Understanding the Types and Stages of Dementia
One of the world’s greatest medical challenges...
Research shows that in the UK alone, someone will develop dementia every three minutes, and by 2051, an estimated 3% of the population will have dementia. An understanding of dementia, its impact on our lives, and how we can help in the ongoing fight to finding a cure is absolutely critical, both for ourselves and future generations.
What Is Dementia?
Not a disease in itself, dementia is the term used for a series of diseases or neurological disorders with similar symptoms that effect the brain. At least two brain functions have to be affected due to mental impairment in order to be diagnosed with dementia. Memory, thinking, language, judgment and behaviour may all be affected by dementia, with mental impairment ranging from mild to severe. It is extremely important that a proper diagnosis is made, which will result in the correct evaluation and necessary treatment being initiated.
Types of Dementia
There are different types of dementia and some people may have a combination of types, however, dementia is unique to each person who experiences it. These are the most common types.
Characterised by brain cell death due to the build up of proteins causing Plaques and Tangles, Alzheimer’s is the most common type of dementia, affecting between 60-80 percent of cases. Over time, the numbers of damaged cells will increase and, as a result, the brain’s function becomes more limited. Initially affecting short-term memory, it usually results in everyday tasks becoming more difficult to perform; however, people may experience it differently as no two people are the same.
The second most common form of dementia and difficult to diagnose, vascular dementia occurs when blood vessels in the brain are damaged, which reduces blood flow carrying oxygen and nutrients to the brain cells. This usually happens after a stroke or a series of ‘mini-strokes’, and is most common in those people between the ages of 60-70.
Vascular dementia is a progressive condition which tends to worsen in steps, differing from the more gradual progression of other forms of dementia. There are also periods of stable behaviour; however, this is usually a temporary situation, as over time brain damage could eventually lead to problems with memory, decision-making, attention and daily living. Usually people with this type of dementia live for approximately five years after the onset of symptoms.
Lewy Body Dementia
Affecting around ten percent of people diagnosed with dementia, this type is caused by small round deposits known as ‘Lewy Bodies’ which damage the tissue of the brain. As a result, the brain does not function as well as it should when receiving and sending messages. People with this type of dementia not only suffer with memory loss but can have hallucinations, tremors, physical stiffness and muscle weakness in their arms and legs. This type of dementia has many symptoms in common with Parkinson’s Disease such that with both conditions, the Lewy Body protein deposits are seen in brain cells. It should be noted that people with Lewy Body Dementia do not necessarily have symptoms of Parkinson’s; likewise, only some people with Parkinson’s may develop this type of dementia.
An umbrella term to describe several types of dementia with one thing in common: the front and side parts of the brain controlling language and behaviour are all affected. Sometimes known as ‘Pick’s disease’, this type of dementia may affect people as young as 45 years of age. Research has shown that even though the exact cause is not yet known, it does have a tendency to run in families, as people with it have mutations in certain genes. Symptoms range from loss of inhibitions and motivation, as well as speech problems and compulsive behaviour.
Extremely common and refers to a situation where more than one type of dementia has been diagnosed. The most common combination is Alzheimer’s and vascular dementia, and research has shown that 45 percent of people with dementia have mixed dementia but are not aware of it. Causing different symptoms in different people, some may experience memory loss first while others experience behaviour and mood changes. However, the majority of people diagnosed will have difficulty walking and speaking as the disease progresses.
Dementia is our most feared illness, more than heart disease or cancer.— David Perimutter
Stages of Dementia
Dividing the course of the particular type of dementia into stages will enable caregivers and medical professionals to measure the progress of a person’s cognitive health or decline; appropriate treatment will then be determined depending on their condition. Stages are not always exact and symptoms can be unpredictable, however, understanding these stages will ease the uncertainty of not knowing what is going to happen next. Once a proper diagnosis has been made, the stages can then be used as a guideline, enabling you to plan for the future. Dementia is usually divided into three stages.
Early Stage Dementia
Early stage dementia is not always easy to spot as the person may still have the ability to live independently—working, driving and socialising. Making it harder is the fact that being forgetful is in itself a symptom of getting older, however, forgetting familiar words or not being able to plan or organise the way they used to is usually a good indication that something is not right.
It’s important at this stage that the person is given a thorough medical examination by their doctor. There are a range of tests used to determine whether a person has dementia; physical exam, neurological exam, mental status tests, and other tests just to rule out other causes of symptoms.
Symptoms of Early Stage Dementia
- Frequently losing or misplacing things
- Struggling when trying to find the right word or name
- Having trouble planning or being able to organise on a daily basis
- Forgetting something they just listened to or read
- Feeling angry or frustrated
- Constantly repeating
- Experiencing low mood
Middle Stage Dementia
Middle stage dementia often lasts the longest, with the symptoms of dementia much more apparent. Increased levels of care will now be needed as people experiencing this stage of dementia are likely to require more assistance in their daily lives.
Symptoms of Middle Stage Dementia
- Everyday tasks such as bathing and grooming will become more difficult, and assistance will be needed with these tasks
- Sleep patterns will change as the person may sleep more during the day and feel restless at night
- Behavioural and personality changes are more common and are often caused by unfounded suspicion and agitation, resulting in paranoia, repetitive behaviour and delusions
- Levels of confusion are elevated
- Greater memory loss
- Some people will experience incontinence
- Becoming withdrawn, especially in social situations.
- There is an increased risk of wandering, especially at night, and getting lost
Later Stage Dementia
The person will need increasing amounts of care and support during the later stage of dementia. As they become increasingly frail, they may find it difficult to walk and may even be confined to bed. At this stage, their immune system is extremely low and they do not have the ability to fight off even simple infections. Although communicating is extremely difficult at this late stage, it is worth noting that many people will respond positively to a smile, affection and a soothing voice. Music can also be a source of comfort and enjoyment.
Symptoms of Later Stage Dementia
- Totally incontinent
- There is a gradual loss of speech
- Eating and swallowing is difficult
- There is very little recognition at this stage of family or friends, although sometimes there are flashes of recognition
- Increased feelings of restlessness
Evidence has shown that lifestyle changes such as eating a heart-healthy diet, stopping smoking and cutting back on alcohol can help protect the brain and reduce the risk of dementia later on. Patients, families and the public can now take part in research to help prevent dementia, manage it better and find a cure. If more volunteers are willing to participate in studies, then researchers can explore their ideas and find ways to help people live a better life.
My father sadly passed away six years ago with complications resulting from dementia with Lewy Bodies. My own feelings of this experience were mainly of helplessness and a sadness which never really goes away. Dad was cared for at home until it became necessary to have him moved into specialist care.
I once asked my mother how she personally coped during the hardest of times. She said that she remembered his patience, especially when we were little and he was teaching us how to ride our bikes. She remembered his understanding during those rebellious teenage years and his unwavering support if things went wrong as we grew into adults. Mostly she remembered his unconditional love, and this to her was the best coping strategy of all.
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
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© 2019 Lorna Lamon