Dementia Rating Scale

Dementia is a progressive disease that affects memory, thinking, and behavior. Health professionals use dementia rating scales to determine the stages of cognitive impairment and assess the progression of the disease.

Dementia Rating Scale
The Global Deterioration Scale for Assessment of Primary Degenerative Dementia

What is the Dementia Rating Scale?

Dementia gets worse over time. Health professionals use a dementia rating scale. This is to help determine the stages of dementia.

Alzheimer’s disease is the most common type of dementia. The Global Deterioration Scale for Assessment of Primary Degenerative Dementia … is often used when assessing the Alzheimer’s disease progression.

The Reisberg Scale

The GDS scale, also known as the Reisberg Scale. It breaks down seven stages of cognitive impairment.

  • Stage 1: A person in this stage has no memory loss or cognitive impairment. A person can function normally in everyday activities and does not have dementia.
  • Stage 2: In this stage a person has minimal cognitive impairment that is normal in the aging process. For example, a person might forget names or where they put their keys. Other people do not notice the symptoms, and the person does not have dementia.
  • Stage 3: A person has mild cognitive impairment. This is associated with forgetting things more often. The individual may find it difficult to concentrate. They become less productive at work. Loved ones will begin to notice that a person gets lost more often. Or has difficulty finding the right words when talking. At this stage, the person does not have dementia. But will develop the disease on average within seven years.
  • Stage 4: This is the early stage of dementia. A person will exhibit moderate cognitive impairment. A person has more difficulty concentrating and begins to forget recent events. Taking care of personal finances and traveling alone to new places becomes difficult. A person may deny their symptoms. Refuse a test for dementia. They may begin to withdraw from family and friends. This is because socialization becomes a challenge. A physician can detect cognitive declines through a patient interview and exam. This stage lasts an average of two years.
  • Stage 5: A person in is the mid-stage of dementia and has moderately severe impairment. The person will need help completing everyday tasks such as… dressing, bathing and fixing meals. A person has major memory loss. They may forget important information like … their address and phone number or the time of day and where they are. The symptoms of this stage may last an average of one and a half years.
  • Stage 6: A person is still in the mid-stage of dementia. However they exhibit severe impairment and needs extensive help with daily activities. They begin to forget easy things like names of friends and family. Often forget things they did recently. Can only remember some details from when they were younger. Counting backward from ten, speaking and completing a task are difficult for them. They will have bladder and bowel control issues.

The patients will have personality changes including delusions, compulsive behavior, anxiety and agitation. These symptoms last on an average for two and a half years.

  • Stage 7:  The final stage is the late-stage of dementia. This is when a person has very severe brain impairment. They need extensive dementia care. A person needs constant help with most activities. These include eating and going to the bathroom. They lose their ability to communicate and psychomotor skills like walking decline. The average duration of this stage is two and a half years.

Patients will not have all the same symptoms or progress at the same rate so a dementia rating scale is a key factor.

Functional Assessment Staging (FAST)

Dr. Barry Reisberg developed the Functional Assessment Staging Test, another dementia rating scale.

It is different from GDS. It rates a person’s functioning level, as well their ability to carry out daily living, versus their cognitive decline.

A person with dementia may be at a different stage functionally than cognitively.

  • Stage 1: Exhibits a normal adult with no functional decline.
  • Stage 2: Exhibits an older adult with awareness of normal age process. They show appropriate functional decline.
  • Stage 3: Exhibits a person with early dementia who notices a difficulty in a demanding job.
  • Stage 4: Exhibits mild dementia. The person needs help with complicated tasks like finances or planning events.
  • Stage 5: Exhibits moderate dementia. Needs help with simpler tasks like choosing clothes to wear.
  • Stage 6: Exhibits moderately severe dementia. Needs more help with simple daily tasks and may have problems with bladder and bowel control.
  • Stage 7: Exhibits severe dementia. Has major trouble speaking and controlling body to walk, sit up, smile and eat.

A caregiver or informant… who can interview the person… and accurately report information.. Should administer the FAST dementia rating scale to determine the stages of dementia.

Critical Dementia Rating Scale

The third most common dementia rating scale is the Clinical Dementia Rating Scale. It is a five-stage scale. It combines the cognitive abilities and functional abilities of a person .. who may have dementia.

The person is evaluated in six domains:

  • Loss of memory
  • Knowledge of time and place
  • Problem solving skills
  • Community affairs
  • Home and hobbies
  • Personal care

The person is assigned a CDR rating. This is from zero indicating no dementia to three indicating severe dementia.

If you notice a change in behavior or personality of your loved one take them to a physician to get evaluated. No single test will prove that a person has Alzheimer’s or dementia. A doctor will consider all the possible causes. Then administer a dementia rating scale.

Have more questions? Check out the Frequently Asked Question section of the website. You will find a lot of different questions answered directly.