Mild Impairment	Moderate Impairment	Severe Impairment	Terminal
Recent memory loss at times	Chronic, recent memory loss	Inability to Carry on any conversation	Mute or few incoherent words
Mild difficulty with verbal expression	Increased inability to comprehend and carry on a conversation	Difficulty with wayfinding	Bedridden or wheelchair bound
Decreased concentration	Difficulty in writing and using objects correctly	Misidentifies persons or objects	Minimally connected to surroundings
Slowed learning and reactions	Visual-spatial perception problems	Bladder incontinence	Little spontaneous movement
Seeks and prefers the familiar; avoids the unfamiliar	Possible delutions, hallucinations and agitation	Unsteady gait	Difficulty in eating and swallowing
Difficulty with planning and decisionmaking	Repetitive actions	Needs help with most or all activities of daily living	Seizures, muscle twitching
Some erros in judgment and calculation	May get lost at times, even inside the home		Cachexia
Lack of spontaneity and lessening of initiative	Needs reminder to perform activities of daily living		Requires total care

Excerpted from DR Kuhn. The normative crises of families confronting dementia

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