Four Stages of Cognitive Impairment: An Overview

What Are The Four Stages Of Cognitive Impairment

Damage to the brain can result in dementia and a progressive decrease in cognitive function that might lead to old age problems. A person with dementia will gradually struggle more with memory, comprehension, communication, and reasoning.

Healthcare professionals frequently use stages to describe a person’s dementia. Choosing an appropriate care plan and conveying the person’s disease to family members or healthcare professionals is crucial.

Read on to learn about the four phases of cognitive impairment and what it is in this post.

What is Cognitive Impairment?

In older adults, cognitive decline is the worry about or problems with thinking, memory, concentration, and other brain skills that goes beyond what is generally expected as part of aging.

Cognitive impairment, commonly referred to as cognitive decline, can develop gradually over time or suddenly and can be either temporary or permanent. It can be scary for the person experiencing the symptoms and their family and friends.

If you’re worried about an older person’s cognitive abilities, some underlying health issues often affect the mind’s function.‌ Those need to be detected and treated if at all possible. It’s recommended that you seek help from your doctor.

What to know about Dementia?

The term “dementia” refers to a group of illnesses that impair memory and other mental abilities. Dementia is a disease that progresses over time and is caused by physical abnormalities in the brain. Dementia can proceed quickly for some people, while taking years for others to reach a severe stage. 

The underlying cause of dementia significantly impacts how quickly it progresses. Although everyone with dementia will experience the stages of the disease differently, most persons with dementia have some symptoms in common.

When thinking, memory, and reasoning skills are lost to the point where they interfere with day-to-day tasks, this condition is known as dementia.

Types of Dementias

Depending on the type of dementia a person has, the disease’s signs and symptoms will change over time. Here are some of the dementia types that are most frequently identified:

  • Alzheimer’s condition

The most prevalent type of dementia is Alzheimer’s disease. Between 60 and 80 percent of cases involve it. The condition normally advances gradually.

Physical needs and changes in the brain, such as protein accumulation and nerve damage, cause Alzheimer’s disease.

  • Arterial dementia

About 10% of all dementia cases are caused by vascular dementia, commonly known as post-stroke or multi-infarct dementia. Blood vessels that are obstructed are the cause. These happen in cases of brain traumas such as strokes.

  • Dementia frontotemporal

A type of dementia known as frontotemporal dementia frequently results in personality and behavior abnormalities. Language problems may result from it. A variety of disorders, such as Pick’s disease and progressive supranuclear palsy, can lead to frontotemporal dementia.

  • Blended dementia

Mixed dementia refers to dementia caused by a variety of different brain disorders. Most frequently, this refers to Alzheimer’s and vascular dementia, though other types of dementia may also be included.

How is dementia identified?

There is no single test that can diagnose dementia. Many medical tests and your medical history are used to make the diagnosis. If you display signs of dementia, your doctor will:

  • a medical checkup
  • more blood testing to rule out alternative explanations of your symptoms
  • a neurological evaluation
  • a mental health evaluation

It’s vital to screen out other illnesses, such as thyroid issues and drug interactions, since not all confusion and memory loss signify dementia.

What are the stages of dementia?

Every person’s case of dementia develops differently. The signs and symptoms of Alzheimer’s disease are common in the following stages:

1. Minimal Cognitive impairment (MCI)

MCI may impact an aging population. Some of these individuals will eventually get Alzheimer’s disease. MCI is characterized by frequent item loss, forgetfulness, and verbal difficulty.

2. Mild dementia

People experiencing moderate dementia will likely need more assistance in their daily lives. It becomes harder to perform regular daily activities and self-care as dementia progresses. Common symptoms during this stage include:

  • increasing confusion or poor judgment
  • greater memory loss, including a loss of events in the more distant past
  • needing assistance with tasks such as getting dressed, bathing, and grooming
  • significant personality and behavior changes, often caused by agitation and unfounded suspicion
  • changes in sleep patterns

3. Moderate dementia

In moderate dementia, people can still be able to work independently. But they will have memory lapses that interfere with daily life, such as forgetting words or where items are. The following are typical signs of mild dementia:

  • Loss of recent event memory
  • Changes in personality, such as becoming more reserved or withdrawn
  • Being lost or losing things
  • Trouble with complex activities and problem-solving, including managing funds
  • Difficulty expressing or arranging one’s thoughts

4. Severe dementia

Once the condition worsens to severe dementia, people will endure mental decline and deteriorating physical ability. Severe dementia can frequently lead to:

  • a lack of communication skills
  • a requirement for constant support with activities like dressing and eating
  • a decline in bodily functions like walking, sitting, and holding one’s head up, as well as, eventually, swallowing, bladder control, and bowel function
  • a greater propensity for infections

What are the prospects for those who have dementia?

