Suspecting you or a loved one have dementia can be extremely distressing. But the more you understand about the condition, the more you can do to improve the outcome.
What is dementia?
Dementia is an umbrella term for disorders resulting from disease or trauma to the brain that lead to memory loss, personality change, and impaired intellectual functions. These changes are not part of normal aging and are severe enough to impact daily living, independence, and relationships. According to figures from Alzheimer’s Disease International, about 50 million people around the world are currently living with dementia and a new case is diagnosed every 3.2 seconds. While Alzheimer’s disease is the most common type of dementia, there are also many other forms, including vascular and mixed dementia.
With any type of dementia, there will likely be noticeable decline in communication, learning, remembering, and problem solving. These changes may occur quickly or very slowly over time. The progression and outcome vary, but are largely determined by the type of dementia and which area of the brain is affected.
Facing up to the possibility of dementia inevitably shifts your perceptions, relationships, and priorities. But experiencing symptoms doesn’t have to mean the end of your normal life. Certain types of dementia can be slowed and some causes even reversed if caught in time. The first step is to understand what distinguishes normal memory loss from dementia symptoms, and how to identify the different types of dementia. Whatever your diagnosis, though, there can be plenty of things you can do to help manage symptoms and continue to enjoy a full and rewarding life for as long as possible.
Signs and symptoms of dementia
As we age, many of us experience lapses in memory. It can be worrying and confusing to realize that something you once took for granted isn’t working as well as it used to. But not all memory changes indicate dementia—and dementia impacts more than just memory. Symptoms can also affect visual and spatial skills, executive functioning, language, and mood or personality. To meet the diagnostic criteria for dementia, you’d need to experience difficulties in at least one of those areas in addition to memory loss.
Common signs and symptoms include:
- Memory loss. Changes in short-term memory, forgetting dates, events, needing more memory aids, repeatedly asking the same questions.
- Impaired judgement. Fall victim to scams, give away money, struggle to care for a pet.
- Difficulties with abstract thinking. Trouble thinking about ideas, solving puzzles, being creative, completing daily tasks.
- Faulty reasoning. Trouble problem solving, working with numbers, balancing check book, or following directions or recipes.
- Inappropriate behavior. Loss of inhibitions, improper sexual comments or actions.
- Loss of communication skills. Difficulty finding words, following conversations or storylines.
- Disorientation and confusion. Become lost in familiar places, confusion about dates or seasons. Not recognizing or being confused about familiar people.
- Gait, motor, and balance problems. Loss of coordination, increasing falls or accidents.
- Neglect of personal care and safety. Decline in personal hygiene, wearing inappropriate clothing for the weather, neglect nutrition.
- Personality changes. Withdraw from social activities, apathy or listlessness, sleep problems, depression, hallucinations, paranoia, or agitation.
Normal memory changes vs. dementia symptoms
It’s something we all have to face but the inevitable changes of aging can still be both humbling and surprising. But while experiencing wrinkling skin, fading hair color, and mild, short-term memory loss is common as we age, severe and rapid memory loss is definitely NOT a part of normal aging. In fact, many people are able to preserve their brainpower as they get older by staying mentally and physically active and making other healthy lifestyle choices.
Differentiating the signs of dementia from normal aging can help to either set your mind at rest or encourage you to begin taking steps to slow the progression of symptoms. In broad terms, normal memory changes associated with aging don’t significantly interfere with your ability to function in your daily life. These may include:
Slower thinking and problem solving – The speed of learning slows down; short-term memory takes longer to function; reaction time increases.
Decreased attention and concentration – More distractedness. All of the interruptions make learning more difficult.
Slower recall – A greater need for hints to jog the memory.
Distinguishing between normal memory loss and dementia symptoms is not an exact science but there are some clues to look for:
|Are your memory changes typical aging or symptoms of dementia?|
|Typical aging:||Symptoms of dementia:|
|You or a loved one complain about memory loss but are able to provide detailed examples of your forgetfulness||You complain of memory loss only if asked but are unable to recall specific instances|
|You occasionally search for words||You experience frequent word-finding pauses and substitutions|
|You may have to pause to remember directions, but don’t get lost in familiar places||You get lost in familiar places and take excessive time to return home|
|You remember recent important events and your conversations are not impaired||You experience a notable decline in memory for recent events and ability to converse with others|
|Your interpersonal social skills are at the same level as they’ve always been||You’ve lost interest in social activities and may behave in socially inappropriate ways|
In a healthy brain, mass and speed may decline in adulthood, but this miraculous organ continues to form vital connections throughout life. However, when connections are lost through inflammation, disease, or injury, neurons eventually die and dementia can develop. While the prospect of literally losing one’s self can be extremely traumatic, early intervention can dramatically alter the outcome.
