Determining the type of dementia patients have helps them and their families understand the symptoms and prepare for the future. This is typically done by diagnosing symptoms and conducting cognitive tests. Brain imaging may be used, but the results can be vague.
While many diseases can cause dementia-like symptoms, the different types of dementia include:
Alzheimer’s disease makes up 60 to 80% of dementia cases. It is typically diagnosed in adults over the age of 80. Early-onset Alzheimer’s — a much rarer form —is diagnosed between ages 30 and 65. Alzheimer’s is caused by plaques that build up between nerve cells in the brain and fibrous tangles that spread within the nerve cells. The plaques and tangles, made up of different types of protein, progressively damage the brain.
The first signs of Alzheimer’s disease may be subtle. These can include memory loss, difficulty completing familiar tasks, misplacing things, increased anxiety, and personality changes. As Alzheimer’s progresses, it leads to difficulties with communication, impulsive and inappropriate behavior, confusion, and trouble recognizing family and friends.
The brain damage eventually worsens to the point where the person is unable to perform basic functions like swallowing or coughing, which leads to death. The prognosis is typically 4 to 8 years. People diagnosed at a younger age can live up to 20 years with Alzheimer’s. While there are medicines available that may slow the progression of Alzheimer’s in some people, there is currently no cure.
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Accounting for 10% of all dementia cases, vascular dementia is caused by a restricted blood flow to the brain, which damages brain tissue. Vascular dementia commonly occurs after a stroke or several minor strokes. It also can develop when blood vessels in the brain narrow with age. Brain imaging can help identify these changes. Depending on the cause, vascular dementia may come on suddenly.
The symptoms and severity of vascular dementia depend on how severely blood flow has been restricted and the part of the brain that is affected. Symptoms can be mild or severe and can include confusion, difficulty walking, impaired judgement, and difficulty speaking.
Lewy Body Dementia
Lewy body dementia is the third most common type of dementia, representing around 5 to 7.5% of cases. Lewy bodies are clumps of protein that form in regions of the brain that affect movement, memory, and thinking. These proteins gradually worsen the brain’s ability to function properly. The disorder has an average prognosis of 5 to 8 years.
Symptoms of Lewy body dementia include confusion, difficulty with focus and attention, and memory loss. What sets it apart from other dementias is that it is often characterized by hallucinations, daytime drowsiness, and movement problems such stiffness and slowness. While there is no cure for Lewy body dementia, medicines and physiotherapy can help to relieve some symptoms.
Frontotemporal dementia is a group of diseases that lead to nerve cell loss in the frontal and temporal lobes of the brain — areas associated with personality, behavior, and speech. Frontotemporal dementia represents 2 to 5% of all dementias and tends to occur at younger ages. It is most frequently diagnosed in those in their 50s and 60s.
Changes in behavior are associated with the disease. This includes becoming more withdrawn or, just the opposite, becoming more impulsive and outgoing. It also leads to language changes like stuttering and difficulty finding the right words. The average survival time is 6 to 8 years, but some patients live longer.
It’s not uncommon for people to have more than one form of dementia. They may have plaques in the brain, the hallmark of Alzheimer’s, as well as vascular changes.
To learn more or to schedule an evaluation, contact the UPMC Alzheimer’s Disease Research Center at 412-692-2700.
Alzheimer's Association. Types of Dementia. https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia
Dr. Nathan Falk, Dr. Ariel Cole, and Dr. Jason Meredith. (2018). Evaluation of Suspected Dementia. American Family Physician. https://www.aafp.org/afp/2018/0315/p398.html
Joesph Kane, et al. (2018). Clinical Prevalence of Lewy Body Dementia. Alzheimer's Research & Therapy. https://alzres.biomedcentral.com/articles/10.1186/s13195-018-0350-6
National Institute of Neurological Disorders and Stroke. Frontotemporal Dementia Information Page. https://www.ninds.nih.gov/Disorders/All-Disorders/Frontotemporal-Dementia-Information-Page
National Institute on Aging. What are the signs of Alzheimer's disease? US Department of Health and Human Services. https://www.nia.nih.gov/health/what-are-signs-alzheimers-disease
National Institute on Aging. Vascular Contributions to Cognitive Impairment and Dementia. US Department of Health and Human Services. https://www.nia.nih.gov/health/vascular-contributions-cognitive-impairment-and-dementia
US National Library of Medicine. Lewy Body Dementia. National Institutes of Health. https://medlineplus.gov/lewybodydementia.html
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