The concept “senile dementia” is used to refer to degenerative diseases that affect cognitive functioning, particularly memory, and that occur at advanced ages. On the other hand, we speak of praecox or presenile dementia when the symptoms occur earlier than would be expected, generally in adulthood.
In this article we will describe the 7 phases of senile and early dementia interchangeably, since the development of cognitive impairment follows the same approximate general lines regardless of the age at which symptoms begin to manifest.
There are a large number of diseases that can cause dementia; Some of the most common and well-known are Alzheimer’s, Lewy’s, and recurrent strokes. Each disorder of this type initially affects different regions of the brain, although symptomatic differences are reduced in advanced stages.
Although the symptoms of dementia depend on the specific alteration of each patient, the general progress that these diseases follow has been divided into seven phases depending on the degree of cognitive impairment that the person presents at a given time.
1. Absence of cognitive impairment
The first stage of cognitive deterioration corresponds to the absence of this; Therefore, most people are in this phase, which can be included together with the next two in the “pre-dementia” category, characterized by normal or practically normal cognitive functioning.
A person is considered to be in phase 1 when does not present significant cognitive symptoms that could be attributable to a deterioration of the brain, such as memory losses more relevant than those that occur due to lack of energy or attention, among other common factors.
2. Age-related memory deficits
Aging, and in particular the onset of senescence, is naturally associated with small memory losses that manifest themselves mainly in the forgetting of names or locations of objects. The second phase of cognitive deterioration is characterized by the presence of these deficits on a more or less regular basis.
Although in many cases the appearance of specific forgetfulness is nothing more than a consequence of age, in some cases memory loss may indicate future severe impairment of cognition especially if the frequency of these is high and if the person is relatively young enough to have forgetfulness typical of old age.
3. Mild cognitive impairment
The concept “mild cognitive impairment” is used to describe cases in which notable signs of impairment appear in memory and in the performance of daily tasks. In this phase the cognitive deficits are more marked than would be expected for the person’s age, even taking aging into account.
People with mild cognitive impairment have a higher risk of developing dementia than those that do not present it, although the progress of the deficits frequently stops at this stage. It is common for those who suffer from this type of impairment to have problems retaining information, remembering words, concentrating or finding their way.
The fourth phase corresponds to the onset of dementia as such. In this stage, which usually lasts approximately two years, changes in personality and mood begin to appear. Since social skills also deteriorate, it is very common for the frequency of social interaction to decrease.
Cognitive problems become much more evident after the onset of dementia. Patients usually have some awareness of their illness when they reach this stage, although dementia also affects this recognition. They also tend to deny their symptoms as a defense mechanism.
5. Moderate dementia
During the middle stage of dementia, affected people begin to needing help from other people to carry out everyday tasks. As the disease progresses, abilities such as using money, telephones or kitchen instruments, reading and writing, remembering information about oneself and even dressing oneself deteriorate.
6. Moderately severe dementia
In this phase, memory and cognition problems have worsened to the point that they interfere with the performance of a large number of activities; This will continue to increase as the dementia progresses. The most common thing when reaching this stage is that the person need constant supervision from one or more caregivers.
As for the most common symptoms and signs, in addition to the worsening of memory problems (which already include the recognition of close people), we find the appearance of feelings of anxiety and agitation, sleeping problems, wandering, obsessive and repetitive behaviors, delusions. or aggressiveness.
7. Severe or advanced dementia
The average duration of late-stage dementia is approximately two and a half years. Advanced dementia is characterized by generalized loss of psychomotor skills including those necessary for talking, walking, eating or using the bathroom.
Although the progress of each case of dementia depends on the disease that causes it, they are all very similar during the final period because the structural deterioration has spread to all regions of the brain.
