The Faces of Dementia

According to a recent study by the Alzheimer’s Association, there are approximately 95,000 seniors in SC suffering from dementia, and that number is projected to rise to 120,000 by 2025. With 11% of our state’s seniors affected, the chances are that you know someone who has been diagnosed or their family member.

Advances in dementia knowledge and treatment options have come along way over the years but there are still many unknowns. One of the biggest misconceptions is that all dementia is the same. This blog is designed to discuss the most common types of dementia along with signs & symptoms of each. The information contained here is not for diagnostic purposes and if you suspect a loved one may be suffering from one of these diseases, please consult with a licensed medical professional.

The Centers for Disease Control and Prevention note that dementia is not a specific disease but rather a general term of the impaired ability to remember, think or make decisions that interferes with doing everyday activities.  The five most common types of diagnosed dementia are: Alzheimer’s disease, Vascular dementia, Lewy body dementia, Fronto-temporal dementia, and Mixed dementia.

Alzheimer’s Disease

• The most common cause of dementia, accounting for 60%-80% of all cases.
• Caused by abnormal build-up of proteins in the brain known as amyloid plaques and tau tangles.
• There is a genetic factor with this disease. Having a first degree relative with Alzheimer’s increases the risk of developing by 10%-30%.
• This is a progressive disease which tends to evolve in three stages: Early, Middle & Late. The symptoms of each stage may overlap.

Early Stage

• Symptoms may be mild and not recognizable except to those closest to the senior.
• Most seniors in this stage still retain some independence including driving, work, and social activities.
• Common symptoms include: short term memory issues like forgetting a conversation within minutes; increased difficulty planning or organizing, misplacing items, difficulty in coming up with the right word or name in conversations.
• Ideal time to put financial, legal, and end-of-life plans together while the senior is still able to participate.

Middle Stage

• Confusion about where they are or what day it is.
• Inability to recall personal information like address, telephone number or schools attended.
• Withdrawal & moodiness in social or mentally challenging situations.
• Trouble controlling bladder & bowels.
• Changes in sleep patterns, often becoming more restless at night.
• An increased tendency to wander and become lost.

Late Stage

• No awareness of recent experiences or surroundings.
• Difficulty communicating.
• Changes in physical abilities like walking, sitting, and eventually swallowing.
• More vulnerable to infections.
• Require around the clock care and could benefit from a senior community and/or hospice services.
• Though interactions with the senior during this phase are limited, seniors can still benefit from music and gentle touch as ways to connect and reassure.

Vascular Dementia

• Linked to cardiac & vascular issues like a stroke. It is caused by conditions that damage blood vessels in the brain or interrupt the flow of blood & oxygen to the brain.
• Symptoms often depend on the area of the brain affected by the stroke.
• Unlike Alzheimer’s disease, Vascular dementia often begins with poor judgment or trouble planning & organizing
• Other symptoms include:
• Memory problems that disrupt the senior’s daily life
• Trouble speaking or understanding speech
• Confusion & agitation
• Problems walking/frequent falls
• Changes in personality & mood
• Accounts for approximately 10% of all dementia cases.
• Progresses in step like fashion as the senior experiences more vascular events.

Lewy Body Dementia

• This form of dementia is caused by abnormal deposits of the protein alpha-synuclein form in the cortex of the brain. It is named for the scientist who discovered it.
• The third most diagnosed form of dementia.
• Memory loss is a less prominent early symptom than other forms of dementia.
• Visual hallucinations are a common sign of this disease.
• Other symptoms include: blanking out or staring; unusual sleepiness during the day; problems with movement including trembling, slowness, and trouble walking.
• Many people with Lewy Body have vivid dreams which cause them to act out physically by talking, walking and kicking.
• Lewy Bodies can be present in other forms of dementia, including Alzheimer's so diagnosis may be more challenging.

Fronto-temporal dementia

• Develops as a result of cell damage to the areas of the brain that control planning, judgment, emotions, speech and movement.
• Primarily affects people aged 40-60.
• Changes in personality and behavior are often the first notable signs. For example, a previously cautious person may make offensive comments or neglect responsibilities at home or work.
• Loss of inhibitions is another key indicator.
• Other symptoms include: problems coming up with the right words for things when speaking and balance problems like shakiness and muscle spasms.
• There are multiple sub-categories of this disease:
• Behavioral Variant (bvFTD)
• Primary Progressive Aphasia (PPA)
• Amyotrophic Lateral Sclerosis (ALS)
• Corticobasal Syndrome
• Progressive Supranuclear palsy (PSP)

Mixed Dementia

• Mixed dementia occurs when there is more than one type of dementia affecting the senior. This can be difficult to diagnose because of the overlapping of symptoms.
• Alzheimer’s and Vascular dementia are the most common combination diagnosed
• More prevalent in people aged 80 and older.
• Disease progression may be faster than with one kind of dementia.

If you recognize these symptoms in yourself or a loved one, please seek the advice of a medical professional. Though there is currently no cure for dementia, there are treatments that can slow progression and help minimize symptoms. Like many other diseases, early detection is the best chance of stalling the stages and living a more active lifestyle for longer.