Middle stage

The moderate degree of dementia is characterised by further loss of memory and initial involvement of cognitive abilities. Now, even events that could be retained at the beginning of the disease are forgotten or confused. Even familiar names and persons are confused or cannot be recalled spontaneously.

Even in familiar surroundings, orientation difficulties increase. Independent ways in unknown places are hardly possible. Patients can no longer concentrate well, which has a negative effect on the ability to calculate and learn.

Longer conversations that are complex in the beginning cannot be followed or puzzles can no longer be solved. As the disease progresses, self-care decreases: personal hygiene is neglected and everyday activities are no longer mastered. The state of disorientation becomes an integral part of the patient’s life.

The reason for paths taken is forgotten and the patient becomes increasingly helpless. Speech disorders or delusions can occur. Sentence structures are simplified or once said sentences are repeated several times.

Mood swings make dealing with patients more difficult and the behaviour of relatives is often negatively influenced. Restlessness allows patients to be active at night, which is a potential risk of falling. From a certain point on, nursing support for the patient is unavoidable, because the patient is no longer capable of leading a completely independent life. Even with moderate dementia, incontinence can occur and everyday life can only be mastered with support.

Final stage

In the final stage of severe dementia, there is an almost complete loss of memory. Spouses and children are no longer recognized. A temporal and local orientation is usually no longer possible and even information concerning the patient can no longer be called up.

At this point, vital functions such as continence, but also the ability to eat or drink independently are almost certainly lost, making the patient a full-time nursing case. Linguistic skills are no longer used sensibly and are eventually also forgotten in the course of the disease. All psychiatric side effects of the previous phases have disappeared again.

The ability to walk can, if at all, only be used with difficulty. The patients are bedridden in the final stage and do not perceive their surroundings or themselves. Death usually sets in through a concomitant disease of immobility (pneumonia) or through old age (cardiac arrest).

Alzheimer’s disease

In linguistic usage, Alzheimer’s disease and dementia are often put on the same level or even used synonymously. This is a misconception, because Alzheimer’s disease is only the most common underlying disease, whose symptoms include a dementia syndrome – dementia. Alzheimer’s disease is a primary dementia, which means that the clinical picture is created by disease-related changes in the brain. All primary dementias are not reversible at the current state of medicine, i.e. they cannot be repaired. In contrast to this is the group of secondary dementia, where an improvement can be achieved by timely treatment.