The global deterioration scale (GDS) is a reliable tool for assessing the progression of primary degenerative dementia. Developed in 1982 by Dr. Steven Roth, GDS consists of seven stages that measure global cognitive decline over time. GDS is used to classify individuals according to their level of impairment and can help healthcare professionals provide better treatment and support.
At Compassus, we use GDS to assess and monitor the condition of our patients. We believe the global deterioration scale is valuable in providing comprehensive care for those with primary degenerative dementia. Reach out to us at 833.380.9583 to better understand the global deterioration scale and how we use this tool with our patients.
Assessing Degenerative Dementia (GDS)
1. No Cognitive Decline
2. Very Mild Cognitive Decline
Subjective complaints of memory deficit, most frequently in the following areas:
- Forgetting the location of objects
- Forgetting familiar names
There is no objective evidence of memory deficit in the clinical interview, employment, or social situations—appropriate concern for symptomatology.
3. Mild Cognitive Decline
Earliest clear-cut deficits. Manifestations in more than one of the following areas:
- The patient may have gotten lost when traveling to an unfamiliar location
- Co-workers become aware of the patient’s relatively poor performance
- Word- and name-finding deficit becomes evident to intimates
- The patient may read a passage or a book and retain relatively little material
- The patient may demonstrate decreased facility in remembering names upon introduction to new people
- The patient may have lost or misplaced an object of value
- Concentration deficit may be evident in clinical testing
4. Moderate Cognitive Decline
A clear-cut deficit in a thorough clinical interview. Deficit manifests in the following areas:
- Decreased knowledge of current and recent events
- May exhibit some deficit in memory or personal history
- Concentration deficit elicited on serial subtractions
- Reduced ability to travel, handle finances, etc
Frequently no deficit in the following areas:
- Orientation to time and person
- Recognition of familiar persons and places
- Ability to travel to familiar locations
- Inability to perform complex tasks
Denial is a dominant defense mechanism. Flattening of effect and withdrawal from challenging situations occur.
5. Moderately Severe Cognitive Decline
The patient can no longer survive without some assistance. During the interview, they cannot recall a significant relevant aspect of their current life (e.g., an address or telephone number of many years, the name of close family members such as grandchildren, or the name of the high school or college from which they graduated).
Frequently some disorientation to time (date, day of the week, season, etc.) or place. An educated person may have difficulty counting back from 40 by 4’s or 20 by 2’s. Patients at this stage retain the knowledge of many major facts regarding themselves and others.
They invariably know their names and their spouse’s and children’s names. They require no assistance with toileting and eating but may have difficulty choosing the proper clothing and may occasionally dress themselves improperly (e.g., putting shoes on the wrong feet).
6. Severe Cognitive Decline
They may occasionally forget the name of a spouse upon whom they are entirely dependent for survival. They will be largely unaware of all recent life events and experiences. Retain some knowledge of their past lives, but this is very sketchy. Generally unaware of their surroundings, the year, the season, etc.
They may have difficulty counting from 10, both backward and sometimes forward. Will require some assistance with activities of daily living (e.g., may become incontinent), will require travel assistance but occasionally will display the ability to travel to familiar locations.
Their daily rhythm is frequently disturbed. They can almost always recall their name. Frequently continue to be able to distinguish from unfamiliar persons in their environment. Personality and emotional changes occur. These are quite variable and include the following:
- Delusional behavior (e.g., patients may accuse their spouse of being an impostor, may talk to imaginary figures in the environment or their reflection in the mirror)
- Obsessive symptoms (e.g., a person may continually repeat simple cleaning activities)
- Anxiety symptoms, agitation, and previously nonexistent violent behavior may occur
- Cognitive abulia (i.e., loss of willpower because an individual cannot carry a thought long enough to determine a purposeful course of action)
7. Very Severe Cognitive Decline
All verbal abilities are lost. Frequently there is no speech at all—only grunting. They may be incontinent of urine and require assistance with toileting and feeding. These patients lose basic psychomotor skills (e.g., the ability to walk). The brain appears to no longer be able to tell the body what to do. Generalized and cortical neurological signs and symptoms are frequently present.
Learn More About the Global Deterioration Scale at Compassus
At Compassus, we understand the importance of assessing and monitoring the condition of our patients. We use the global deterioration scale (GDS) to evaluate and monitor primary degenerative dementia. Our team is dedicated to providing comprehensive care for those suffering from this debilitating disorder. Please contact us any time if you want more information on GDS and how it can help provide better treatment and support. We are here to help! Call us today at 833.380.9583.
