The Abnormally Aging Brain
In a person with mild cognitive impairment (MCI), the symptoms are more significant than those for normal aging. It’s not uncommon for people to notice the following:
- Difficulty following conversations
- Declining ability to make sensible decisions
- Getting lost easily
- Poor concentration and attention span
Those people with MCI that do progress to dementia generally follow the progression charted by the Global Deterioration Scale (GDS) developed by Dr. Barry Reisberg in 1982. This score has seven stages:
- Stage 1: No problems identified by doctors or the patient.
- Stage 2: The patient recognizes that he has a problem, perhaps with remembering names, but he scores normally on diagnostic tests.
- Stage 3: Subtle problems carrying out thought processes start to affect work and social activities. Tests may begin to pick up problems (this is mild cognitive impairment).
- Stage 4: Clear-cut difficulties develop in terms of memory and carrying out tasks such as dealing with finances or traveling. Denial is common. Early dementia has set in.
- Stage 5: The person needs some assistance but is still quite capable of washing, dressing, eating, going to the bathroom, and choosing appropriate clothes. Forgetfulness in relation to names and places is becoming more severe.
- Stage 6: The person is largely unaware of anything that’s happened to him in the recent past. He needs help with most of the basic activities of daily living and may need to be looked after in a nursing home. Incontinence is common.
- Stage 7: By this stage the person is experiencing severe dementia. He’s completely dependent on others for everything, often including mobility. Verbal communication skills are extremely restricted.