Recognizing The Symptoms Of Different Types Of Dementia

Dementia isn't a single condition, but a set of symptoms associated with certain neurological conditions that cause damage to brain cells. The World Health Organization (WHO) estimates that dementia affects over 55 million people worldwide, with an average of 10 million new cases emerging yearly. Most dementia-related conditions are chronic, terminal, and worsen with time. However, symptoms can be managed as they progress to maintain the individual’s quality of life as much as possible.

Below, we'll explore some different types of dementia and symptoms of each one. We'll also outline treatment options and provide tips for managing symptoms for both individuals with dementia and their families. 

Alzheimer's disease: A brain disorder

Alzheimer's disease is the most common dementia-related brain disorder, contributing to an estimated 60–70% of cases. It’s caused by abnormal protein deposits in nerve cells in the brain that interfere with structure and functioning. Alzheimer's typically presents in individuals around 65 years of age but may also emerge as early as the mid-30s in those with early-onset Alzheimer's disease.

Early symptoms of Alzheimer’s disease

Alzheimer's symptoms can significantly impact many areas of an individual's life, as they typically affect cognition, mood, and behavior.

Mild symptoms might take time to recognize at first. They usually include: 

• Impaired memory. People with Alzheimer's might forget recently learned information or information they would normally remember, such as important dates or names. In the early stages, the individual may recall the information later.  
• Confusion. Alzheimer's can cause confusion about location, the time, or months/seasons. 
• Disorientation. During this phase, some people may become easily disoriented and "wander." They might not remember where they are or how they got there in such episodes.
• Poor judgment. Individuals with mild Alzheimer's might begin showing a pattern of poor or uncharacteristically risky decisions, such as giving away money without consideration, behaving inappropriately in public places, or neglecting personal hygiene. 
• Repeating questions/information. People with Alzheimer's may forget that they've already asked a question or shared a story, so they'll frequently repeat themselves.
• Misplacing things in unusual spots. People with mild Alzheimer's might begin returning items in inappropriate places or accidentally leaving them behind. For example, they might put items from the refrigerator in the pantry or leave their wallet at the store after buying groceries.
• Difficulty completing everyday tasks. Alzheimer's disease often affects an individual's ability to solve problems and think reasonably, making it difficult to complete everyday tasks.
• Changes in personality and mood. People in the early phases of Alzheimer's may become withdrawn, lose interest in activities they once enjoyed, or show diminished affect.
• Irritability, anxiety, and/or aggression. Some individuals present excessive impatience, irritability, and aggressive behavior or speech. They might have difficulty coping with stressful situations and everyday challenges.

In the first stages, Alzheimer's symptoms may be mistaken as a sign of "normal aging" or another disorder, such as anxiety or depression. However, dementia symptoms are not a normal part of the aging process. Plus, unusual changes in personality or mood—which may be more recognizable—typically accompany other cognitive symptoms in Alzheimer's disease. 

Moderate symptoms of Alzheimer’s disease

In the next stage of Alzheimer's, core symptoms like confusion and memory loss become more severe. Additional symptoms to watch for include:

• Problems with language, writing, and reading. People at this stage of dementia might also have trouble working with numbers, making it challenging to complete household responsibilities like paying bills or making appointments. 
• Diminished attention span. It may become difficult for individuals to remain focused during a movie, conversation, or other activities.
• Difficulty learning new things. Problems with cognitive functioning may create challenges with learning a new skill or completing a new task.
• Problems with logical thinking/organization. These types of challenges can also hinder one's ability to take care of daily responsibilities and commitments.
• Sleep disruptions. Some people in this stage of Alzheimer's often experience changes in sleeping patterns, such as nighttime restlessness and daytime sleepiness.
• Inability to cope with new situations. Frustration associated with a diminished ability to function independently can create challenges for people with Alzheimer’s when they’re trying to cope with unfamiliar difficulties or situations.
• Repetitive movements or speech. Decreased attention and increased disorientation may cause some people with Alzheimer’s to repeat themselves often.
• Difficulty with emotional regulation. Individuals at this stage of dementia might begin having mood disturbances like extreme agitation or tearfulness. 