Dementia patients will move through these stages at varying rates and with various symptoms. Speak with your doctor if you are displaying early signs of dementia. Although Alzheimer’s disease and other prevalent dementias have no known cures, early detection can assist affected individuals and their families in future preparations. Participation in clinical trials is also made possible by early diagnosis. It aids scientists in creating fresh therapies and ultimately discovering a cure.

Alzheimer’s disease and altered thinking

Being cruel to family members when having dementia is frequently a result of the altered thinking brought on by neurodegeneration, which is the loss of cellular health and function in the central nervous system.

According to board-certified psychiatrist Dr. Sudhir Gadh of New York City, dementia can cause various neuropsychiatric symptoms, such as agitation, aggression, and violence.

Which drugs are likely to impair cognitive function?

These frequently given medications could impair cognitive function.

Cognitive impairment caused by drugs, both chronic and acute, is a problem that can be avoided in medicine. Certain drug classes carry a higher risk for certain impairments, and fragile patient populations are frequently more vulnerable. 

Particularly, dementia, advanced age, and pre-existing cognitive impairment all provide risks for drug-induced cognitive impairment.

Here are some of the medications that might contribute to the cognitive restraint of older adults.

Psychedelic substances

Here is a list of particular cognitive deficits linked to psychotropic medicines, per the study.

  • Amitriptyline, benzodiazepines, topiramate, and paracetamol all impair verbal-numerical reasoning.
  • Amitriptyline, benzodiazepines, levetiracetam, paracetamol, quetiapine, and topiramate all impair memory.
  • Amitriptyline, benzamides, benzodiazepines, carbamazepine, fluoxetine, gabapentin, lamotrigine, levetiracetam, mirtazapine, olanzapine, opioids, paracetamol, risperidone, sertraline, trazodone, and valproic acid all affect one’s ability to react quickly.

In one literature review published in Mental Health Clinician, the author stated that using all antihypertensives, particularly in the case of polypharmacy or inappropriate dosing, can cause hypotension and bradycardia, as a result, change mental/cognitive status due to decreased cerebral perfusion.

Cognitive Behavioral Therapies

Cognitive Behavioral Therapies includes a variety of methods and strategies that target our attitudes, feelings, and actions. These can include self-help techniques as well as organized psychotherapies

Several particular treatment modalities that use cognitive behavioral therapy include:

  • The main goals of cognitive therapy are to recognize and alter faulty thought processes, emotional reactions, and behaviors.
  • Dialectical behavior therapy (DBT) addresses destructive or disturbing thoughts and behaviors while incorporating treatment strategies such as emotional changes and mindfulness.
  • Multimodal therapy suggests that psychological issues must be treated by addressing seven different but interconnected modalities: behavior, affect, sensation, imagery, cognition, interpersonal factors, and drug/biological considerations.
  • Rational emotive behavior therapy (REBT) involves identifying irrational beliefs, actively challenging these beliefs, and finally learning to recognize and change these thought patterns.

Four Stages of Cognitive Impairment

The four phases of cognitive severity, which range from healthy aging to dementia, are:

1. No Cognitive Impairment (NCI)

People do not feel a decline in their cognitive capacities or ability to perform complex tasks that require them. The NCI stage describes those aging normally and those with a cognitive problem, but it is not severe enough to cause any deterioration in these abilities. NCI typically lasts for 30 years.

2. Subjective Cognitive Impairment (SCI)

A perceived or subjective decline in cognitive or functional abilities that does not interfere with a person’s ability to do routine or most difficult tasks. People know that some of their abilities have declined, but they can still compensate for it. 

The SCI stage describes both those aging normally and those whose cognitive abilities are slowly deteriorating due to cognitive disease. The SCI stage of Alzheimer’s disease lasts 15 years.

3. Mild Cognitive Impairment (MCI)

A loss in cognitive skills, including language, memory, logic, judgment, or perception, that is not related to aging normally. People with moderate to severe MCI can independently drive, shop, cook, pay bills, handle money, do domestic duties, and perform other well-learned tasks that don’t need them to learn a lot of new material.

4. Dementia

The degree of severity found in most cognitively impaired conditions following the MCI stage. The capacity to carry out essential everyday tasks, such as cooking, grocery shopping, driving to known places, paying bills, conducting housework or home repairs, and engaging in well-learned hobbies or interests, has deteriorated in people in the dementia stage. 

As the dementia stage advances, even more previously taught abilities, known as basic daily living skills, are affected. These include showering, dressing, using the toilet, and planning to urinate or defecate, so they arrive at the bathroom promptly. 

Eventually, dementia impairs walking, talking, swallowing, trunk, neck, and facial control. The dementia stage, caused by one or more cognitive problems, is not present in people who are just becoming older. 


Rarely does someone with dementia act cruelly against family members and professional care trying to care for them because they have bad feelings for someone they love. As memory loss exacerbates feelings of anxiety and irritation and the body loses its capacity to control emotional responses, dementia can include aggressive symptoms.

While there is no known treatment for progressive forms of dementia, caregiver emphasis on consistency, freedom of choice, and compassionate care may be helpful.