Dementia results in the loss or deterioration of cognitive functions such as memory, thinking, and decision making. Advanced or severe dementia is a later stage that results in greater impairment of physical and cognitive functions.

The Centers for Disease Control and Prevention (CDC)Trusted Source note that about 5 million people ages 65 and over were living with dementia in 2014. They predict that this number will rise as high as 14 million by 2060.

Advanced dementia is a later stage of dementia. It results in increased loss of body and brain functions.

This article will explore what advanced dementia is, the signs and symptoms of the condition, and the treatment options available. It will also explore how a person may support an individual with advanced dementia and cover some frequently asked questions about the condition.

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Advanced dementia is a severe form of dementia that typically occurs during the later stages of dementia. In addition to the loss of cognitive function, an individual with advanced dementia may experience symptoms that affect other parts of the body.

According to a 2020 reviewTrusted Source, most people with advanced dementia will need additional care, including institutional care, to help them manage these symptoms.

Symptoms of advanced dementia may include:

  • severe forgetfulness
  • increased need for help with personal hygiene, including assistance to use the toilet
  • reduced mobility
  • inability to speak
  • breathlessness
  • pain
  • increased health complications, such as respiratory or urinary infections
  • problems with eating
  • difficulty swallowing
  • psychiatric symptoms, such as agitation and lack of interest

Different treatment options are available for advanced dementia, including medication and ongoing care support. The most suitable option for an individual will depend on the severity and type of advanced dementia.

The CDCTrusted Source notes that there is no specific drug treatment for advanced dementia, but a doctor may prescribe medication to ease the condition’s symptoms. Possible medications include:

  • Donepezil (Aricept): This medication belongs to a class of drugs called cholinesterase inhibitors. It can help treat the cognitive symptoms of advanced dementia.
  • Memantine (Namenda): This medication belongs to a class of drugs called glutamate regulators. A doctor may prescribe it for moderate to severe dementia. It can help treat cognitive symptoms and improve a person’s ability to perform simple tasks.
  • A combination of donepezil and memantine (Namzaric): A doctor may prescribe this to treat moderate to severe dementia.
  • Rivastigmine (Exelon): This is another type of cholinesterase inhibitor. A doctor may prescribeTrusted Source this to treat mild, moderate, or severe dementia due to Alzheimer’s disease.

Some medications, such as cholinesterase inhibitors, may not be beneficial in all cases of advanced dementia. A 2022 studyTrusted Source found that discontinuing cholinesterase inhibitors in those with advanced dementia did not result in the decline of cognitive function.

An older 2015 articleTrusted Source states that healthcare professionals should prescribe daily medications that align with the goals of the treatment plan and stop prescribing medications that do not appear to be beneficial.

A 2019 article suggests that about 50% of people with dementia have behavioral and psychological symptoms of dementia (BPSD). Doctors may consider prescribing antipsychotic medications to treat these symptoms. However, these medications can carry a risk of severe side effects, such as cardiovascular events, in older adults.

Other forms of treatment may depend on the symptoms a person is experiencing and the type of dementia.

Non-pharmacological treatment options

Doctors may also suggest non-pharmacological options to treat BPSD. The most appropriate non-pharmacological treatment may vary depending on the symptoms a person with advanced dementia is experiencing.

Non-pharmacological treatment options may include physical exercise, art therapy, and cognitive therapy.

It is important for caregivers to offer support to a person with advanced dementia. This may involve creating a clear routine, communicating well, and assisting with sensitive care such as personal hygiene. A person with advanced dementia may also benefit from the emotional or spiritual comfort a caregiver can provide.

According to the National Institute on Aging (NIA)Trusted Source, targeting the senses may bring comfort to a person with advanced dementia and help reduce agitation. Caregivers can target a person’s senses by playing music, white noise, or nature sounds or providing physical contact such as a massage.

A person supporting an individual with advanced dementia may also aid in selecting hospice or palliative care when the symptoms progressively worsen and the individual needs more support.

According to a 2020 reviewTrusted Source, most people with advanced dementia will need long-term palliative or hospice care and will experience a range of symptoms and complications.

However, organizations such as the NIATrusted Source are available to provide support to people with advanced dementia and their caregivers, and doctors may be able to ease symptoms with medication.

Advance care planning (ACP) allows people with dementia to record their decisions about treatment, future support, and end-of-life care.

It is important to have these conversations early, while the person with dementia can make shared decisions. ACP helps caregivers stick to a person’s wishes when the symptoms of advanced dementia progress and the person becomes less able to communicate and make decisions.

A 2020 review suggests that ACP may improve end-of-life care for people with dementia and that it has an association with lower numbers of hospitalizations for people with dementia.

A person should consult a doctor if they or someone close to them is experiencing the symptoms listed above or if someone with dementia is experiencing worsening symptoms, such as severe memory loss or difficulty carrying out day-to-day activities.

Here are some frequently asked questions about advanced dementia.

How long can you live with advanced dementia?

According to a 2020 reviewTrusted Source, people with dementia have shorter life expectancies than those without dementia. The average survival time after a dementia diagnosis is 4–5 years.

Life expectancy with dementia may depend on factors such as age, sex, and the type of dementia a person has. However, it is difficult to accurately predict the survival time of a person with advanced dementia.

Is advanced dementia a cause of death?

The cognitive symptoms of dementia do not usually directly result in death. However, a person with advanced dementia can develop complications, such as an increased riskTrusted Source of pneumonia, which can be life threatening.

Pneumonia is an infection of the lungs that results in the buildup of fluid or pus in the air sacs of the lungs.

Advanced dementia is a form of dementia that results in increased loss of cognitive and bodily functions.

Symptoms of advanced dementia include severe memory loss and an increased need for help with tasks such as personal hygiene and grooming, using the toilet, and moving around.

A doctor may prescribe drug treatment depending on the severity of the advanced dementia, but some people may be better suited to alternatives such as ongoing care.

A person with advanced dementia may receive comfort through palliative or hospice care, emotional and spiritual support, or activities that engage their senses, such as massages or listening to music.