How To Identify Different Varieties And Symptoms Of Dementia

You may be aware that dementia can be a debilitating and progressive loss of brain function, but do you know how to recognize it? Dementia symptoms can be more varied than many people realize, and they can differ depending on the specific form of the disease. Learning about the characteristic features of dementia may help you recognize when you or a loved one needs to visit a neurologist or consider specialized care. 

Difficulties with memory tend to be the most common symptom of dementia, but impairments in language use, movement, and awareness of time and place also occur in many cases. These are only a few of the many possible symptoms, some of which may be specific to particular forms of dementia. Recognizing early warning signs may help individuals access more effective care and improve their long-term quality of life. Therapy can be an important part of treatment for both people with dementia and their caregivers.

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What is dementia?

The term “dementia” can refer to a broad range of specific illnesses involving a widespread decline in cognitive functions, such as memory, language use, awareness, and mental focus. 

The current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) refers to dementia as a “major neurocognitive disorder.” There are many different subtypes based on the various kinds of brain damage or degeneration that can cause cognitive decline. Different causes may produce different collections of symptoms. 

There’s a difference between dementia and the kind of mild forgetfulness that can be a normal part of aging. While many individuals with major neurocognitive disorders experience memory loss, occasionally misplacing objects or forgetting appointments as an older adult doesn’t necessarily mean that you’re developing dementia.

Symptoms of mild cognitive impairment

Many individuals who eventually develop dementia first experience a period of mild but gradually worsening dementia-like symptoms. This phenomenon is usually known as mild cognitive impairment or MCI. 

Many people with MCI never transition into dementia, and some can recover a significant amount of cognitive function. Identifying the signs and providing appropriate care may improve a person’s chances of avoiding or delaying the more debilitating symptoms of dementia.

Some of the above symptoms can also be seen in diagnosable cases of dementia. However, in MCI, they’re typically not severe enough to seriously impact a person’s ability to manage their day-to-day life safely and effectively.

Different forms of dementia and their symptoms

Rather than a single disease, dementia can be seen as a class of neurological and behavioral illnesses that can be caused by a variety of other health problems. The specific type of dementia a person develops can affect which symptoms they’re most likely to experience. 

Alzheimer’s disease symptoms

Alzheimer’s disease can be considered the most common variety of dementia. It’s believed to account for 60% to 80% of cases and ranks as the sixth most common cause of death in America. The disease generally involves the progressive degeneration of brain cells and neural connections due to the buildup of clumps and fibrous tangles of protein fragments. 

Early symptoms of Alzheimer’s disease can resemble a more severe version of MCI, including behaviors like asking the same question over and over or repeatedly losing track of important tasks and responsibilities. Some people may also exhibit pronounced changes in personality, such as becoming suspicious, paranoid, fearful, or prone to anger.

As the disease progresses, additional symptoms may include the following:

• Severe confusion about time and place
• Loss of memories of identity and personal history
• Inability to take in new information
• Challenges with logical thinking
• Severe difficulty using language, such as having trouble constructing coherent sentences or reading and writing
• Sleep schedule disruptions
• Major difficulty carrying out daily tasks, like getting dressed or preparing food
• Inability to consistently recognize family and friends
• Hallucinations or delusions
• Pronounced agitation, restlessness, and a tendency to wander away
• Impulsivity or inappropriate behavior
  

As Alzheimer’s disease progresses, the individual may lose all ability to direct their movement or communicate with others. Basic physical functions, such as swallowing and bladder control, may break down. Seizures, respiratory difficulties, and death can occur in late-stage Alzheimer’s disease.

While this type of dementia tends to be most common in people aged 65 and older, some individuals develop early-onset Alzheimer’s disease in their 30s or 40s. This form of the disease seems to be heavily influenced by genetic factors, and the symptoms may be more severe and progress more rapidly. 

Vascular dementia symptoms

Vascular dementia typically occurs when the blood vessels that feed the brain become damaged or blocked, causing dysfunction, injury, and death of the neural cells that depend on them. This can result from a variety of cardiovascular risk factors, including those listed below:

• Smoking
• High blood pressure
• Diabetes
• Obesity
• Heart fibrillations

The specific symptoms of vascular dementia may depend on which brain regions are most strongly affected. Common examples of vascular dementia symptoms include the following: 

• Difficulty completing everyday tasks
• Frequently getting lost 
• Challenges with learning new things
• Forgetting or losing things
• Sleep pattern changes
• Loss of language skills
• Personality, mood, and behavior changes, such as depression or aggression
• Impaired judgment

Many of the symptoms of vascular dementia are similar to those seen in Alzheimer’s disease, and researchers have found that the two illnesses often overlap. When they occur together, the patient may be diagnosed with mixed dementia.

