Dementia, a general term for a decline in cognitive function, can be a frightening diagnosis for both those experiencing it and their loved ones. However, with knowledge comes power. In this blog post, we’ll delve into the seven stages of dementia, exploring the different types and symptoms you might encounter at each stage, and even discuss treatment options available. By understanding how dementia progresses, we can better prepare to face it and ensure the highest quality of life for ourselves or those we care about.
What is Dementia?
Dementia, as defined by the CDC, isn’t a singular disease but an umbrella term for a decline in cognitive abilities that disrupts daily life. While Alzheimer’s is a well-known type, dementia encompasses various conditions. Though affecting millions globally, it’s important to remember dementia isn’t a natural part of aging. There’s no cure currently available, and symptoms worsen over time. The progression typically unfolds in stages, ranging from mild to severe dementia.
Types of Dementia
Dementia is a versatile problem and can have different conditions. Some more common than others are discussed here.
1. Alzheimer’s Disease
Alzheimer’s disease reigns as the most recognized and prevalent form of dementia, accounting for a staggering 60 to 80 percent of all dementia cases. This theft of memory wreaks havoc on cognitive abilities and behavior. People with Alzheimer’s often struggle to retain new information, experience memory lapses, and lose track of time and place. Daily tasks become a challenge, and poor judgment creeps in. Misplacing belongings repeatedly becomes a hallmark symptom. Despite ongoing research, the exact cause of Alzheimer’s remains under investigation, though theories point to the buildup of abnormal proteins around brain cells as a prime suspect.
2. Lewy Body Dementia
Lewy body dementia, another prominent form, arises from protein clumps wreaking havoc in the brain’s cortex. While the exact cause remains elusive, these clumps are linked to the demise of specific neurons responsible for producing crucial brain chemicals, impacting memory and learning. Lewy body dementia unfolds in a characteristic progression known as the 7 stages of Lewy body dementia. Symptoms throughout these stages include:
Visual hallucinations: Vivid, often disturbing, visuals that aren’t real.
Severe thinking and cognitive decline: marked deterioration in memory, reasoning, and problem-solving abilities.
Difficulty balancing or moving: increased risk of falls and impaired coordination.
Disrupted sleep patterns: restless nights, frequent daytime napping, or vivid dreams.
3. Frontotemporal Dementia
Frontotemporal dementia (FTD), also known as frontotemporal disorders, chips away at neurons in the brain’s frontal and temporal lobes. The exact culprit behind this damage remains a mystery, although genetics play a role in 10-30% of cases, suggesting a possible familial link. The 7 stages of frontotemporal dementia map a characteristic course of the disease. Symptoms can vary but often include:
Difficulty planning and problem-solving – Tasks that previously came quickly become overwhelming.
Repetitive behaviors: Individuals with FTD may get stuck in loops, repeating words or actions incessantly.
Speech and movement issues: Communication and physical coordination become progressively more challenging.
Behavioral changes: Apathy towards once-loved activities, mood swings, and social withdrawal are common signs.
Concentration and prioritization struggles: Focusing on tasks and managing priorities become increasingly difficult.
4. Vascular Dementia
Vascular dementia disrupts memory and behavior by damaging the brain’s blood vessels. While a definitive cause remains elusive, potential links have been identified with stroke history and cardiovascular disease. The disease progresses through stages, and symptoms can include:
Difficulty with once-routine tasks: Managing finances, following recipes, or keeping track of appointments can become burdensome.
Memory lapses: People with vascular dementia may forget recent events or conversations.
Frequently misplaced items: Keys, wallets, or phones become difficult to track.
Challenges with reading or writing: Communication skills can decline.
Disorientation: Getting lost in familiar places or confusion about the date and time is expected.
Loss of interest: Activities that once brought joy may no longer hold appeal.
Personality shifts: mood swings, anger outbursts, depression, anxiety, or social withdrawal can surface.
Impaired judgment: Risky behaviors or an inability to recognize dangerous situations may arise.
