What are the 7 stages of dementia?

Dementia is a progressive condition, meaning symptoms gradually worsen over time. While every person’s experience is unique, understanding the 7 stages of dementia can help families recognise early signs, plan ahead, and arrange the right level of care at the right time.

Why is it important to understand the stages of dementia?

Understanding how dementia progresses can help you:

• Spot early signs of dementia
• Plan finances and legal matters in good time
• Adapt the home environment for safety
• Arrange appropriate dementia care
• Prepare emotionally as a family.

Different types of dementia progress in slightly different ways. For example:

• Alzheimer's disease is the most common cause of dementia and typically begins with memory loss.
• Vascular dementia is linked to reduced blood flow to the brain and may progress in steps.
• Lewy Body dementia often includes hallucinations and physical symptoms such as tremors.
• Frontotemporal dementia more commonly affects behaviour, personality, or language in its early stages.

The 7 stages of dementia explained

Stage 1: No cognitive decline

At this stage, there are no noticeable symptoms. However, changes in the brain may already be developing.

In Alzheimer's disease, for example, abnormal protein build-up can begin 10–15 years before symptoms appear. This is sometimes referred to as preclinical Alzheimer’s.

There is no impact on daily life at this point, and dementia is not yet diagnosable based on symptoms alone.

Stage 2: Very mild forgetfulness

This stage may look like normal age-related memory lapses, such as:

• Occasionally misplacing items
• Forgetting names briefly
• Missing an appointment but remembering later.

It can be difficult to distinguish between normal ageing and early dementia at this stage.

With Frontotemporal dementia, subtle behavioural changes or slight language difficulties may appear rather than memory problems.

Stage 3: Mild cognitive decline (early-stage dementia)

This is often when family members begin to notice consistent changes.

Symptoms may include:

• Asking the same questions repeatedly
• Difficulty planning or organising
• Forgetting recently read information
• Struggling to remember new names
• Withdrawing from social situations.

This stage can last several years. Many people remain largely independent but may benefit from light-touch support, regular check-ins, or companionship care.

It’s also a sensible time to discuss:

• Lasting Power of Attorney
• Financial planning
• Future care preferences.

Stage 4: Moderate cognitive decline (mild dementia)

At this stage, symptoms become clearer and a formal diagnosis is often made.

Common signs include:

• Difficulty managing finances
• Problems cooking safely
• Forgetting medication
• Changes in sleep patterns
• Increased confusion about recent events.

People can usually still manage personal care but may need structured support.

In Vascular dementia, progression may feel more sudden or step-like following small strokes.

This stage typically lasts around two years, but timing varies widely.

Stage 5: Moderately severe decline (mid-stage dementia)

At this stage, more consistent daily support becomes necessary.

A person may:

• Need help choosing appropriate clothing
• Forget recent visits or conversations
• Become disoriented about time or place
• Experience personality changes
• Show signs of paranoia or suspicion.

With Lewy body dementia, hallucinations may become more prominent.
With Frontotemporal dementia, mobility or swallowing difficulties may begin.

Reminiscence activities, such as looking through photographs, can be particularly comforting during this stage.

Stage 6: Severe cognitive decline (late-stage dementia)

At this point, significant support is required, often including full-time live-in care.

Symptoms may include:

• Needing help with washing, dressing, and toileting
• Incontinence
• Limited awareness of surroundings
• Difficulty recognising close family
• Mood swings or agitation
• Increased risk of falls.

People living with Alzheimer's disease may lose much of their recent memory while retaining fragments of long-term memories.

24-hour care at home or in a specialist setting is often needed to ensure safety and comfort.

Stage 7: Very severe decline (advanced dementia)

In this final stage of dementia:

• Speech becomes very limited or stops entirely
• Assistance is needed with eating and drinking
• Mobility is significantly reduced
• The body becomes increasingly frail.

The brain’s reduced function affects the body’s systems, increasing vulnerability to infections such as pneumonia.

At this stage, care may be provided:

• At home with round-the-clock carers
• In a specialist dementia care home
• In hospice care.

Some people may pass away before reaching this final stage.

How long do the 7 stages of dementia last?

There is no fixed timeline. On average:

• Early stages may last several years
• Mid-stage dementia often lasts 2–4 years
• Late-stage dementia can last 1–3 years.

However, progression varies significantly depending on:

• The type of dementia
• Age at diagnosis
• Overall health
• Quality of care and support.

What if there’s a sudden worsening of symptoms?

Dementia is progressive but sudden changes are not typical.

If someone experiences acute confusion, rapid memory loss, delirium or sudden behavioural changes, seek medical advice immediately.

Infections, dehydration, medication side effects, or other treatable conditions can temporarily worsen dementia symptoms. A GP or healthcare professional can investigate and advise.

How Elder can help plan care through the stages of dementia

Dementia care needs often change gradually – from occasional help in the early stages to more consistent, round-the-clock support later on. Thinking ahead can make those transitions feel more manageable and less overwhelming.

For many families, remaining at home in familiar surroundings provides comfort, stability, and a greater sense of independence.

Elder can help you arrange specialist live-in dementia care that adapts as your loved one’s needs evolve, allowing them to stay safe and supported at home.

If you’re starting to consider care, exploring your options early can make all the difference. Find out how Elder can support your family today.