Dementia is a decline in cognitive function. To be considered dementia, mental impairment must affect at least two brain functions. Dementia may affect:
Dementia is not a disease. It may be caused by a variety of illnesses or injuries. Mental impairment may range from mild to severe. It may also cause personality changes.
Some dementias are progressive. This means they get worse over time. Some dementias are treatable or even reversible. Some experts restrict the term dementia to irreversible mental deterioration.
In its early stages, dementia can cause symptoms, such as:
- Not coping well with change. You may have a hard time accepting changes in schedules or environment.
- Subtle changes in short-term memory-making. You or a loved one can remember the events of 15 years ago like it was yesterday, but you can’t remember what you had for lunch.
- Reaching for the right words. Word recollection or association may be more difficult.
- Being repetitive. You may ask the same question, complete the same task, or tell the same story multiple times.
- Confused sense of direction. Places you once knew well may now feel foreign. You may also struggle with driving routes you’ve taken for years because it no longer looks familiar.
- Struggling to follow storylines. You may find following a person’s story or description difficult.
- Changes in mood. Depression, frustration, and anger are not uncommon for people with dementia.
- Loss of interest. Apathy may occur in people with dementia. This includes losing interest in hobbies or activities that you once enjoyed.
- Confusion. People, places, and events may no longer feel familiar. You might not remember people who know you.
- Difficulty completing everyday tasks. You may struggle to recall how to do tasks you’ve done for many years.
Memory problems are not always a sign of dementia. These 10 early signs may indicate you are experiencing a decline in memory and mental ability.
In most cases, dementia is progressive, getting worse over time. Dementia progresses differently in everyone. However, most people experience symptoms of the following stages of dementia:
Mild cognitive impairment
Older individuals may develop mild cognitive impairment (MCI) but may never progress to dementia or any other mental impairment. People with MCI commonly experience forgetfulness, trouble recalling words, and short-term memory problems.
At this stage, people with mild dementia may be able to function independently. Symptoms includes:
- short-term memory lapses
- personality changes, including anger or depression
- misplacing things or forgetfulness
- difficulty with complex tasks or problem solving
- struggling to express emotions or ideas
At this stage of dementia, people impacted may need assistance from a loved one or care provider. That’s because dementia may now interfere with daily tasks and activities. Symptoms include:
- poor judgment
- increasing confusion and frustration
- memory loss that reaches further into the past
- needing help with tasks like dressing and bathing
- significant personality changes
At this late stage of dementia, the mental and physical symptoms of the condition continue to decline. Symptoms include:
- inability to maintain bodily functions, including walking and eventually swallowing and controlling bladder
- inability to communicate
- requiring full-time assistance
- increased risk for infections
People with dementia will progress through the stages of dementia at different rates. Understanding the stages of dementia can help you prepare for the future.
There are many causes of dementia. In general, it results from the degeneration of neurons (brain cells) or disturbances in other body systems that affect how neurons function.
Neurodegenerative means that neurons gradually cease to function or function inappropriately and eventually die.
This affects the neuron-to-neuron connections, called synapses, that are how messages are passed along in your brain. This disconnect can result in a range of dysfunction.
Some of the more common causes of dementia include:
- Alzheimer’s disease
- Parkinson’s disease with dementia
- vascular dementia
- medication side effects
- chronic alcoholism
- certain tumors or infections of the brain
Another cause is frontotemporal lobar degeneration, which is a blanket term for a range of conditions that cause damage to the frontal and temporal lobes of the brain. They include:
Other causes of dementia
Dementia may also be caused by other conditions, including:
- structural brain disorders, such as normal-pressure hydrocephalus and subdural hematoma
- metabolic disorders, such as hypothyroidism, vitamin B-12 deficiency, and kidney and liver disorders
- toxins, such as lead
Some of these dementias may be reversible. These treatable causes of dementia may reverse symptoms if they’re caught early enough. This is one of the many reasons why it’s important to see your doctor and get a medical workup as soon as symptoms develop.