Severe symptoms of Alzheimer’s disease

As the disease progresses to its final stages, people with Alzheimer's may be unable to care for themselves and will usually require around-the-clock care. People in the last stages of Alzheimer's might:

• Have little or no awareness of their surroundings and experiences
• Be completely unable to communicate verbally (possibly grunting, groaning, or moaning instead)
• Have difficulty swallowing
• Experience significant weight loss and show little or no interest in eating
• Sleep more frequently
• Experience problems with incontinence 
• Have seizures and general physical complications such as skin and dental problems

Frontotemporal dementia (FTD)

This type of dementia is caused by neuronal damage in the frontal and temporal lobes of the brain. It's less common and emerges earlier in life than most types of dementia. Typical age of onset is 40 to 65 years. Like other types of dementia, FTD is a progressive disease with symptoms that worsen with time. 

Symptoms of frontotemporal dementia 

Many frontotemporal dementia symptoms are similar to Alzheimer's, but there are some key differences. For example, Alzheimer's typically begins with memory loss, while frontotemporal dementia usually first presents as symptoms like changes in behavior, personality, and judgment. Also, people with the disorder might have some of the same cognitive symptoms as Alzheimer’s, but their memory may stay intact.  

Types of frontotemporal dementia

Frontotemporal dementia is one of three frontotemporal disorders (FTD):

• Behavioral variant frontotemporal dementia (bvFTD) 

This is the most common type and involves judgment, personality, and behavior changes. Cognitive symptoms include difficulty with prioritizing, planning, and sequencing. Behavior symptoms might include apathy towards people or activities the individual once cared about and saying/doing uncharacteristically impulsive or inappropriate things. Language and motor problems may occur with time.

• Primary progressive aphasia (PPA)

PPA is characterized by changes in one’s ability to communicate, read, write, and understand others. People with PPA might have a hard time speaking properly or using/understanding words. Some might become unable to speak entirely. As the condition progresses, classic cognitive dementia symptoms may emerge, and some might experience changes in mood and behavior as well. 

• Frontotemporal movement disorders

Several types of frontotemporal disorders are associated primarily with dysfunction in parts of the brain that control movement. Individuals with such disorders might have difficulty using their hands or arms, walking, or swallowing. Some people may move very slowly and fall unexpectedly. Other potential symptoms include loss of facial expression and affect, body stiffness, and trouble with eye movements. Frontotemporal movement disorders may also affect language and cognition, but not always. 

Lewy body dementia (LBD)

Lewy body dementia is characterized by the presence of abnormal protein deposits, called Lewy bodies, in the brain. Like most other dementias, LBD is progressive and affects thinking, behavior, and movement. It is the second-most common form of progressive dementia after Alzheimer's. 

Symptoms of LBD

Unlike Alzheimer's disease, visual hallucinations are often an early, prominent symptom of LBD. Patients with LBD might also experience tremors, stiffness, and slow movement. Fluctuations in cognition and alertness are also common.

Progression of LBD

Individuals with LBD may experience sudden changes in cognition, alertness, and motor functioning that can make it challenging to predict the disorder's progression. In contrast, Alzheimer's disease progresses gradually over time with a more predictable decline, beginning with mild memory loss and eventually leading to severe cognitive and memory impairment.

Challenges in managing Lewy body dementia

Due to the fluctuating nature of the condition, Lewy body dementia can present some unique challenges. For example:

• Diagnostic difficulty

LBD can be difficult to diagnose because its symptoms often overlap with other neurodegenerative disorders. In addition, the presence of visual hallucinations, cognition fluctuation, and movement disorders can make it challenging to differentiate from other conditions. 

• Medication sensitivity

Researchers are still unsure why, but many people with LBD are highly sensitive to the antipsychotic medications often prescribed to help manage hallucinations. These types of medications can worsen cognitive symptoms and/or lead to severe side effects like increased confusion, sedation, or movement problems.

• Challenges for caregivers

The fluctuating nature of LBD symptoms such as cognitive impairment, hallucinations, and movement difficulties can make it additionally challenging to provide care and support to people with this type of dementia. 

Vascular dementia

Vascular dementia is a common type of dementia caused by reduced blood flow to the brain, typically as a result of blood vessel-related conditions like stroke or high blood pressure. 

Symptoms of vascular dementia

Symptoms of vascular dementia can vary depending on damage severity and the specific area of the brain that’s affected. Symptoms can also vary from person to person and may change over time as the disease progresses.

As with Alzheimer's disease, people with vascular dementia may experience confusion, memory problems, difficulty communicating, and changes in mood and behavior. Unlike Alzheimer's, however, the most prominent symptoms of vascular dementia often involve changes to cognitive processing speed in areas like problem-solving and planning rather than memory loss. 

