Early stage patterns

Using Dr. Barry Reisberg's Global Deterioration Scale, early stage dementia is equivalent to his Stages 3 and 4, middle stage is equivalent to his Stages 5 and 6, and late stage is equivalent to his Stage 7, but there is tremendous variation within each of those stages. For example:

In Stage 3, a person with AD may be unable to follow a map and consequently get lost driving to a new location.  By Stage 4, he may still be able to find familiar locations, but he may misjudge the distance of an approaching car or be unable to interpret the meaning of a traffic signal, so that his impaired judgment makes him an unsafe driver. (Some would say he is an unsafe driver even in Stage 3.)

In Stage 3, a person with AD may have gone from misplacing her glasses (Stage 2 = all of us!) to misplacing an object of real value, often wedding rings or other jewelry.  By Stage 4, she may start to hoard or hide objects for safekeeping, particularly if she is under the delusion that "people are stealing things." Sometimes, however, it may not be a matter of "hiding" as much as simply randomly "putting away" with no memory for where.  People who want to try to preserve order usually find that labeling drawers and leaving notes works pretty well in these early stages.

We all lose our train of thought from time to time, particularly if we are under stress or there is a lot going on around us, but by Stage 3 you will have begun to notice in the person word-finding difficulties, particularly for names, that go beyond the expected. By Stage 4, the give and take of normal conversations may be slowed, but if you allow the person with AD to set the pace and scope of the conversation, many can still do quite well.

Next up: More on early stage patterns of progression in AD.