This week, I wanted to continue the dementia discussion by sharing information about dementia staging and the Global Deterioration Scale.
The Global Deterioration Scale (GDS), was developed by Dr. Barry Reisberg and was first made available in 1982. It provides caregivers an overview of the stages of cognitive function for those suffering from a primary degenerative dementia such as Alzheimer's disease. It is broken down into 7 different stages.
Stages 1-3 are the pre-dementia stages and include:
- No cognitive decline
- Very mild cognitive decline- age related difficulties
- Mild cognitive decline- Mild Cognitive Impairment (MCI)
Stages 4-7 are the dementia stages and are described as follows:
4. Moderate cognitive decline- mild dementia
5. Moderately severe decline- moderate dementia
6. Severe cognitive decline- moderately severe dementia
7. Very severe cognitive decline- severe dementia
Patients, caregivers and family members can get a rough idea of where an individual is at in the disease process by observing that individual's behavioral characteristics and comparing them to the GDS. Using this 7 point scale, I have helped family members better understand dementia and its progression. It has also been my experience that staging using the GDS enables families and caregivers to recognize cognitive deficits and set realistic goals for living situations and therapy. It can be a real eye-opener.
There are several versions of the GDS available on the Internet. The link to my favorite printable version is here. I have kept it within reach on my work desk for the last 8 years.
Our practice standards expect evidence-based approaches to the care we deliver. More and more, health insurance plans, including Medicare, are requesting standardization and outcomes to measure the value of the services we provide. Incorporating standardized test is an easy way to show evidence-based data to support our intervention.
A highly recognized measure of function, the GDS is considered a standardized assessment tool. It enables the identification of dysfunction and deficits, it removes subjective factors, and provides results that can be generalized and repeated.
If you're a healthcare provider reading this blog, print out a copy of the scale, and take it with you to work. Use it to complete assessments, plan therapy and provide education. I believe you will find it a very valuable tool.
If you're a friend or family member reading, you may think this information is very technical and irrelevant to your daily life. I invite you to recall the statistics from last week: 1 in 3 seniors dies with a dementia diagnosis. Dementia is likely to affect someone you know, and if you have a brain, you, too, are at risk.
Have a great week...thanks for reading!
Knowledge is power. Information is liberating. Education is the premise of progress. Kofi Annan