VASCULAR DEMENTIA IN THE ELDERLY: THE 7 STAGES OF THE GLOBAL DETERIORATION SCALE

Dementia staging is an inexact art, but several tools have been developed to help with ascertaining where your loved one may be in the process.  The bigger problem is that no one knows definitely how long a stage will last, or for sure that every person with the disease will pass through every stage. 

These tools can assist caregivers with understanding and planning.  They  more clearly define the disease progression and what they could face if the symptoms persist and the person continues to live with the disease.  Many people with dementia have co-existing health problems, many of which may have contributed to the development of dementia in the first place.

We will set out the 7 stages offered in the Global Deterioration Scale developed by Dr. Barry Reisberg as adapted by Dr. Doug Drummond in six posts with personal observations about our own experience detailed after each stage.  Stages 1 and 2 will be combined in one post.  Please feel free to offer comments, tell us your own experience, and state your opinions about information offered in the posts.

Dr. Drummond's stages will be italicized for clarity of origin and personal observations will follow.


Dr. Drummond's information assesses the following:

Stage 1   Subjectively and objectively normal.  Usual Care Setting-independent.

Stage 2   Subjective complaints of mild memory loss.  Objectively normal on testing.  No functional deficits.  Usual care setting-independent.


As mentioned in previous posts, we spent a lot of time looking for hearing aids, less frequently, but still often, for glasses. My mother had a good habit of putting her purse in a certain place, and that helped as this stage moved forward. She would occasionally forget names or words during the second phase, and she expressed frustration when these eluded her.

An adaptation of the GDS by Dr. Doug Drummond and published in the American Journal of Psychiatry breaks the stages into "Deficits in cognition and function" and explains the "Usual Care Setting" for the person at that stage.
When the initial symptoms started slowly surfacing, our mother was still able to drive, manage herself and her household.  In fact, one of the things we laughed about was that when we insisted that she get a physician (she honestly had not had a family physician in over 25 years-I do not suggest this as a plan to emulate), he gave her a little test of some sort to check her mental status.  One of the things he asked her to do was write a paragraph.  My sister, a professional writer, had taken her for the appointment, and said that Mother had written an eloquent paragraph with quite a few four syllable words written in her tiny flowing cursive. It certainly made us look like we were imagining things.

To sum up, we knew something was wrong, but we couldn't prove it.  Just as well, we continued to monitor,  grateful for every day that she was able to function on her own and live independently.

DEMENTIA HINT:  Take your loved one for an examination by a physician if you suspect memory or cognitive issues.  Early intervention or medication could help, but if not recommended, at least you have a baseline test for cognitive and functional ability.

Installed