Alzheimer

Dementia Stages and Inconsistencies | Truthful Loving Kindness

Tru here.

 

. i am often asked about this so …

3 stages: i like the version shared at >> https://www.alz.org/alzheimers-dementia/stages .

5 stages/CDR:  Clinical Dementia Rating evaluates cognitive and functional performance in six areas: memory, orientation, judgment & problem solving, community affairs, home & hobbies, and personal care.  Table 6.2 at >> https://www.sciencedirect.com/topics/medicine-and-dentistry/clinical-dementia-rating .

7 stages/GDS: The Barry Reisberg scale is 7 stages, also known as the GDS – or Global Deterioration Scale for Assessment of Primary Degenerative Dementia. >> https://www.fhca.org/members/qi/clinadmin/global.pdf . (SUMMARIZED here in a strictly “Alzheimer’s” context >> https://www.alzheimers.net/stages-of-alzheimers-disease ).

7 stages/FAST: The Functional Assessment Staging Test uses activities of daily living (ADLs) to determine stages of ALZHEIMER’S, and also co-relates score of MMSE (the short mini-mental screen given at doctor’s office).  >> http://www.mciscreen.com/pdf/fast_overview.pdf .

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With the more complex staging scales, Most of us living with dementia are in several “stages” of dementia simultaneously, because our swiss-cheese “holes” in the brain create many inconsistencies.

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INCONSISTENCIES:

i speak haltingly, but i can still speak quicker than what i can understand someone else speaking. 
i think recently my words flow better typing with a keyboard than they do flowing out of my mouth verbally

My ability to write is much better than my ability to understand what i read.  
i started typing before age 10, and by 12 years old i was typing forms and letters for our family business.  so i still write/type a blog entry almost every week, but when i am interrupted while writing a paragraph, that paragraph often makes no sense to me when i read it back to myself to refresh my memory in order to finish the paragraph.  … So my ability to write is much better than my ability to understand what i read.  

Every person had things they did very well, and sometimes those abilities carry over to better functionality in those particular areas, which can distort guesses of dementia “stage”.  (Altho i was in accounting, and number-ability is one of the first things i lost.)

Personally i have Loads and Loads of dys-Abilities, but my ability to figure out a graph or pictorial representation is still above average. So i cannot understand the WORDS when husband tries to tell me something, but if he can make it into a picture then i can understand.  My ability to understand visual concepts is much better than my ability to understand spoken (audio) concepts.

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There are huge “stage” inconsistencies in dementia abilities, and also, some types of dementia carry the characteristic of tremendous variation of abilities throughout the day, that are not consistently shown on any particular day (thinking Lewy Body here but there may be others).  LBD can hit many ability levels during any given day, with strong abilities at unpredictable times.

On the 7-stage GDS scale, lack of remembering grandchildren’s names and last names of married daughters, along with not recognizing my husband would have put me in stage 5 for past 5 years or so, and my other abilities probably fit more in stage 4.  But i have very good coping strategies and my last testing about 3 years ago still indicated Mild Cognitive Impairment (stage 3 on GDS scale).  of course my Grandmother tested well enough that she did not get a dementia diagnosis until her Activities of Daily Living were quite impaired  and my mother had been caring for her a couple years (probably about 2000).

Personally, i think the 7-stage versions of dementia progression cause much more confusion than they help.  So i think of dementia in 3 stages instead;
there is “early-stage” with few symptoms, and strategies for any particular symptom have only needed revised a few times. Many folks can still drive in early stages (but i suggest frequent evaluations to make sure they are still safe).
Middle stages cover lots of ground,
… then end-stage (also known as late-stage).

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LINKS:

 

Mayo Clinic “Stages” at https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers-stages/art-20048448 ; 

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