Dementia Stages and Scales for Assessment
When assessing the stages of Dementia, there are three main scales or systems that are used by most Doctors.
The Clinical Dementia Rating Scale (CDR)
The Functional Assessment Staging (FAST) Scale
Both are used mainly for the initial assessment of the Dementia Stages.
The Global Deterioration Scale (GDS) is used to fine-tune the assessment once dementia has been diagnosed.
Assessing what stage of dementia a patient is in.
Clinical Dementia Rating (CDR) Scale.
This is the most widely used staging system in dementia research.
Here, the person with suspected dementia is evaluated by a health professional in six areas:
·memory
· orientation
· judgment and problem solving
· community affairs
· home and hobbies
· personal care
One of five possible stages is assigned.
1. CDR-0 – No dementia
2. CDR-0.5 – Mild-Memory problems are slight but consistent
Some difficulties with time and problem-solving
Daily life slightly impaired
3. CDR-1 Mild-Memory loss moderate, especially for recent events, and interferes with daily activities.
Moderate difficulty with solving problems
Cannot function independently at the community affairs
Difficulty with daily activities and hobbies, especially complex ones.
4. CDR-2 Moderate-More profound memory loss, only retaining highly learned material
Disoriented concerning time and place
Lacking good judgment and difficulty handling problems
Little or no independent function at home
Can only do simple chores and has few interests.
5. CDR-3 Severe
Severe memory loss
Not oriented concerning time or place
No judgment or problem-solving abilities
Cannot participate in community affairs outside the home
Requires help with all tasks of daily living and requires help with most personal care
The patient often experiences incontinence.
Functional Assessment Staging (FAST)
Another staging method for dementia, the Functional Assessment Staging (FAST), focuses more on an individual’s level of functioning and activities of daily living versus cognitive decline.
Note: A person may be at a different stage cognitively (GDS stage) and functionally (FAST stage).
Stage 1 — Normal adult – No functional decline
Stage 2 — Normal older adult
The Patient is aware of some functional decline.
Stage 3 — Early Dementia
There are noticeable deficits in demanding job situations.
Stage 4 — Mild Dementia
The patient requires help in complicated tasks such as handling finances, balancing a checkbook, etc.
Stage 5 — Moderate Dementia
The patient needs help in picking out the appropriate clothes to wear.
Stage 6 — Moderately severe Dementia
Assistance is required for dressing, bathing, and toileting. Patient experiences urinary and fecal incontinence.
Stage 7 — Severe Dementia
Speech ability declines to about a half-dozen intelligible words. A progressive lack of ability to walk, sit up, smile, and hold head up.
The Global Deterioration Scale (GDS)
Developed by Dr. Barry Reisberg, The Global Deterioration Scale gives caregivers and health providers an overview of the progression of dementia.
The scale consists of seven different stages.
Stages 1-3 are the pre-dementia stages.
Stages 4-7 are the dementia stages.
Starting at stage 5, a patient will need assistance to survive.
Caregivers can get a general idea of what stage an individual is at by observing the individual’s behavior and comparing it to the GDS.