People with vascular dementia might also have:

• Problems with coordination, balance, and walking
• Muscle stiffness or weakness
• Trouble with visual-spatial perception, leading to difficulty with judging distances, recognizing objects, or navigating familiar environments

Management of vascular dementia

Strategies for managing symptoms of vascular dementia are often the same as those for other dementias; however, addressing the risk factors is typically the first line of treatment. This approach may include managing and controlling high blood pressure, high cholesterol, heart disease, and diabetes to help reduce the risk of further damage to the blood vessels in the brain.

Individuals with vascular dementia may need to consult with specialists who can develop a nutrition and exercise plan to improve their cardiovascular health, reduce their risk of stroke, and support brain health.

Parkinson's disease dementia (PDD)

Studies suggest that up to 80% of individuals with Parkinson's disease (PD) will eventually develop dementia. Both Parkinson's and dementia symptoms typically present later in life—between ages 50–85 for PD and 65 and older for dementia.

Symptoms of PDD

On average, individuals begin developing dementia symptoms about ten years after the movement problems associated with PD begin. PDD shares many of the same symptoms as other types of dementia, such as problems with memory, attention, executive function, and visual-spatial abilities. 

People with Parkinson’s disease dementia may also experience behavioral changes, mood disturbances, and visual hallucinations. In addition to cognitive decline, they often continue to present symptoms related to motor functioning, like tremors, rigidity, instability, and slowness of movement. 

Severity of later stages of PDD

Later stages of PDD typically vary in severity depending on factors like overall health, the progression of Parkinson's disease, and the types of dementia symptoms the individual experiences. As PDD progresses, cognitive decline and worsening of PD symptoms can lead to increased disability and risk of falls and injury. 

Mixed dementia (Alzheimer’s disease and vascular dementia)

It’s also possible for individuals to have a combination of dementia types. For example, a person may have Alzheimer's disease and vascular dementia together. This is referred to as mixed dementia, which is more common in those over 75 years of age.

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Diagnosis and treatment options for symptoms of dementia

Receiving a dementia diagnosis and establishing a treatment plan typically involves a combination of methods.

Diagnosis

Early diagnosis can help individuals with dementia and their loved ones be better prepared to manage symptoms as they emerge. The process typically begins with a preliminary evaluation of the person’s symptoms, past and/or current medical issues, medication use, nutrition and lifestyle, and any personality or behavior changes. To diagnose dementia, physicians may also administer:

• Physical and neurological exams
• Blood and imaging tests
• Biomarker tests (in some cases)
• Neuropsychological assessments

Typical treatments and symptom management

There is currently no cure for dementia. Dementia treatments aim to help individuals manage symptoms, prolong functionality, and increase quality of life. They may include:

• Medications
• Cognitive and behavioral therapies
• Managing medical comorbidities
• Quality nutrition, regular physical exercise, and sleep management
• Social engagement and support
• Support programs for caregivers

Ensuring a safe environment for individuals with dementia is also essential for preventing accidents and injuries. This might include eliminating fall hazards, installing grab bars, and implementing assistive devices. Caregivers may also consider strategies to prevent wandering.

Support for loved ones of individuals with different types of dementia

Dementia can present a wide variety of daily challenges for both the individual experiencing it and those who care for them. Early partnership with healthcare professionals experienced in treating dementia and supporting their families is usually critical for sustaining the best quality of life possible for all involved as symptoms progress. 

A significant part of the treatment strategy for dementia typically involves caring for caregivers as well. Caring for a loved one with dementia can be physically, mentally, and emotionally taxing, and without adequate support, caregivers may experience burnout, depression, and stress-related concerns. Many find that attending support groups and engaging in individual therapy help them process and cope with the often-complex emotions associated with being a dementia caregiver. 

Despite its potential advantages, some caregivers experience barriers that prevent them from getting the mental health support they need. For example, managing their loved one's treatment schedule may not leave much time to travel to and from in-person therapy sessions. The cost of sessions may also be a concern.

In such cases, virtual therapy can be a convenient alternative to conventional therapy. It can offer greater flexibility in scheduling and the ability to attend appointments remotely. Additionally, online therapy platforms often offer treatment options that are more affordable than traditional in-office therapy without insurance coverage. Plus, research suggests that online therapy can be an effective method of support for informal caregivers in particular.