Most cases of dementia are a symptom of a specific disease. Different diseases cause different types of dementia. The most common types of dementia include:
- Alzheimer’s disease. The most common type of dementia, Alzheimer’s disease makes up 60 to 80 percent of dementia cases.
- Vascular dementia. This type of dementia is caused by reduced blood flow in the brain. It may be the result of plaque buildup in arteries that feed blood to the brain or a stroke.
- Lewy body dementia. Protein deposits in nerve cells prevent the brain from sending chemical signals. This results in lost messages, delayed reactions, and memory loss.
- Parkinson’s disease. Individuals with advanced Parkinson’s disease may develop dementia. Symptoms of this particular type of dementia include problems with reasoning and judgment, as well as increased irritability, paranoia, and depression.
- Frontotemporal dementia. Several types of dementia fall into this category. They’re each affected by changes in the front and side parts of the brain. Symptoms include difficulty with language and behavior, as well as loss of inhibitions.
Other types of dementia exist. However, they’re less common. In fact, one type of dementia occurs in only 1 in 1 million people. Learn more about this rare type of dementia and others.
No single test can confirm a dementia diagnosis. Instead, a health care provider will use a series of tests and exams. These include:
- a thorough medical history
- a careful physical exam
- laboratory tests, including blood tests
- a review of symptoms, including changes in memory, behavior, and brain function
- a family history
Doctors can determine if you or a loved one is experiencing symptoms of dementia with a high degree of certainty. However, they may not be able to determine the exact type of dementia. In many cases, symptoms of dementia types overlap. That makes distinguishing between two types difficult.
Some health care providers will diagnose dementia without specifying the type. In that case, you may wish to see a doctor that specializes in diagnosing and treating dementia. These doctors are called neurologists. Some geriatricians also specialize in this type of diagnosis.
Two primary treatments are used to alleviate symptoms of dementia: medications and non-drug therapies. Not all medicines are approved for each type of dementia, and no treatment is a cure.
Medications for dementia
Two types of medication are used to treat symptoms of Alzheimer’s disease:
- Cholinesterase inhibitors. These drugs increase a chemical called acetylcholine. This chemical may help form memories and improve judgment. It may also delay worsening symptoms of Alzheimer’s disease (AD).
- Memantine. This drug is used to delay the onset of cognitive and behavioral symptoms in people with moderate or severe AD. It may let people with AD maintain normal mental functions for a longer period of time.
These two drugs may also be prescribed together. Side effects can occur, so learn more about the possible complications of these medications.
These therapies may help reduce symptoms of dementia and alleviate some of the manageable complications of the diseases. Common non-drug treatments for dementia include:
- Modifying your environment. Clutter, noise, and overstimulation may reduce focus.
- Modifying common tasks. You can work with a therapist or other health care provider to break down everyday tasks, such as showering or grooming, into manageable tasks.
- Occupational therapy. These specialized health care providers can help you learn to be safer and more secure with tasks including walking, cooking, and driving.
For decades, doctors and researchers believed dementia could not be prevented or cured. However, new research suggests that may not be the case.
A 2017 review found that more than one-third of dementia cases may be the result of lifestyle factors. Specifically, the researchers identified nine risk factors that may increase a person’s chances of developing dementia. They include:
- lack of education
- midlife hypertension
- midlife obesity
- hearing loss
- late-life depression
- physical inactivity
- social isolation
The researchers believe that targeting these risk factors with treatment or intervention could delay or possibly prevent some cases of dementia.
Dementia cases are expected to nearly triple by 2050, but you can take steps to delay the onset of dementia today.
Individuals living with dementia can and do live for years after their diagnosis. It may seem that dementia is not a fatal disease because of this. However, late-stage dementia is considered terminal.
It’s difficult for doctors and health care providers to predict life expectancies in people with dementia. Likewise, factors that influence life expectancy may have a different impact on length of life in each person.