Frontotemporal dementia symptoms

Also known as frontotemporal lobe dementia or FTD, this condition is normally caused by the degeneration of the brain's frontal and anterior temporal lobes. Like Alzheimer’s disease, abnormal protein deposits in brain tissues may play a significant role in this process. 

FTD is usually classified into two subtypes with distinct symptoms:

1. Behavioral variant frontotemporal dementia or bvFTD: This tends to be the most common type, characterized by progressive changes in personality, often involving inappropriate behavior or lack of impulse control. Below are several possible symptoms:

• • Lack of interest in things that the individual once considered important
  • Limited ability to plan and carry out multi-step tasks
  • Difficulty with organization and prioritizing
  • Repetitive speech and actions
  • Impulsive behavior, often involving rudeness, insensitivity, or lack of concern for ethics and consequences
  • Loss of motor control

2. Primary progressive aphasia or PPA: This variant can result from damage to the parts of the brain that control language. It can be further divided into two varieties:

• • Semantic variant of PPA: Usually causes loss of comprehension of the meaning of words, progressing to a lack of ability to recognize familiar objects and people
  • Nonfluent/agrammatic variant of PPA: Generally causes difficulty putting together sentences, often resulting in slow, halting speech and, sometimes, the loss of speaking ability

Certain kinds of movement disorders can also occur in FTD:

• Muscle weakness
• Lack of coordination
• Stiffness of limbs
• Changes in posture
• Difficulty walking

Lewy body dementia symptoms

Dementia with Lewy bodies, or LBD, can result from the accumulation of a protein called alpha-synuclein inside brain cells. This protein usually forms clumps known as Lewy bodies, which can disrupt neural function more and more as they build up. 

The most common symptoms of LBD include those listed below:

• Alzheimer’s-like symptoms, such as confusion, difficulty planning and carrying out tasks, impaired visual perception, and challenges with logical thinking; memory loss can also occur with LBD, but often appears later than in other forms of dementia
• Frequent and unpredictable changes in cognitive performance, such as staring into space for long periods, drowsiness, or sudden lapses into incoherent speech or thought; these changes can vary in severity from day to day
• Hallucinations, especially visual hallucinations
• Movement difficulties including slowness, stiffness, loss of coordination, limited facial expressions, difficulty balancing, and tremors
• Sleep disorders, especially REM sleep disorder, which can involve the person acting out their dreams — for example, fighting off imaginary attackers
• Dysregulation of autonomic functions like blood pressure, temperature, urination or defecation, and sexual response

LBD sometimes, but not always, occurs in people with Parkinson’s disease.

Symptoms of other forms of dementia

The four varieties listed above are usually seen as the most common types of dementia. However, other kinds of brain disease and damage can also cause dementia symptoms:

• Chronic traumatic encephalopathy (CTE) due to repeated traumatic head injury: Symptoms may include impulsive behavior, mood instability, personality changes, and difficulty with memory and cognition.
• Normal pressure hydrocephalus (NPH), an accumulation of cerebrospinal fluid in the brain: This may involve an odd walking pattern, mild forgetfulness and inattention, a decline in cognitive skills, and loss of bladder control.
• Creutzfeldt-Jakob disease (CJD), a rare brain disease involving misfolded proteins spreading through neural tissue: Symptoms tend to appear and worsen rapidly and may include confusion, mood changes or mood swings, memory problems, muscle stiffness and twitching, vision problems, and disorientation.

Preventing and managing symptoms of dementia

Many medical professionals view an early dementia diagnosis as a significant factor in achieving better outcomes. Recognizing the illness when it’s first developing can enable patients and their loved ones to plan for their future care. In some cases, it might also be possible to slow mental decline with strategies like cognitive training. 

Building up your resistance to dementia before symptoms appear may be an even more effective strategy. Evidence suggests that individuals whose brains are highly active throughout their lives may develop a “cognitive reserve” that can protect against dementia. You may be able to cultivate your cognitive reserve through regular physical exercise and mentally stimulating activities like learning new skills, reading books, playing challenging games, and engaging in creative hobbies.

Taking care of your mental health could also benefit your brain function. Some studies suggest that depression can be a risk factor for dementia, and treating it might have a protective effect. By talking with a psychotherapist when challenging feelings or difficult life circumstances arise, you might reduce your long-term risk of dementia.

If you’re not sure how to find the time for mental health care, you may want to explore internet-delivered therapy. Online therapy sessions are often easier to fit into your schedule since providers typically have greater flexibility, and you can attend appointments without leaving the house.

Researchers are increasingly finding that internet-based interventions can work well for many mental health disorders. For example, a 2020 meta-analysis reviewed 17 different studies and concluded that online cognitive-behavioral therapy appeared to be equally effective at treating depression as face-to-face sessions. Taking the time to talk with a therapist online about symptoms of depression might help you avoid dementia later in life.