In recent years, scientists have greatly demystified the origins of dementia, although there is still much that remains unclear. Genetics may increase your risks, but it’s likely a combination of hereditary, environmental, and lifestyle factors are also at work.
Dementia can be caused by:
Medical conditions that progressively attack brain cells and connections, most commonly seen in Alzheimer’s disease, Parkinson’s disease, or Huntington’s disease.
Vascular conditions such as strokes that disrupt oxygen flow and rob the brain of vital nutrients. Additional strokes may be prevented by reducing high blood pressure, treating heart disease, and quitting smoking.
Poor nutrition, dehydration, and certain substances, including drugs and alcohol. Treating conditions such as insulin resistance, metabolic disorders, and vitamin deficiencies may reduce or eliminate symptoms of dementia.
Single trauma or repeated injuries to the brain. Depending on the location of the brain injury, cognitive skills and memory may be impaired.
Infection or illness that affects the central nervous system, including Creutzfeldt-Jakob disease and HIV. Some conditions are treatable, including liver or kidney disease, depression-induced pseudo dementia, and operable brain tumors.
Dementia risk factors
Some risk factors for dementia are outside your control. Advancing age, a family history of dementia, head injury, or Down syndrome, for example, may increase your risk of developing dementia. However, you may have more influence over other lifestyle factors, such as your diet and activity levels.
Factors that put you at a higher risk of dementia include:
Poor heart health. Heart and brain health are strongly linked. Hypertension, high cholesterol, atherosclerosis (narrowing of the arteries), heart disease, and stroke can all increase your risk for dementia.
Diabetes. Poorly managed diabetes can lead to stroke and heart disease, increasing your risk for dementia, especially vascular, Alzheimer’s, or mixed dementia.
Smoking. Smoking increases your risk of cardiovascular disease, which in turn heightens your risk of mental decline and dementia.
Alcohol abuse. Heavy or binge drinking can increase your risk of developing Alzheimer’s disease and other forms of dementia, including Korsakoff syndrome, a type of dementia commonly caused by alcohol abuse.
Neglected mental health. Untreated depression, loneliness, social isolation, and a lack of mental stimulation can all contribute to an increase in the likelihood of developing dementia.
Sleep apnea. Untreated sleep apnea can disrupt your sleep and lead to daytime sleepiness, impaired brain function, and an increased risk of developing dementia later in life.
Poor diet. Eating a diet high in processed food, unhealthy fats, sugar, and refined carbs can take a toll on your heart and brain health and increase your risk of diabetes, vascular disease, and Parkinson’s, all red flags for dementia.
Lack of exercise. Leading a sedentary lifestyle can impact your resilience, disrupt your sleep, increase your risk of heart disease, and accelerate cognitive decline and the onset of dementia symptoms.
Hearing loss. Hearing impairment may cause a faster rate of atrophy in the brain and cognitive decline. It can also make it harder to socialize with friends, another risk factor for dementia.
Types of dementia
All dementias involve cognitive decline that can impact daily living. However, it’s important to pinpoint the specific type of dementia in order to optimize treatment. More than 50 conditions involve dementia, including:
This is the most common form of dementia, which according to the Alzheimer’s Association accounts for 60 to 80 percent of all diagnosed cases. The following 10 warning signs may indicate that your dementia symptoms are the result of Alzheimer’s disease:
1. Your memory loss is sufficient to disrupt your daily life. You forget things you’ve recently learned, forget important dates or events, repeatedly ask for the same information, or rely more and more on memory aides or family members.
2. You’re having difficulties with problem-solving. You’re not able to follow plans, work with numbers, follow recipes, or keep track of bills.
3. Having trouble completing daily tasks such as driving to a familiar place, remembering rules to a game, or completing assignments at work.
4. Experiencing confusion over time or place. You lose track of dates, forget where you are or how you got there.
5. Misplacing things. Putting things in strange places, being unable to retrace your steps, perhaps even accusing others of stealing.
6. Developing problems with spoken or written words. You have difficulties following a conversation, often repeat yourself, struggle to find the right word, or call things by the right name.
7. Having difficulty understanding visual images. Trouble reading, judging distances, colors, or contrast, or recognizing your own reflection.
8. Displaying poor judgement. There’s a decline in your decision making, you’re giving away large sums of money, paying less attention to personal grooming.
9. Withdrawing from work or social activities. You have trouble remembering how to complete a work project or favorite hobby, difficulty following sports, withdraw from social events.
10. Exhibiting changes in mood. Becoming confused, depressed, suspicious, fearful, or anxious.
Early diagnosis of Alzheimer’s can help to prolong independence and is the first step towards treatment, management, and continuing to enjoy a full life.
Vascular dementia results from a series of small strokes or changes in the brain’s blood supply. A sudden onset of symptoms can indicate vascular dementia, and while it severely impacts memory and cognitive functioning, there are ways to reduce its severity.
