Denial begins to become manifest in patient. Mild to moderate anxiety accompanies symptoms. Deficits noticed in demanding employment situations. Clear-cut deficit on careful clinical interview. Inability to perform complex tasks.
Denial is dominant defense mechanism.
Flattening of affect and withdrawl from challenging situations occur. Patient can no longer survive without some assistance. An educated person may have difficulty counting back from 40 by 4s or from 20 by 2s. Persons at this stage retain knowledge of many major facts regarding themselves and others. They invariably know their own names and generally know their spouse's and children's names.