Dementia is a common problem among older adults. Just look at the numbers: Currently, more than 55 million people worldwide are living with dementia, and 10 million new cases are diagnosed every year, according to the World Health Organization. In the U.S, the Centers for Disease Control and Prevention estimates that as many as 6.7 million adults were living with Alzheimer’s disease — the most common type of dementia — in 2023. That number is projected to rise to about 14 million by 2060.
But dementia isn’t just one issue, and the way it progresses can vary greatly from one person to the next. In this guide, we’ll explore the types of dementia, what causes it and what treatment options are available.
What Is Dementia?
Dementia isn’t exactly a disease, says Dr. Arun Ramamurthy, a geriatric neurologist with the Ohio State University Wexner Medical Center in Columbus.
“Dementia is a syndrome or a set of symptoms,” he explains. “It’s not an actual pathologic kind of diagnosis of dementia. It means that you have cognitive and thinking problems that affect you significantly enough to impair your ability to function independently.”
[READ Anosognosia vs. Alzheimer’s: Understanding the Key Differences]
Types of Dementia
There are several different types of dementia, all with different causes, says Dr. Elizabeth Landsverk, a geriatrician based in the San Francisco area. These include:
— Alzheimer’s disease, which, as mentioned, is the most common type of dementia. It’s marked by loss of memory and eventually loss of the ability to care for oneself.
— Vascular dementia, which is associated with obesity, diabetes, hypertension, smoking and higher cholesterol. Vascular dementia can also be related to strokes and damage to arteries in the brain from vascular or cardiovascular diseases, Ramamurthy adds. It’s the second most common type of dementia.
— Lewy body dementia, which is marked by the development of abnormal deposits of alpha-synuclein, a type of protein in the brain. These deposits are called Lewy bodies, and they disrupt normal brain signaling. This type of dementia can be associated with Parkinson’s disease, a progressive and incurable neurodegenerative condition. Lewy body dementia is often made worse by the medications used to treat Parkinson’s, though symptoms can improve by adjusting medications, Landsverk says.
— Frontotemporal dementia, which is marked by damage to neurons in the frontal and temporal lobes of the brain. These regions are where higher executive functions, such as emotional regulation, the ability to plan, reason and problem solve, occur. This form of dementia is difficult to diagnose because you may not have much memory loss, but reasoning and judgment begin to wane, Landsverk points out. A common sign, however, is a loss of boundaries with social and sexual behavior in public, she adds.
— Alcohol-related dementia, which is related to the volume of alcohol a person consumes. The more alcohol you drink, the greater your chance of developing dementia and the greater potential for severe symptoms, Landsverk says.
— Brain injury-related dementia, which can result from any damage to the brain, such as after a fall or a concussion. Chronic traumatic encephalopathy, better known as CTE, falls under this category of dementia and has been associated with contact sports like football. This form of dementia is often marked by angry outbursts and strange behavior years after the brain injury was sustained, Landsverk says.
[READ: Everything You Need to Know About Dementia Care in Assisted Living Communities.]
Alzheimer’s vs. Dementia
Alzheimer’s disease and dementia may be used interchangeably, but they’re not the same condition.
“Alzheimer’s is a brain disease, whereas dementia is a state of cognition,” explains Dr. S. Ahmad Sajjadi, a neurologist with UCI Health.
About 10% of people ages 65 and older have dementia, and that percentage increases to 50% among those ages 85 and older, Landsverk adds. Alzheimer’s disease accounts for 65% of all cases.
[READ: What Increases Dementia Risk?]
Stages of Dementia
Landsverk says there are seven specific stages of dementia. These include:
— No detectable cognitive impairment. Tests, however, may indicate a problem on the way.
— Very mild decline. Someone may be exhibiting memory lapses, such as not being able to remember the names of friends and family, and they may have trouble keeping track of familiar objects.
— Mild cognitive decline. Memory and cognitive issues become more frequent. Signs include missing appointments, getting lost and finding driving more difficult, and struggling to find the right words. In addition, in these first three stages (no detectable impairment, very mild and mild decline), symptoms may not be noticeable enough for a diagnosis, but changes in the brain are still taking place.
— Moderate decline. During this stage, someone may become moodier, withdraw from friends and family, have trouble with routine tasks and forget recent events. They may also seem less sharp and in denial of what they’re experiencing.
— Moderately severe decline. Symptoms become quite noticeable at this stage and include pronounced memory loss, confusion, forgetfulness, disorientation and a tendency to wander.
— Severe decline. During this late stage, symptoms include pronounced memory loss, an inability to recognize loved ones, heightened aggressiveness and radical changes in personality.
— Very severe decline. In the final stage, dementia patients lose their ability to speak and move without assistance, and their bodily functions become impaired.
“These stages may appear in a different order and may overlap,” Landsverk adds. “Behaviors may develop at one stage then disappear only to reappear later on. The primary symptoms, such as memory loss, problems with language, confusion and interruptions in thinking, are consistent overall and tend to worsen over time.”
Dementia Causes
Different forms of dementia are caused by different factors. With Alzheimer’s disease, for example, an accumulation of abnormal clumps of proteins called amyloid and tau can disrupt normal brain function. In vascular dementia, damage to the blood vessels in the brain is the culprit. With Lewy body dementia, the development of Lewy bodies can interrupt normal brain signaling. Other forms of dementia can be related to alcohol use and brain injury.
Early Signs and Symptoms of Dementia
Dementia can be difficult to spot in the earliest stages as symptoms may be subtle at first and gradually worsen over time. Initially, poor decision-making skills and confusion can be signs.
Other signs to watch for include:
— A decline in memory, attention or thinking.
— Changes in behavior or mood.
— A decline in functional ability, such as cooking and cleaning.
— Repeating stories and questions in the same conversation.
— Changes in language use.
Dementia Treatments
While dementia is incurable, there are some treatment options available that can slow its progression. Treatments
are focused mainly on addressing the symptoms of dementia, rather than correcting the underlying disorder.
Current treatments for dementia include cholinesterase inhibitors, a class of medications that boosts levels of a chemical messenger integral to memory and judgment. Specific medications in this class include:
— Donepezil (Aricept, Adlarity).
— Rivastigmine (Exelon).
— Galantamine (Razadyne ER).
“Such meds have been known to help 40% of patients slow the decline for six months or so,” Landsverk notes.
Memantine (Namenda), which works by regulating glutamate, a chemical messenger in the brain that’s associated with learning and memory, is another option. Antidepressants, sleep aids or other medications to help treat depression, hallucinations, agitation, sleep problems or Parkinson’s disease, may also be prescribed.
How to Prevent Dementia
There’s no surefire way to prevent dementia, but some general means of lowering your risk include:
— Eating a healthy diet, such as the Mediterranean diet.
— Quitting smoking and limiting alcohol consumption.
— Avoiding tackle sports and other activities that could lead to brain injury or concussions.
— Getting appropriate treatment for hypertension, diabetes, obesity, heart disease and sleep disorders, such as insomnia.
Bottom Line
While there is no cure for dementia, treatments are available, and addressing symptoms can help those with dementia lead longer and healthier lives.
“Dementia is a chronic disease that typically progresses slowly, giving patients and their families years to live despite restrictions caused by the degenerative brain disease,” points out Sajjadi, who also serves as associate professor of neurology and chief of the memory disorders division of the neurology department at the UCI School of Medicine.
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What Are the Stages of Dementia? originally appeared on usnews.com