In one study, women diagnosed with Alzheimer’s disease lived an average of 5.7 years after diagnosis. Men lived 4.2 years. Life expectancies, the study found, are shorter for individuals with other types of dementia.
Certain risk factors increase the likelihood of death in people with dementia. These factors include:
- increased age
- being of the male gender
- decreased capabilities and functionality
- additional medical conditions, diseases, or diagnoses, such as diabetes or cancer
However, it’s important to remember that dementia doesn’t follow a specific timeline. You or your loved one may progress through the stages of dementia slowly, or the progression may be rapid and unpredictable. This will affect life expectancy.
Dementia and Alzheimer’s disease (AD) are not the same. Dementia is an umbrella term used to describe a collection of symptoms related to memory, language, and decision-making.
AD is the most common type of dementia. It causes difficulty with short-term memory, depression, disorientation, behavioral changes, and more.
Dementia causes symptoms such as forgetfulness or memory impairment, loss of sense of direction, confusion, and difficulty with personal care. The exact constellation of symptoms will depend on the type of dementia you have.
AD can also cause these symptoms, but other symptoms of AD may include depression, impaired judgment, and difficulty speaking.
Likewise, treatments for dementia depend on the type you have. However, AD treatments often overlap with other non-pharmacological dementia treatments.
In the case of some types of dementia, treating the underlying cause may be helpful in reducing or stopping the memory and behavior problems. However, that is not the case with AD.
Alcohol use may be the most preventable risk factor for dementia. A 2018 study found that the majority of early onset dementia cases were related to alcohol use.
Alcohol use disorders, the researchers discovered, increase a person’s risk for dementia threefold.
Not all drinking is dangerous to your memories and mental health. Moderate levels of drinking (no more than one glass per day for women and two glasses per day for men) may be beneficial to your heart’s health.
Alcohol may be toxic to more than your memories, but how much you drink matters. Find out what’s safe for you to drink if you’re looking to lower your risk for dementia.
It’s absolutely normal to forget things once in a while. Memory loss by itself does not mean you have dementia. There is a difference between occasional forgetfulness and forgetfulness that is cause for serious concern.
Potential red flags for dementia include:
- forgetting who someone is
- forgetting how to do common tasks, such as how to use the telephone or find your way home
- inability to comprehend or retain information that has been clearly provided
Seek medical attention if you experience any of the above.
Getting lost in familiar settings is often one of the first signs of dementia. For example, you might have trouble driving to the supermarket.
The number of people diagnosed with dementia or living with it is increasing. This increase is due partly to increasing life expectancy.
By 2030, the size of the population 65 years of age and older in the United States is expected to almost double from 37 million people in 2006 to an estimated 74 million by 2030, according to the Federal Interagency Forum on Aging-Related Statistics Older Americans.
Scientists all over the world are working hard to gain a better understanding of the many different aspects of dementia. This might help to develop preventive measures, improved early detection diagnostic tools, better and longer-lasting treatments, and even cures.
For example, early research suggests a common asthma drug called zileuton might slow, stop, and potentially reverse the development of proteins in the brain. These proteins are common in people with Alzheimer’s disease.
Another recent research development suggests deep brain stimulation could be an effective way to limit symptoms of Alzheimer’s in older patients. This method has been used to treat symptoms of Parkinson’s disease, such as tremors, for decades.
Now, researchers are looking at the possibility of slowing the progression of Alzheimer’s.
Scientists are investigating a variety of factors they think might influence the development of dementia, including:
- genetic factors
- various neurotransmitters
- factors that influence programmed cell death in the brain
- tau, a protein found in neurons of the central nervous system
- oxidative stress, or chemical reactions that can damage proteins, DNA, and lipids inside cells
This research can help doctors and scientists better understand what causes dementia, and then discover how best to treat and possibly prevent the disorder.
There is also increasing evidence that lifestyle factors may be effective in decreasing the risk of developing dementia. Such factors might include getting regular exercise and maintaining social connections.