Dementia is the term given to a set of symptoms that occur when cells in the brain stop working normally. There are different types of dementia and they can share similar symptoms, which makes diagnosing the different types of dementia complicated.
Symptoms of dementia include memory loss, difficulty communicating, confusion, and sudden mood changes. Dementia can be stressful and frightening for both the patient and the people who love them. Unfortunately dementia is non-reversible, but early diagnosis can help give more time to make plans for patient care, and to ensure dementia patients receive the right type of support for their needs as soon as possible.
Types of Dementia
Whilst dementia itself is not a disease, there are some diseases, such as Alzheimer’s, which cause it. Sometimes different types of dementia are present in a patient at the same time. When this happens, it is known as mixed dementia.
Information about the different types of dementia is available below. At the bottom of the page, there is some advice about what to do after dementia has been diagnosed.
What is Alzheimer’s?
Alzheimer’s is actually a disease, and is the most common cause of dementia. Of the 850,000 people with dementia in the UK, approximately two thirds of them has been diagnosed with Alzheimer’s disease.
In normal ageing there are changes which occur in the brain. For people with Alzheimer’s disease, these changes can be accelerated and more severe. As Alzheimer’s progresses, more and more nerve cells in the brain become damaged. This damage leads to the symptoms of Alzheimer’s.
What causes Alzheimer’s?
The causes of Alzheimer’s are not wholly understood, but it is believed to be triggered by a build of proteins.
Whilst not typical of the ageing process, Alzheimer’s is more common in older age. Only about 5% of people diagnosed with Alzheimer’s disease are under the age of 65. The symptoms of early-onset Alzheimer’s are largely similar to those experienced by older sufferers.
YoungDementia UK can advise on specialised services for people with young-onset dementia and their families.
What are the symptoms of Alzheimer’s?
Symptoms of Alzheimer’s typically include confusion and forgetfulness. Sufferers may find it more difficult to identify people, remember where they are, or misplace items. It can become difficult to remember words and to communicate with others. These symptoms can cause a drop in self-confidence. Irritability and low mood are also common symptoms of Alzheimer’s.
As the disease develops, Alzheimer’s patients sometimes experience hallucinations. Others may believe things to be true that haven’t actually happened, known as ‘delusions’.
Mobility issues can develop, with people finding it difficult to walk. Swallowing food may also become difficult, which can require a change in diet. Alzheimer’s sufferers might also experience seizures.
As the disease progresses, help with daily activities like dressing, eating and using the toilet is often needed.
Because initial symptoms of Alzheimer’s can be subtle, it is sometimes difficult for a diagnosis to be made. The Doctor may suggest further testing at a later date to make a comparison, or make a referral to a specialist. MRI, CT, or SPECT scans might be required, or a lumbar puncture to test spinal fluid.
Unfortunately there are no treatments available for Alzheimer’s, though research continues.
People in the early stages of Alzheimer’s might be offered a type of drug called a cholinesterase inhibitor. It works by aiding the production of chemicals which help messages travel around the brain, which can help function at a higher level for longer.
The life expectancy of someone diagnosed with Alzheimer’s is, on average, 6 – 8 years. Alzheimer’s can go undiagnosed for quite some time, and the age at which someone is diagnosed can also have an effect on life expectancy.
Support for Alzheimer’s
A Doctor or specialist can help plan how to manage the symptoms of Alzheimer’s. There are also support groups available.
For more information about Alzheimer’s:
- Alzheimer’s Research UK
- Alzheimer’s Association
- In this article on our website, Jane Yendall describes her experience of her Mother’s Alzheimer’s progression.
What is vascular dementia?
Vascular dementia is a type of dementia caused by a problem with blood flow to the brain. About 17% of people diagnosed as having dementia will have vascular dementia. It is the second most common form of dementia. Like most types of dementia, vascular dementia is usually rare in people under the age of 65.
What causes vascular dementia?
If there is a problem with blood circulation to the brain, cells in the brain can become damaged and stop working properly. Vascular dementia is a broad term given to the conditions which happen as a result of this.
The brain’s blood supply can be affected by small blood clots which stop oxygen getting to the brain tissue. These are sometimes referred to as Transient Ischaemic Attacks, or TIAs. Damage can also be caused if arteries become blocked, or if blood vessels within the brain burst (known as a brain haemorrhage).
After a TIA takes place, there is sometimes a small recovery period, though this might only be temporary if brain cells have been damaged by a lack of oxygen. This pattern is sometimes referred to as ‘stepwise progression’.
What are the symptoms of vascular dementia?
People suffering from vascular dementia might experience slowness of thought, taking longer to process and act on information. Concentration levels may drop, and there might be feelings of disorientation and an ability to understand.
Vascular dementia can cause sufferers to feel depressed and apathetic, with bursts of emotion. Memory recall and the ability to remember words and communicate can worsen. Mobility issues can develop, with difficult balancing and walking.
The symptoms of vascular dementia can vary depending on which part of the brain has been damaged.
Diagnosing vascular dementia?
There isn’t a set test for making a diagnosis of vascular dementia. The Doctor will consider medical history and symptoms, and might request an MRI, CT, or SPECT scan to look for signs of dementia and any possible damage to the brain’s blood vessels.
Treating vascular dementia
There is no cure for vascular dementia, though there are treatments which can help slow it down.
Treatment for vascular dementia focuses on the reducing the risk of the causes of it. This might include cutting down on or quitting smoking,exercising, tackling obesity and lack of exercise and other ‘lifestyle’ factors which carry a higher risk.
