Assessment Tool: Global Deterioration Scale (GDS)

Select the stage that best reflects the patient's overall level of cognitive and functional decline based on clinical history and direct assessment. GDS staging supports care planning and goals-of-care conversations.

Global Deterioration Scale (GDS / Reisberg Scale)

A seven-stage framework for characterising the severity of primary degenerative dementia (e.g. Alzheimer's disease). Developed by Barry Reisberg, M.D. Used in staging care needs and communicating prognosis with families.

Note: GDS is a clinical staging tool, not a scored calculator. Select the stage that best matches the clinician's overall impression based on history, observation, and collateral information.

Stage 1 No subjective complaints of memory deficit

No memory deficit in clinical interview. Normal for age.

Normal aging. No functional impairment.

Stage 2 Very mild cognitive decline

Subjective forgetfulness: forgetting names and misplacing objects. No deficits in employment or social situations.

Age-associated memory impairment. Consistent with normal aging.

Stage 3 Mild cognitive decline

Earliest clear-cut deficits. Getting lost in unfamiliar areas, decreased work performance, difficulty word-finding, losing valuables.

Mild cognitive impairment (MCI). Detectable by objective testing. Anxiety often accompanies.

Stage 4 Moderate cognitive decline (Mild Alzheimer's)

Clear-cut deficit on careful interview. Decreased knowledge of current events, reduced memory of personal history, difficulty with complex tasks.

Mild dementia. Difficulty managing finances, travel, and complex ADLs. Some loss of insight may begin.

Stage 5 Moderately severe cognitive decline (Moderate Alzheimer's)

Patient cannot survive without assistance. Unable to recall major relevant aspects of current life (address, phone, names of grandchildren). Frequently disoriented.

Moderate dementia. Still able to recognise spouse and children. Toilet and eating ability retained.

Stage 6 Severe cognitive decline (Moderately severe Alzheimer's)

May occasionally forget spouse's name. Largely unaware of recent events; requires assistance with ADLs. Urinary/bowel incontinence common.

Moderately severe dementia. Personality and emotional changes common; delusions, compulsive behaviour, agitation.

Stage 7 Very severe cognitive decline (Severe Alzheimer's)

All verbal abilities lost. No basic psychomotor skills (walking, sitting, smiling). Brain appears unable to control body.

Severe dementia. Total ADL dependence. Aspirations, skin breakdown, and infections are major clinical concerns.