Dementia is a broad term used to describe a group of symptoms that occur when brain cells stop working properly. It is certain diseases that damage the brain and cause dementia.
This post will explain the different dementia types, their symptoms, progression and where to go for further advice and support.
Alzheimer’s disease is the most common cause of dementia, affecting around 500,000 people in the UK.
It is a progressive disease that develops slowly over time and in early stages, it can be difficult to distinguish Alzheimer’s from mild forgetfulness, which can be seen in normal ageing.
People with Alzheimer’s have a shortage of some important chemicals in their brain. These chemical messengers help to transmit signals around the brain and when there is a shortage of them, the signals are not transmitted as effectively.
Over time, more parts of the brain become more damaged and the symptoms become more severe.
The symptoms of Alzheimer’s disease can be broken down into earlier symptoms and later symptoms.
Typical early symptoms of Alzheimer’s may include:
- Forgetting recent events, names and faces
- Becoming increasingly repetitive, e.g. repeating questions after a very short interval
- Misplacing items or putting them in odd places
- Uncertainty about the date or time of day
- Unsure of their whereabouts or getting lost, particularly in unusual surroundings
- Becoming low in mood, anxious or irritable, losing self-confidence or showing less interest in what’s happening
The rate at which Alzheimer’s progresses is different with every person. As it progresses, more symptoms may occur or worsen, such as:
- Degraded ability to remember, think and make decisions
- Communication and language become more difficult
- Difficulty recognising familiar faces or household objects
- Difficultly in day-to-day tasks, for example eating, dressing, using a TV remote control, phone or kitchen appliance
- Some people become sad, depressed or frustrated about the challenges they face. Anxieties are also common and people may seek extra reassurance or become fearful or suspicious
- People may experience hallucinations, where they may see things or people that aren’t there
- People may become increasingly unsteady on their feet and are at greater risk of falling
Current treatments do not unfortunately stop the disease, but medication is available to those with Alzheimer’s that helps to delay the decline of memory loss, thinking, language and thought process.
Different options to ease the symptoms can be discussed with your GP.
Vascular dementia is the most widely recognised as the second most common cause of dementia and can occur when blood flow to the brain becomes reduced.
In some cases, people may have both vascular dementia and Alzheimer’s – this is known as mixed dementia.
Vascular dementia is sometimes given more specific names based on the changes in the brain that cause it. The most common of these are:
- Stroke-related dementia – vascular dementia that develops after a stroke (called post-stroke dementia) or after a series of small strokes (called multi-infarct dementia).
- Subcortical vascular dementia – vascular dementia that is caused by changes to very small blood vessels in the brain (often referred to as small vessel disease).
The speed of progression for vascular dementia varies from person to person and there may be a sudden change in progression after events such as a stroke.
Vascular dementia can have symptoms similar to Alzheimer’s and other forms of dementia.
Symptoms of vascular dementia include memory loss, disorientation and problems with communication. In addition to this, there may also be more specific symptoms and these may differ depending on the area of the brain that is affected.
These may include:
- Thinking skills – taking more time to process information and having problems with attention, planning and reasoning.
- Personality changes – these may include depression and losing interest in things. People may also become more emotional.
- Movement problems – difficulty walking or changes in the way a person walks.
- Bladder problems – frequent urge to urinate or other bladder symptoms. This can be common in older age, but can be a feature of vascular dementia when seen with other symptoms.
The symptoms of vascular dementia get worse over time. In the later stages, the symptoms become more widespread and people need help eating, dressing and toileting.
Similar to Alzheimer’s, there is currently no specific treatment available, however you can go to your doctor to discuss medication and other methods to reduce the rate of the symptoms.
Dementia with Lewy bodies
Dementia with Lewy bodies (DLB) is thought to be the actual second most common dementia, due to high instances of wrongly diagnosing the condition as something else, such as Parkinson’s disease.
It is caused by small round clumps of a protein that build up inside nerve cells in the brain. The proteins formed are called Lewy bodies and they damage the way nerve cells work.
In DLB, the nerve cells that are affected by Lewy bodies are in areas of the brain that control thinking, memory and movement.
People with DLB can also show some changes in the brain that are typical of Alzheimer’s. This sometimes makes it hard to tell the difference between the two diseases.
In DLB, there are some more specific symptoms associated with the disease.
These symptoms include:
- Unpredictable changes in alertness, attention and confusion
- Parkinson’s disease-type symptoms such as slowed movements, muscle stiffness and tremors
- Visual hallucinations – seeing things that are not really there
- Sleep disturbances – acting out dreams or shouting out while sleeping, which can disrupt sleep and potentially cause injury
- Fainting, unsteadiness and falls
DLB is a progressive condition, which means symptoms get worse over time. As the disease progresses, people will need increasing help with eating, moving, dressing and toileting.
DLB can progress slowly over several years but the speed of progression and type of symptoms can vary from person to person.
Frontotemporal dementia (FTD) is caused by damage to cells in areas of the brain called the frontal and temporal lobes.
The frontal lobes regulate our personality, emotions and behaviour, as well as reasoning, planning and decision-making.
The temporal lobes are involved in the understanding and production of language. This can cause different types of FTD:
- Behavioural variant frontotemporal dementia – parts of the frontal lobe that regulate social behaviour may be most affected.
- Semantic dementia – parts of the temporal lobe that support understanding of language and factual knowledge are most affected.
- Progressive non-fluent aphasia – parts of the frontal and temporal lobes that control speech are most affected.
Early symptoms of FTD vary from person to person and depend on which area of the brain is affected. Symptoms may include:
- Personality changes – may include change in how people express their feelings towards others or a lack of understanding of other people’s feelings
- Lack of personal awareness – may fail to maintain their normal level of personal hygiene and grooming
- Lack of social awareness – may include making inappropriate jokes, or showing a lack of tact
- Changes in food preference, over-eating or over-drinking
- Behaviour changes – humour or sexual behaviour may change
- Difficulty with simple plans and decisions
- Communication difficulties
- Difficulty recognising people or knowing what objects are for
- Day-to-day memory may be relatively unaffected in the early stages, but problems with attention and concentration could give the impression of memory problems
- Movement problems – this may include stiff or twitching muscles, muscle weakness and difficulty swallowing
Symptoms get worse over time, gradually leading to more widespread problems with day-to-day function. Some people may develop motor problems similar to those seen in Parkinson’s.
Over time people with FTD can find it harder to swallow, eat, communicate and move. The speed of change can vary widely but as time progresses they will require more support to look after themselves.
Dementia advice and support
Whichever type of dementia you may be dealing with, there is always help and support available.
Accessing services and support can make a real and positive difference to someone with dementia and their family.
Some services are provided by local authorities and others can be arranged through GPs. The type of services available may vary depending on where you live, but can include home, day and respite care.
There’s also a range of technology available that can be invaluable to those living with dementia.
In addition to this, we’ve listed some of our favourite dementia charities that can help you out, regardless of the dementia type.
We hope this information has been helpful for understanding the different dementia types and always remember that there is help and support on hand.