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The Dementia Stages and Scales for Assessment

By Evan Nasseri Subscribe to RSS | June 21st 2012 | Views:
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When assessing the Dementia Stages there are three main scales or systems that are used by most Doctors. The Clinical Dementia Rating Scale (CDR) and the Functional Assessment Staging (FAST) Scale are used mainly for the initial assessment of the Dementia Stages. The Global Deterioration Scale (GDS) is used to fine tune the assessment once dementia has been diagnosed.

Below is a quick rundown of each of the three scales used for assessing what stage of dementia a patient is in.

Clinical Dementia Rating (CDR) Scale.

This is the most widely used staging system in dementia research. Here, the person with suspected dementia is evaluated by a health professional in six areas: memory, orientation, judgment and problem solving, community affairs, home and hobbies, and personal care and one of five possible stages is assigned.

1. CDR-0 -- No dementia

2. CDR-0.5 – Mild-Memory problems are slight but consistent; some difficulties with time and problem solving; daily life slightly impaired

3. CDR-1 Mild-Memory loss moderate, especially for recent events, and interferes with daily activities. Moderate difficulty with solving problems; cannot function independently at community affairs; difficulty with daily activities and hobbies, especially complex ones.

4. CDR-2Moderate-More profound memory loss, only retaining highly learned material; disoriented with respect to time and place; lacking good judgment and difficulty handling problems; little or no independent function at home; can only do simple chores and has few interests.

5. CDR-3 – Severe-Severe memory loss; not oriented with respect to time or place; no judgment or problem solving abilities; cannot participate in community affairs outside the home; requires help with all tasks of daily living and requires help with most personal care. Patient often experiences incontinence.

Functional Assessment Staging (FAST)

Another staging method for dementia, the Functional Assessment Staging (FAST), focuses more on an individual's level of functioning and activities of daily living versus cognitive decline. Note: A person may be at a different stage cognitively (GDS stage) and functionally (FAST stage).

Stage 1 -- Normal adult - No functional decline

Stage 2 -- Normal older adult

The Patient is aware of some functional decline.

Stage 3 -- Early Dementia

There are noticeable deficits in demanding job situations.

Stage 4 -- Mild Dementia

The patient requires help in complicated tasks such as handling finances, balancing a check book, etc.

Stage 5 -- Moderate Dementia

The patient needs help in picking out the appropriate clothes to wear.

Stage 6 -- Moderately severe Dementia

Assistance is required for dressing, bathing, and toileting. Patient experiences urinary and fecal incontinence.

Stage 7 -- Severe Dementia

Speech ability declines to about a half-dozen intelligible words. A progressive lack of ability to walk, sit up, smile, and hold head up.

(Reisberg, et al., 1988)

The Global Deterioration Scale (GDS)

Developed by Dr. Barry Reisberg, The Global Deterioration Scale gives caregivers and health providers an overview of the progression of dementia. The scale consists of seven different stages.Stages 1-3 are the pre-dementia stages. Stages 4-7 are the dementia stages. Starting at stage 5, a patientwill need assistance to survive.Caregivers can get a general idea of what stage an individual is at by observing the individual's behavior and comparing them to the GDS.

Evan Nasseri - About Author:
To find out what the Stages of theGlobal Deterioration Scale are and learn more about dementia and Alzheimer’svisitThe Seven Dementia Stages.

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