Support for vascular dementia sufferers
Admiral Nurse Dementia Helpline, Call 0800 888 6678
Dementia with Lewy bodies (DLB)
What is dementia with Lewy bodies (DLB)?
Also known as Lewy body dementia, DLB occurs when proteins group together inside brain cells. These protein deposits are known as Lewy bodies. They typically form in the parts of the brain which control thinking, vision, and muscle movement.
This protein build-up also happens with Parkinson’s disease, and dementia with Lewy bodies is sometimes misdiagnosed as this.
It is not understood what causes the protein build-up or how it is a problem, though research into it is ongoing.
Symptoms of Lewy bodies dementia
DLB can cause unpredictable levels of attention. The ability to concentrate might fluctuate considerably between alertness and sleepiness over a period of hours or days.
Movements can become difficult, and sufferers might experience muscle stiffness or tremors. People with dementia with Lewy bodies might have hallucinations, and sleep might become severely disturbed. DLB can also cause fainting and unsteadiness, and falls.
Fainting, unsteadiness and falls.
Diagnosing dementia with Lewy bodies
As with most types of dementia, there is no single method of making a diagnosis for Lewy bodies dementia.
A doctor will take a medical history and consider all symptoms. A follow-up appointment might be suggested in order to make a comparison of how symptoms progress, and ability to respond to questions and cognitive tests.
MRI, SPECT, and CT scans might be required to check for damage to the brain and any indication of dementia.
Treating Lewy bodies dementia
Sadly there is not a cure for DLB, or any treatments which can help to slow its progress.
The symptoms of dementia with Lewy bodies become worse over time. The rate of progression can vary from person to person, but usually it takes place over several years.
Support for dementia with Lewy bodies
The NHS website goes into more detail about dementia with Lewy bodies:
Frontotemporal Dementia (FTD)
What is frontotemporal dementia?
The front and the sides of the brain are known as the frontal and temporal lobes. Frontotemporal dementia is a type of dementia which affects these areas.
Whilst dementia usually affects people aged 65 and older, frontotemporal dementia (FTD) can start at a much younger age. Typically people diagnosed with FTD are aged between 45 – 65.
FTD (sometimes referred to as Pick’s disease, or progressive aphasia) is one of the more rare types of dementia in older people, though for people aged under 65 it is the third most common type.
What causes frontotemporal dementia?
Proteins build up in the frontal (behind the forehead) and temporal (either side) lobes of the brain. This protein build-up causes nerve cells to die, affecting the way which messages are transmitted in the brain.
What are they symptoms of frontotemporal dementia?
Frontotemporal dementia affects the areas of the brain which deal with behaviour, problem-solving, planning and the control of emotions, speech and the meaning of words and the names of objects, and recognising faces and familiar objects. Damage to these areas usually means that people who have frontotemporal dementia struggle with these things.
People suffering with frontotemporal dementia develop personality changes, including how they express their feelings, and lack an understanding of other people’s feelings. They may show a lack of interest, and also become uninhibited, causing inappropriate behaviour. Personal and social awareness can be affected, so personal hygiene and grooming might decline.
Around one in every eight people with behavioural variant FTD also develop movement problems or motor neurone disease. This can include stiff or twitching muscles, muscle weakness and difficulty swallowing.
As frontotemporal dementia progresses, some people might develop motor problems similar to those seen in Parkinson’s, and find it harder to swallow, eat, communicate, and move.
Diagnosing frontotemporal dementia
There is no straightforward way to diagnose frontotemporal dementia. A doctor or specialist may make an assessment of mental abilities over a period of time, in order to make a comparison. MRI, CT or PET scans can help identify which parts of the brain are affected, and to rule out any other issues with the brain. Blood tests or a lumbar puncture might be required to rule out conditions which have similar symptoms.
Treating frontotemporal dementia
Unfortunately there is no cure for frontotemporal dementia though research is ongoing.
There are medications and treatments which can help manage some of the symptoms. Antidepressants and antipsychotic medicines may help reduce the behavioural problems associated with frontotemporal dementia.
Support for frontotemporal dementia
Young Dementia UK, 01993 776295, YoungDementia UK, PO Box 315, Witney, Oxfordshire, OX28 1ZN,
Other Types of Dementia
Though they are much more rare, there are other types of dementia. 5% of all dementia cases in the UK are caused by rarer forms of dementia.
Corticobasal degeneration (CBD)
A type of dementia that occurs when the surface and a deep part of brain is damaged by the build-up of a protein called tau.
A hereditary type of dementia which takes about 20 years to progress, usually starting to appear when a person is aged 30 – 50.
Niemann-Pick disease type C
A very rare disease which affects all ages, caused by a build-up of lipids (fats) which damages brain cell function.
Normal pressure hydrocephalus (NPH)
This occurs when fluid build up on the brain, causing damage to its cells sometimes resulting in lasting dementia.
Parkinson’s disease dementia (PDD)
Parkinson’s disease dementia develops when the brain’s cells are damaged by a buildup of proteins which form into clumps called Lewy bodies. The difference between this and Lewy bodies dementia is generally accepted as being down to the timing of when symptoms appear.
Posterior cortical atrophy (PCA)
Brain cells at the back of the head become damaged, affecting the ability to judge distances, recognise people and objects, and tolerate light.
Progressive supranuclear palsy (PSP)
Caused by protein building up in the brain, this is a progressive condition which affects speech, balance, movement, vision, and swallowing.
Also known as CJD, symptoms include shaking, stiffness of limbs, incontinence, and an inability to move or speak.
After a Diagnosis
A diagnosis of any sort of dementia can be very upsetting. To try and lessen at least some of the anxiety, our information guides might be useful to help understand what practical things can be done next.