Early signs and the seven stages of dementia
Memory isn’t a single system. Each part can be affected differently, which is why the pattern of change matters as much as the change itself.
What’s normal, and what’s worth checking
Working memory
The mind’s notepad: holding a phone number, following a conversation.
Short-term memory
Recent events: what you had for lunch, where you parked the car.
Long-term memory
Facts, skills and your life story, built up over many years.
Normal ageing
- Forgetting a name, then remembering it later
- Misplacing things now and then
- Taking a little longer to learn something new
- Words on the “tip of the tongue”
Worth checking
- Forgetting recent conversations or events
- Repeating questions or stories
- New difficulty with money, plans or familiar tasks
- Friends or family noticing changes
Seek help promptly
- Sudden confusion, which can signal infection
- Rapid change over days or weeks
- Getting lost in familiar places
- Signs of stroke, such as face drooping, arm weakness or slurred speech: call 999
10 early warning signs
One sign on its own is rarely a cause for alarm. Several together, or a change that keeps getting worse, is worth checking.
- Memory loss that disrupts daily lifeForgetting recent information, dates or events
- Difficulty planning or solving problemsTrouble with bills, budgets or following a recipe
- Struggling with familiar tasksAt home, at work or with favourite hobbies
- Confusion with time or placeLosing track of dates, seasons and time passing
- Trouble with images and distanceDifficulty reading, judging distance or colour
- New problems with wordsStruggling to find the right word mid-conversation
- Misplacing thingsLosing items and being unable to retrace steps
- Poor judgementNeglecting grooming, or giving money to cold callers
- Withdrawing from social lifeStepping back from work, hobbies or friends
- Changes in mood and personalityBecoming confused, suspicious, anxious or low
Seven stages of dementia, and the importance of early intervention
Dementia usually develops gradually over many years, and the earliest changes are easy to miss or put down to age. The most important message is simple: the earlier you act, the more can be done.
The early intervention window · stages 1–4
No impairment
Memory and daily function are normal.
Very mild decline
Occasional lapses, such as a forgotten word or misplaced keys, usually unnoticed by others.
Mild cognitive decline
Family and friends begin to notice. Trouble with new names, remembering what’s been read and staying organised.
Moderate decline
Recent events are forgotten; money, bills and complex tasks become difficult.
The window for change is early
In stages 1 to 4, the brain still has considerable capacity to respond. Reversible causes can be found and corrected, and the factors that drive progression, such as blood sugar, circulation, inflammation, hormones, sleep and nutrition, can be meaningfully addressed. This is where our clinic focuses its work.
By stage 5, the changes in the brain are too established for lifestyle and functional approaches to alter the course. Care is then led by the medical and care teams, and our role becomes supporting you and your family.
Later stages · care led by your medical team · stages 5–7
Moderately severe decline
May not recall their own address or the date, and needs help choosing suitable clothing. Can still eat and use the toilet independently.
Severe decline
Names of close family may be forgotten. Help is needed with dressing and personal care. Personality and behaviour may change; wandering and incontinence are common.
Very severe decline
The ability to communicate and respond is largely lost. Full-time care is needed, and swallowing may become difficult.
Not sure where to start?
Take the Memory Profile: a structured look at memory, focus, mood, sleep, metabolic and hormonal symptoms. Not a diagnostic test, but a clear place to start.