managing medications
- Reducing clutter in the home to help with memory and focus
- Encouraging activities that stimulate the brain, such as crossword puzzles and reading4
- Forgetting familiar names and words
- Increased difficulty with managing finances and paying bills
- Decreased problem-solving abilities
- Difficulty with everyday tasks, such as cooking and shopping
- Problems with driving a car
- Withdrawing from social activities
- Loss of interest in favorite activities
- Mood swings and irritability
- Encouraging your loved one to see their provider for diagnosis and treatment
- Using labels, signs and other visual aids to help your loved one navigate their home
- Automating specific processes, such as setting up automatic bill pay
- Seeking additional support for your loved one, such as taking them to community centers with activities for seniors with dementia
- Changes in personality
- Increased frequency and severity of mood swings
- Gaps in memory
- Mistaking one person for another
- Difficulty with choosing the proper clothing based on the weather, special events, etc.
- Urinary incontinence
- Answering repeated questions with patience
- Reminding your loved one who you are at times of confusion
- Not asking your loved one if they remember specific memories, which can make them feel overwhelmed or frustrated
- Extreme changes in mood and personality
- Extreme confusion
- Severe anxiety
- Wandering off and getting lost
- Sleep disturbances
- Daytime sleepiness
- Changes in eating habits
- Delusions, such as thinking it is winter when it is summer
- Difficulty speaking and communicating
- Engaging with them consistently to support their memory
- Installing safety features in their home, such as extra locks on doors
- Removing clutter that could lead to falls and accidents
- Locking up dangerous substances such as painkillers and alcohol
- Creating a calm, quiet environment with minimal distractions
- Establishing a daily routine that includes a variety of brain-stimulating activities
- Inability to walk, talk or use the restroom without assistance
- Difficulty eating and swallowing
- Weight loss
- Dehydration
- Increased infections
- Loss of bladder and bowel control
- Constant disorientation
- Preparing soft, nutritious foods that are easy to chew and swallow
- Helping your loved one move around when possible, to reduce the risk of stiffness and bedsores
- Do simple activities together, such as sitting outside or listening to music
- Exercising regularly. The CDC recommends doing at least 150 minutes of moderate-intensity physical activity a week, plus two days of strength-training activities.7
- Eating foods that support brain health. Foods such as leafy greens, fish and nuts are loaded with antioxidants and other nutrients that naturally ward off dementia.8
- Keeping your blood pressure in a normal range. High blood pressure can damage your blood vessels and limit blood supply to the brain.
- Managing diabetes. Chronically high blood sugar levels can also damage the brain and other organs in the body.
- Correcting hearing issues. Any degree of hearing loss can make the brain work harder at remembering things and processing information, which may contribute to dementia.9
- Not smoking. Smoking can damage blood vessels in the brain and expose the brain to harmful chemicals. These factors can contribute to inflammation and the death of brain neurons.
- Drinking in moderation. Alcohol can spike your blood pressure and affect your brain health, increasing your risk for dementia.
- Connecting with friends and family. Engaging with others regularly can stave off loneliness and isolation—both of which are dementia risk factors.10
- 1. National Institutes of Health. (2023, April 5). Alzheimer’s Disease Fact Sheet. https://www.nia.nih.gov/health/alzheimers-and-dementia/alzheimers-disease-fact-sheet
- 2. Centers for Disease Control and Prevention. (2024, August 27). Reducing Risk for Dementia. https://www.cdc.gov/alzheimers-dementia/prevention/index.html
- 3. National Institutes of Health. (2022, December 28). What Is Dementia? Symptoms, Types, and Diagnosis. https://www.nia.nih.gov/health/alzheimers-and-dementia/what-dementia-symptoms-types-and-diagnosis
- 4. Pillai, J.A., Hall, C.B., Dickson, D.W. et al. (2011, November). “Association of Crossword Puzzle Participation with Memory Decline in Persons Who Develop Dementia.” JINS 17 (6). https://doi.org/10.1017/S1355617711001111.
- 5. Yates, L., Csipke, E., Moniz-Cook, E., et al. (2019, September 10). “The Development of the Promoting Independence in Dementia (PRIDE) Intervention to Enhance Independence in Dementia.” Clin Interv Aging. (14): 1615–30. https://pmc.ncbi.nlm.nih.gov/articles/PMC6748161/.