5. Parkinson’s Disease Dementia
Parkinson’s disease dementia, a complication affecting some Parkinson’s patients, is a decline in thinking and reasoning abilities that emerges at least a year after the initial Parkinson’s diagnosis, according to the Alzheimer’s Association. Not everyone with Parkinson’s will develop this dementia, and the exact cause remains unclear. However, brain changes associated with Parkinson’s are believed to contribute to its development. Symptoms of Parkinson’s dementia can include disturbing visual hallucinations, paranoia, memory lapses and concentration difficulties, disrupted sleep patterns, and behavioral changes like depression, irritability, and anger. Additionally, muffled speech or difficulty speaking may arise.
6. Huntington disease
Separate from the dementias discussed previously, Huntington’s disease is a unique inherited neurodegenerative disorder. Unlike those, Huntington’s disease isn’t caused by a mutated gene but by protein buildup in the brain. This mutation triggers the progressive breakdown of nerve cells, especially in areas controlling movement, thinking, and emotions. Huntington’s disease has a distinct set of symptoms, including uncontrollable jerky movements, difficulty with coordination, and problems with memory, reasoning, and behavior. The disease is hereditary, and while it can develop at any age, it often begins in mid-life, casting a long shadow over individuals and their families.
Symptoms of dementia
- Memory loss
While it might seem repetitive, memory loss is a crucial symptom to highlight in dementia. It’s often the earliest and most noticeable change. This forgetfulness can manifest in many ways, from misplacing belongings to struggling to recall recent conversations or events. The severity of memory loss can vary depending on the type and stage of dementia, but it’s a hallmark sign that shouldn’t be ignored.
- Difficulty concentrating
Difficulty concentrating is another hallmark symptom of dementia, often accompanying memory loss. People with dementia may find focusing on tasks or conversations increasingly challenging. Simple activities that were once manageable, like following a recipe or paying bills, can become frustrating due to lapses in concentration. Distractions become more disruptive, and the ability to sustain attention dwindles. This decline in focus can significantly impact daily life and independence.
- Problems with language
Problems with language are a frustrating symptom for both those experiencing dementia and their loved ones. Communication can become a hurdle as individuals struggle to find the right words, substitute them with related terms (“cup” for “glass”), or even describe something with a simple phrase like “that thing you sit on” instead of “chair.” Sometimes, the order of words might get jumbled, or the person might use nonsensical language altogether. This decline in language ability can hinder self-expression and make everyday interactions more challenging.
- Disorientation
Disorientation can be a frightening and isolating symptom of dementia. People with dementia may become lost in familiar places, even their homes. They might struggle to grasp the date or time, feeling this anchored from the present moment. This confusion can lead to anxiety and difficulty navigating daily routines. Simple tasks like driving or following directions become fraught with challenges due to the disorientation brought on by dementia.
- Poor judgment
Poor judgment is a significant symptom of dementia that can disrupt daily life and safety. Those with dementia may struggle to make sound decisions, like managing finances responsibly or recognizing potential dangers. This can manifest in risky behaviors, neglecting personal care, or falling victim to scams. The inability to weigh consequences and make appropriate choices underscores the importance of support and supervision as dementia progresses.
- Personality changes
Personality changes are a common and often upsetting symptom of dementia. The person you knew and loved may become withdrawn and uninterested in activities they once cherished. In some cases, irritability, agitation, or even aggression can surface, leaving loved ones confused and heartbroken. These shifts are due to the underlying brain changes in dementia and can be incredibly challenging. Patience and understanding are crucial in navigating these personality changes, and seeking professional guidance can help families cope and provide the best care.
- Loss of coordination
Loss of coordination, though not always present in the early stages, can emerge as dementia progresses. This can manifest in a few ways: gait may become unsteady, increasing the risk of falls. Simple tasks requiring hand-eye coordination, like buttoning a shirt or pouring a cup of tea, may become difficult. In some cases, tremors or stiffness in the muscles can develop. This decline in physical coordination can necessitate adjustments to daily living and highlight the need for additional support.
Stages of Dementia
Stage 1: No Cognitive Decline
While the early stages of dementia may not present any outward symptoms, this can be a critical window for medical evaluation and planning. Even though a person with early dementia might appear unchanged, tests could detect underlying problems. This pre-symptomatic phase offers a valuable opportunity for families to work with their loved ones to establish future care preferences and make informed decisions about their journey with dementia.
