Global Deterioration Scale

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Therapists

Evaluation

Introduction

Creating a person and family-centered plan of care requires a thorough understanding of the stages of dementia and the expected cognitive, physical and functional abilities of the person with dementia.

Strategies for Success

Dementia is usually considered in stages and understanding the stage of the person with dementia will help with treatment planning and improving communication.

Diagnosis	Stage	Signs & Symptoms
No Dementia	Stage 1: No Cognitive Decline	Normal function No memory loss People with NO dementia are considered in Stage 1
No Dementia	Stage 2: Very Mild Cognitive Decline	Forgets names Misplaces familiar objects Symptoms not evident to loved ones or doctors
No Dementia	Stage 3:	Increased forgetfulness Slight difficulty concentrating Decreased work performance Gets lost more frequently Difficulty finding right words Loved ones begin to notice
Early-Stage	Stage 4: Moderate Cognitive Decline	Difficulty concentrating Forgets recent events Cannot manage finances Cannot travel alone to new places Difficulty completing tasks In denial about symptoms Socialization problems: Withdraw from friends or family Physician can detect cognitive problems
Mid-Stage	Stage 5: Moderately Severe Cognitive Decline	Major memory deficiencies Need assistance with ADLs (dressing, bathing, etc.) Forgets details like address or phone number Doesn’t know time or date Doesn’t know where they are
Mid-Stage	Stage 6: Severe Cognitive Decline (Middle Dementia)	Cannot carry out ADLs without help Forgets names of family members Forgets recent events Forgets major events in past Difficulty counting down from 10 Incontinence (loss of bladder control) Difficulty speaking Personality and emotional changes Delusions Compulsions Anxiety
Late Stage	Stage 7: Very Severe Cognitive Decline (Late Dementia)	Cannot speak or communicate Requires help with most activities Loss of motor skills Cannot walk

More Info

The GDS is only one commonly used scale. Here is a great resource that provides an overview of a person's capabilities based on GDS, Functional Assessment Staging Test (FAST) and Clinical Dementia Rating (CDR)

Click here to learn more.