This is a condition in which Alzheimer’s disease and vascular dementia occur simultaneously. The combination of the two types of dementia most commonly occurs in advanced senior years, often indicated by cardiovascular disease and dementia symptoms that get worse slowly over time.
Less common forms of dementia
Pick’s Disease affects personality, orientation and behavior. It may be more common in women and occurs at an early age.
Creutzfeldt-Jakob Disease progresses rapidly along with mental deterioration and involuntary movements.
Huntington’s Disease is an inherited, degenerative disease. The disease causes involuntary movement and usually begins during mid-life.
Parkinson’s Disease Dementia can develop in the later stages of Parkinson’s disease, a progressive disorder of the central nervous system.
Lewy Body Dementia causes symptoms similar to Alzheimer’s disease. People with Lewy Body dementia experience hallucinations and can become fearful.
Mild cognitive impairment (MCI)
Mild cognitive impairment (MCI) is a stage between normal aging and dementia and involves problems with memory, language, or other cognitive functions. But unlike those with full-blown dementia, people with MCI are still able to function in their daily lives without relying on others.
Many people with MCI eventually develop Alzheimer’s disease or another type of dementia. However, others plateau at a relatively mild stage of decline and are able to live independently. Some people with mild cognitive impairment even return to normal.
It is not yet fully understood why MCI progresses to Alzheimer’s disease in some people, while remaining stable in others. The course is difficult to predict, but in general, the greater the degree of memory impairment, the greater the risk of developing Alzheimer’s down the line. According to the Alzheimer’s Association, roughly 15 to 20 percent of the population over the age of 65 experience some degree of mild cognitive impairment.
Symptoms of MCI include:
- Frequently losing or misplacing things.
- Frequently forgetting conversations, appointments, or events.
- Difficulty remembering the names of new acquaintances.
- Difficulty following the flow of a conversation.
Obtaining an early diagnosis of dementia is critical, especially if your symptoms appear suddenly. Some medications for dementia may be more beneficial if given early in the progression of the disease. Timely intervention may also help you better control symptoms and prolong your quality of life.
There is no single medical test used to diagnose dementia. To make a diagnosis, your doctor will assess your memory problems, changes in thinking, behavior, and function, and conduct medical tests to rule out other conditions and drug interactions that may be causing your symptoms.
While your doctor may be able to broadly diagnose dementia, determining the specific type can sometimes be challenging. Many symptoms overlap between different types of dementia, so you may need to consult a specialist neurologist or psychologist for a full diagnosis.
Coping with a diagnosis
Being diagnosed with dementia is a life-changing experience—for both you and your loved ones. It can turn your world upside down and leave you grappling with a host of conflicting emotions, from shock, anger, and grief to profound sadness and isolation.
While there is currently no cure for dementia, a diagnosis doesn’t mean that your life is over. There are treatments available for the symptoms. There are also steps you can take to help slow the progression of the disease and delay the onset of more debilitating symptoms, enabling you to prolong your independence and live a rich and full life for longer.
Preventing dementia or slowing its progression
Recent research suggests that healthy lifestyle habits and mental stimulation may help prevent dementia altogether, delay its onset, or if you’ve already been diagnosed, slow the onset of more debilitating symptoms. In fact, research published in the Journal of the American Medical Association in 2019 concluded that healthy lifestyle changes can reduce the risk of dementia even if you have a genetic predisposition.
Just as physical exercise keeps you physically fit, exercising your mind and memory can help you stay mentally sharp, no matter your family history or how old you are. The following strategies can help:
1. Regular exercise. Starting a regular exercise routine, including cardio and strength training, may significantly reduce your risk of developing dementia. Aim for 30 minutes of moderate exercise on most days of the week.
2. Social engagement. The more socially active you are, the more you connect face-to-face with others, the stronger your memory and cognition is likely to be.
3. Healthy diet. Brain-healthy eating habits, such as those promoted in the Mediterranean diet, can help reduce inflammation, protect neurons, and promote better communication between brain cells. Daily servings of fruit and vegetables and weekly servings of fish may help to lower your risk for dementia.
4. Mental stimulation. By continuing to learn new things and challenge your brain, you can strengthen your cognitive skills, stay mentally sharp, and may delay or prevent dementia symptoms.
5. Quality sleep. Getting quality sleep may help to flush out brain toxins and avoid the build-up of damaging plaques.
6. Stress management. Unchecked stress takes a heavy toll on the brain, shrinking a key memory area, hampering nerve cell growth, and worsening dementia symptoms.
7. Vascular health. Controlling your blood pressure, monitoring your cholesterol levels, and quitting smoking can have beneficial effects on both your heart and brain health.
To learn more about putting these strategies into action, see Preventing Alzheimer’s Disease—or Slowing its Progress.