Dementia can be categorized in many different ways. These categories are designed to group disorders that have particular features in common, such as whether or not they are progressive and which parts of the brain are affected.
Some types of dementia fit into more than one of these categories. For example, Alzheimer’s disease is considered to be both progressive and cortical dementia. Here are some of the most commonly used groupings and their associated symptoms.
This term refers to a disease process that primarily affects the neurons of the brain’s outer layer (cortex), Cortical dementias tend to cause problems with:
- social behavior
This type of dementia affects parts of the brain below the cortex. Subcortical dementia tends to cause:
- changes in emotions
- changes in movement
- slowness of thinking
- difficulty starting activities
As the name implies, this is a type of dementia that gets worse over time. It gradually interferes with cognitive abilities like thinking, remembering, and reasoning skills.
This is dementia that does not result from any other disease.
This is dementia that occurs as the result of a physical disease or injury. One common cause could be a head injury.
Even for a given type of dementia, symptoms can vary from patient to patient and they are usually progressive over time. For example, the symptoms associated with Alzheimer’s disease (AD) are often described in phases, representing the ongoing, degenerative nature of the disease.
Mild Alzheimer’s disease
In addition to memory loss, early clinical symptoms will likely include:
- confusion about the location of usually familiar places
- taking longer to accomplish normal daily tasks
- trouble handling money and paying bills
- poor judgment leading to bad decisions
- loss of spontaneity and sense of initiative
- mood and personality changes and increased anxiety
Moderate Alzheimer’s disease
As the disease spreads to more regions of the brain, additional clinical symptoms may include:
- increasing memory loss and confusion
- shortened attention span
- problems recognizing friends and family members
- difficulty with language
- problems with reading, writing, or working with numbers
- difficulty organizing thoughts and thinking logically
- inability to learn new things or to cope with new or unexpected situations
- inappropriate outbursts of anger
- perceptual-motor problems (such as trouble getting out of a chair or setting the table)
- repetitive statements or movement, occasional muscle twitches
- hallucinations, delusions, suspiciousness or paranoia, irritability
- loss of impulse control (such as undressing at inappropriate times or places or using vulgar language)
- exacerbation of behavioral symptoms, such as restlessness, agitation, anxiety, tearfulness, and wandering — especially in the late afternoon or evening. This is called “sundowning.”
Severe Alzheimer’s disease
At this point, plaques and tangles (the hallmarks of AD) can be seen in the brain when looked at using an imaging technique called MRI. This is the final stage of AD, and symptoms may include:
- essentially complete inability to recognize family and loved ones
- loss of sense of self
- inability to communicate in any way
- lack of bladder and bowel control
- weight loss
- skin infections
- frequent groaning, moaning, or grunting
- increased sleeping
- total dependence on others for care
- difficulty swallowing