- 6. Bartolone, S.N., Prasun, S., Chancellor, M.B., et al. (2021, December 17). “Urinary Incontinence and Alzheimer’s Disease: Insights from Patients and Preclinical Models.” Front Aging Neurosci. (13): 777819. https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2021.777819/full
- 7. Centers for Disease Control and Prevention. (2023, December 20). Adult Activity: An Overview. https://www.cdc.gov/physical-activity-basics/guidelines/adults.html
- 8. Gómez-Pinilla, F. (2008, July). “Brain Foods: The Effects of Nutrients on Brain Function.” Nat Rev Neurosci. 9 (7): 568–78. https://www.nature.com/articles/nrn2421
- 9. Johns Hopkins. (2021, November 12). Hearing Loss and the Dementia Connection. https://publichealth.jhu.edu/2021/hearing-loss-and-the-dementia-connection
- 10. National Institutes of Health. (2025, January 16). Loneliness linked to dementia risk in large-scale analysis. https://www.nia.nih.gov/news/loneliness-linked-dementia-risk-large-scale-analysis
- 11. Centers for Medicare & Medicaid Services. (n.d.). Guiding an Improved Dementia Experience (GUIDE) Model. https://www.cms.gov/priorities/innovation/innovation-models/guide
Treatment for stage 3 dementia usually involves monitoring the condition closely and seeing the doctor regularly for checkups. Your loved one’s provider may recommend starting medications at this time.
Stage 4: Moderate changes, mild dementia
Symptoms of dementia become more prominent during stage 4, which is when the condition may also be diagnosed in some. Short-term memory becomes more impaired, and your loved one may forget recent events and conversations. New tasks and situations may also seem more overwhelming, such as driving to a new place or learning the rules of a new board game.
Signs of stage 4 dementia may include:
How caregivers can help
During stage 4 dementia, you may feel tempted to take over many of your loved one’s responsibilities to lessen the burden of their condition. However, it’s essential to encourage your loved one’s independence during this time while making sure they stay safe.5
Ways to help during stage 4 include:
Treatment at stage 4 usually involves monitoring and managing the disease, and taking steps to slow its progression. Your loved one’s provider may also prescribe medications that can stabilize or improve cognitive function.
Stage 5: Moderate dementia
Everyday living becomes significantly more difficult with stage 5 dementia, which is also considered mid-level dementia. Your loved one may struggle with doing tasks on their own and need help and support from a caregiver.
During stage 5 dementia, your loved one may still remember most of their past and recognize the faces of close friends and relatives.
Signs of stage 5 dementia include:
How caregivers can help
Patience is key to helping your loved one navigate stage 5 dementia. Mood swings, agitation and depression are normal during this stage. Many times, these emotions come out when your loved one is trying to cope with their condition.
You can support your loved one during stage 5 by doing the following:
Stage 6: Moderately severe dementia
In stage 6 of dementia, your loved one will likely need 24-hour care and live-in assistance for help with daily activities. By this stage, they may not remember many details about their past, and they may not recognize you and other loved ones.
Physical symptoms of dementia also become more prominent during stage 6, such as urinary incontinence and difficulty swallowing.6
Signs of stage 6 dementia may include:
How caregivers can help
Stage 6 may be one of the most difficult dementia stages, especially when caring for a close friend or relative. During this time, it’s crucial to continue collaborating with your loved one’s provider to ensure their health needs are being fully addressed.
As a caregiver, you can support your loved one by:
Stage 7: Severe dementia
During this last stage of dementia, your loved one may no longer remember you or any details about their life. They will require 24-hour care, as they will not be able to function on their own.
Characteristics of stage 7 dementia include:
How caregivers can help
Your loved one’s cognitive functioning may be significantly impaired during late-stage dementia stages; however, they can still feel discomfort, pain and frustration about their situation. Focus on making your loved one feel as comfortable as possible while continuing to nurture your relationship.
Some things that may help:
How to prevent dementia, or slow its onset
It is not possible to completely prevent dementia. However, it is possible to reduce your risk or slow its onset if you or a loved one has been diagnosed with this condition.
Steps you can take to reduce your risk include:
The Centers for Medicare & Medicaid Services predicts there will be 14 million projected cases of dementia by 2060.11 If you spot signs of dementia in your loved one, don’t hesitate to seek help. Treatment plans for dementia can be personalized for your loved one based on their unique health needs and can enhance their quality of life at every stage of the disease.
WellMed can help you navigate dementia
WellMed is dedicated to providing quality health care with a strong focus on prevention. Our healthcare professionals can work with you through the dementia stages to help you support your loved one. Contact WellMed today at (888) 781-WELL or visit our website to find a doctor near you.
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