The term dementia can be confusing as it is not a disease. It’s a word used to describe a group of symptoms that occur when brain cells stop working properly. This happens inside specific areas of the brain, it affects the ability to think, remember and communicate. But there is more that just one type of dementia. Which is even more confusing as there are different types of dementia.
Types of Dementia
Alzheimer’s disease is the most common cause of dementia, but there are other types of dementia too. It is possible to have more than one type of dementia at the same time. Alzheimer’s is sometimes seen with vascular dementia or dementia with Lewy bodies. You might hear this called ‘mixed dementia’.
Alzheimer’s is a disease that causes dementia. It’s the most common cause of all the different types dementia, accounting for about two-thirds of cases in older people. It often develops slowly over many years. It is not always obvious to see that someone is suffering with Alzheimer’s to begin with as symptoms can be subtle and overlap with other illnesses such as depression. In the early stages, it can sometimes be difficult to distinguish Alzheimer’s from mild forgetfulness which can be seen in normal ageing.
Everyone with Alzheimer’s will experience symptoms in their own way, but certain changes are characteristic of the disease.
Early symptoms of Alzheimer’s may include:
- Regularly forgetting recent events, names and faces.
- Becoming increasingly repetitive, e.g. repeating questions after a very short interval.
- Regularly misplacing items or putting them in odd places.
- Uncertainty about the date or time of day.
- A person becoming unsure of their whereabouts or getting lost, particularly in unusual surroundings.
- Problems finding the right words.
- Becoming low in mood, anxious or irritable, losing self-confidence or showing less interest in what’s happening.
Alzheimer’s progressively gets worse over time, but the speed of change varies from person to person.
As the disease progresses:
- People find that their ability to remember, think and make decisions worsens.
- Communication and language become more difficult.
- People may have difficulty recognising household objects or familiar faces.
- Day-to-day tasks become harder, for example using a TV remote control, phone or kitchen appliance. People may also have difficulty locating objects in front of them.
- Changes in sleep patterns often occur.
- 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.
- Daily activities like dressing, toileting and eating become more difficult, and people gradually require more help.
It’s confusing with all the different types of dementia that exist but it’s so important to get the right diagnosis to determine which dementia your parent has and how you can support them. Vascular dementia is a type of dementia, with people suffering the symptoms of memory loss, disorientation and problems with communication. There can 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 apathy (becoming less interested 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. Vascular dementia normally progresses over several years. Like all the other different types of dementia the speed of progression can vary over time and from person to person. There may be a sudden or stepwise change after an event such as a stroke.
Dementia with Lewy’s bodies (DLB)
Different types of dementia include Dementia with Lewy’s Bodies (known as DLB). It can cause common dementia symptoms including memory loss, spatial awareness problems and a decline in problem-solving skills. There are also some more specific symptoms associated with the disease. Some of which are also seen in Parkinson’s dementia.
These symptoms include:
- Changes in alertness, attention and confusion, which may be unpredictable and change from hour to hour or day to day.
- Parkinson’s disease-type symptoms such as slowed movements, muscle stiffness and tremors.
- Visual hallucinations – seeing things that are not really there, e.g. people or animals. These often happen repeatedly and are realistic and well-formed.
- Sleep disturbances – acting out dreams or shouting out while sleeping, which can disrupt sleep and potentially cause injury.
- Fainting, unsteadiness and falls.
Similar to all the other different types of dementia 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)
Frontotemporal dementia or FTD (sometimes called Pick’s disease) is a relatively rare form of dementia. The early symptoms of FTD vary from person to person and depend on which area of the brain is affected.
In behavioural variant frontotemporal dementia, the parts of the frontal lobe that regulate social behaviour may be most affected. In semantic dementia, the parts of the temporal lobe that support understanding of language and factual knowledge are most affected. In progressive non-fluent aphasia, parts of the frontal and temporal lobes that control speech are most affected.
Symptoms may include:
- Personality changes. This may include a change in how people express their feelings towards others or a lack of understanding of other people’s feelings. They may also show a lack of interest or concern, become disinhibited or behave inappropriately.
- Lack of personal awareness. People may fail to maintain their normal level of personal hygiene and grooming.
- Lack of social awareness. This might 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. People may become more aggressive, develop unusual beliefs, interests or obsessions. Some people become impulsive or easily distracted.
- Difficulty with simple plans and decisions.
- Lack of awareness of any changes in personality or behaviour.
- Decline in language abilities. This might include difficulty getting words out or understanding them. People may repeat commonly used words and phrases, or forget the meaning of words.
- 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 – about one in every eight people with behavioural variant FTD also develops movement problems of motor neurone disease. This can include stiff or twitching muscles, muscle weakness and difficulty swallowing.
Similar to the other types of dementia symptoms get worse over time, gradually leading to more widespread problems with day-to-day function. Some people may develop motor problems like those seen in Parkinson’s. Over time people with FTD can find it harder to swallow, eat, communicate and move. They will require more support to look after themselves. The speed of change can vary widely, but some people live with the condition for more than 15 years.
Creutzfeldt-Jakob disease known as CJD is caused by an abnormally shaped protein called prion which infects the brain. Proteins are molecules made up of amino acids, which help the cells in the body function properly. But with the CJD it begins as a string of amino acids then turning themselves into a three dimensional shape. The disease usually affects people over the age of 40 and is one of the most common causes of dementia. CJD is said to affect one in every 1 million people each year. Diagnosis can be difficult as a range of causes including Alzheimer’s disease and vascular dementia need to be ruled out first as the symptoms are very similar.
Symptoms may include:
- Forgetfulness with minor lapses of memory.
- Changes in behaviour and mood with loss of interest.
- Clumsiness, feeling muddled and confused.
- Low movement and speech abilities including becoming unstable and having slow or slurred speech.
- Symptoms can progress to jerky movements, shakiness and stiffness of limbs.
- Incontinence and loss of ability to move or speak.
- Difficulties with awareness of their surroundings or disabilities.
The different types of dementia are very similar but with CJD, unfortunately people affected usually die within six months to a year of their early symptoms developing. Although a small number of people affected by the disease may take longer to run it’s course.
Young-onset dementia is when people younger than the age of 65 are experiencing symptoms of dementia. It is caused by a wide range of diseases that cause young-onset dementia and younger people are said to experience a rarer form of dementia. A significant difference to all the different types of dementia already mentioned, early-onset dementia is more likely to be hereditary than late on-set dementia. Around 10 percent of all people with young-onset dementia seems to have been inherited from a parent.
Symptoms may include:
- Problems with movement including walking, co-ordination and balance.
- Memory loss and difficulty determining time and places.
- Problems with planning and solving problems.
- Vision loss and speech problems.
- Misplacing items, thinking they are lost.
- Difficulty making decisions
The dementia progresses more quickly if the person is physically unwell, so it’s very important that they try to take care of themselves. Including having regular exercise, refraining from smoking and alcohol, trying to have a better healthy diet and keeping fit, staying at a healthy weight.
Rarer Types of Dementia
As already mentioned, Alzheimer’s disease is the most common cause of dementia, but there are other rarer diseases conditions that can lead to dementia. 5 percent of all dementia cases in the UK are caused by the more rarer forms of dementia. The rarer forms of dementia are as follows:-
- Corticobasal degeneration (CBD)
- Huntington’s disease
- Multiple sclerosis (MS)
- Niemann-Pick disease type C
- Normal pressure hydrocephalus (NPH)
- Parkinson’s disease dementia (PDD)
- Posterior cortical atrophy (PCA)
- Progressive supranuclear palsy (PSP)