What Is Dementia? Stages, Types, Treatments, & Care

Alzheimer’s Disease

As the most common type of dementia and the sixth-leading cause of death in the U.S., Alzheimer’s disease poses major challenges for patients, loved ones, caregivers, and the nation’s healthcare system. Alzheimer’s is currently a terminal disease, meaning that it is fatal and irreversible; no cure exists. So the toll it takes can be overwhelming for everyone involved.

Like most other forms of dementia, Alzheimer’s disease comes on gradually. People with this disease tend to appear perfectly normal during the earliest stages. But as the disease progresses, the symptoms slowly become more obvious and life-altering. Every patient is different, but some of the most characteristic symptoms of Alzheimer’s disease include:

• Memory problems (especially when it comes to remembering new information)
• Trouble using words to communicate
• Confusion and disorientation
• Impaired thinking and poor decision-making
• Strange, out-of-character behavior
• Emotional problems, such as sadness, fear, or anxiety
• Lack of interest in previously enjoyed hobbies
• Trouble completing routine tasks and daily activities
• Restlessness and agitation
• Incontinence
• Impaired motor functions, such as trouble walking and swallowing (mostly during advanced stages of the disease)

Researchers continue to make discoveries about what happens to the brains of Alzheimer’s patients. They’ve already discovered that this disease causes changes to a person’s brain at both a structural and cellular level. At the structural level, the disease impairs the limbic system first, followed by the cerebral cortex and then the brain stem. The disease can also prevent the formation of new blood vessels in different parts of the brain. At the cellular level, the disease progressively destroys a person’s brain cells (known as neurons). As neurons die, affected areas of the brain start to shrink. Two proteins are thought to play a role in that process:

• Beta-amyloid: In Alzheimer’s patients’ brains, abnormal plaques (mostly consisting of this protein) form like scar tissue between neurons. As more and more of these plaques accumulate in the brain, neurons are less and less able to send messages to each other.
• Tau: In a healthy brain, this protein helps neurons maintain their internal structure. But in people with Alzheimer’s disease, it forms tangled bundles of fibers that prevent the normal functioning of neurons.

So for people with Alzheimer’s disease, it’s like their internal “lights” are slowly being dimmed and shut off. And there is currently no way to turn those lights back on; the damage is permanent. That’s what makes Alzheimer’s such a scary illness. Plus, the damage often begins ten or more years before any symptoms emerge.

Here are some additional facts about Alzheimer’s disease:

• Data from the World Health Organization (WHO) indicates that it may play a major role in as many as 60 to 70 percent of all dementia cases.
• According to a report from the Alzheimer’s Association, about 10 percent of seniors above the age of 65 have the disease.
• The above report also found that nearly two-thirds of Alzheimer’s patients in the U.S. are women.

Vascular Dementia

Vascular dementia is another prevalent form of dementia. But many people with vascular dementia also have Alzheimer’s disease. With medication and lifestyle changes, you can treat vascular dementia and slow down its progression. However, the damage that’s already done cannot be reversed. And the condition itself cannot yet be cured. With vascular dementia, symptoms generally vary a little depending on the underlying cause.

Vascular dementia is caused by interruptions to the flow of blood in a person’s brain. Those interruptions can be due to strokes or build-ups of fatty material that result in the narrowing of blood vessels. Some patients have both problems. Symptoms of vascular dementia can include:

• Memory loss
• Trouble organizing thoughts and coordinating actions
• Difficulty with decision-making
• Struggles with problem-solving
• Trouble communicating verbally
• Personality changes
• Agitation
• Confusion
• Loss of bladder control
• Mobility problems
• Numbness or weakness in a particular area of the body

Not everyone who has a stroke develops vascular dementia. But having a stroke does increase your risk. Roughly one-third of stroke survivors who previously had no dementia eventually develop this condition—often within one year.

Lewy Body Dementia (LBD)

As the second most common type of degenerative dementia, this sometimes-overlooked disease affects many people—about 1.4 million people in the U.S. alone. But it can be very difficult to diagnose since it often occurs alongside Alzheimer’s disease or vascular dementia. It can even occur alongside Parkinson’s disease. Patients with LBD can display a wide variety of symptoms. Some of the most distinctive signs of Lewy body dementia can include:

• Delusions
• Visual hallucinations
• Symptoms that get better or worse from one moment (or hour) to the next
• Physically acting out violent or vivid dreams at night
• Staring with a blank facial expression
• Shaking while walking
• Standing or moving stiffly, slowly, or with a shuffle

Other symptoms often include the same ones displayed by Alzheimer’s patients or those with vascular dementia. In the brains of people with LBD, abnormal protein deposits (known as Lewy bodies) accumulate and make it difficult for neurons to communicate. As the disease progresses, more and more neurons die, causing all kinds of cognitive, behavioral, and physical problems, particularly at the most advanced Lewy body dementia stages.

Frontotemporal Dementia (FTD)

Unlike other types of dementia, FTD doesn’t usually cause memory problems until late in the disease cycle. That’s because it first attacks the parts of the brain that control speech, personality, thought, and behavior. FTD is considered a group of dementias, with each type affecting a person in particular ways. For example:

• A person with progressive nonfluent aphasia will have difficulty speaking or finding the right words to use.
• Someone with semantic dementia will have a hard time understanding what other people are saying.
• People with behavioral variant FTD will often have trouble planning, concentrating, and solving problems. They also frequently have personality changes that lead to strange, obsessive, or inappropriate behavior.

Many people with FTD also experience muscle weakness and trouble with physical movement. The underlying cause of FTD is currently unknown. However, in some patients, certain genes may play a role. And some FTD patients have abnormal accumulations of proteins (called Pick bodies) in their brains.