Stage 2: Very Little Cognitive Decline
The early signs of dementia can be subtle. Someone in this stage might struggle to find the right words in conversation, forget details when planning activities, or occasionally misplace belongings. Despite these changes, they’ll likely still be independent, and their usual personality will shine through.
Stage 3: Mild Cognitive Impairment
As dementia progresses, the subtle changes become more noticeable. Loved ones might start to observe forgetfulness regarding recently made plans or conversations. Daily tasks like managing finances, medications, or appointments may become trickier. They might struggle to keep track of dates or even forget essential events altogether. While the person can likely still function independently, there’s a growing difficulty with concentration and overall thinking abilities.
Stage 4: Moderate Cognitive Decline
In the middle stage of dementia, the challenges become more apparent. Everyday tasks like laundry or cooking might become a struggle. Misplacing belongings like glasses or phones happens more frequently. They may forget recent events entirely and have difficulty focusing. Common signs are feeling lost in unfamiliar places and being unable to complete tasks independently. While long-term memories may remain intact, navigating the present becomes increasingly tricky.
Stage 5: Moderately Severe Cognitive Decline
The late stage of dementia is marked by significant memory loss and a decline in physical abilities. Daily living requires assistance, as individuals may forget familiar details like their addresses or family member’s names. Disorientation to time and place becomes common. Personality changes and mood swings may become more pronounced. They may need help with basic tasks like eating and toileting.
Stage 6: Severe Cognitive Decline
In the very late stages of dementia, memory loss becomes severe. Individuals may not recognize even close family members or forget significant life events. Daily activities like bathing and eating require constant assistance. Personality changes become more pronounced, with possible delusions and compulsions. Communication becomes limited, and incontinence is common. This stage necessitates full-time care from a loved one or a healthcare professional.
Stage 7: Very Severe Cognitive Decline
The final stage of dementia brings a significant decline in both mental and physical abilities. Communication becomes minimal or nonexistent. Loss of motor skills makes walking difficult and often necessitates a wheelchair. Daily activities require complete assistance as the person can no longer care for themselves. This stage is very demanding and necessitates full-time care.
How To Treat Dementia
Medications
While there’s no cure for dementia, medications can manage some symptoms. Cholinesterase inhibitors like donepezil, rivastigmine, and galantamine help improve memory and thinking by increasing essential brain chemicals. Memantine (Namenda) regulates another key brain chemical involved in learning and memory. Additionally, doctors might prescribe medications to address specific concerns like depression, anxiety, or sleep problems that often accompany dementia.
Therapies
Dementia can be managed without solely relying on medication. Occupational therapists can equip patients with coping mechanisms and modify their home environment to ensure safety. This may involve decluttering, hiding hazardous objects, and installing monitoring systems to prevent wandering. Additionally, simplifying daily tasks and establishing routines can reduce confusion and make daily life easier for those with dementia.
FAQs
How Fast Does Dementia Progress?
Dementia is considered a progressive problem and can become more prominent and worsen. But it also goes into a specific timeline and has particular factors that can help to progress dementia;
Some specific types of dementia, like Alzheimer’s disease, progress slower than others.
It is also a common belief that dementia progresses slower in old age people than the younger.
A person with other medical conditions, like heart problems, has more progressive dementia than others.
How Long Can a Person Live With Dementia?
A person with dementia can live for years if diagnosed, but this life factor depends on other factors like age, health conditions and the type of dementia.
Alzheimer’s disease: 8–10 years ( some 15–20 years)
Lewy body dementia: 6 years
Vascular dementia: 5 years
Frontotemporal dementia: 6–8 years
When To See a Healthcare Provider?
Early detection of dementia is crucial, even though noticeable symptoms might not appear until later stages. Here are some key reasons to see a healthcare provider:
Family history: If dementia runs in the family, a checkup can be helpful despite a lack of current symptoms. Early detection allows time for planning and discussing future care preferences.
Increased forgetfulness or personality changes: While occasional forgetfulness is daily with age, consistent memory lapses or noticeable behavior shifts warrant a doctor visit. Family members who observe these changes can also encourage a checkup.
PCP referral to a specialist: A primary care physician is often the first point of contact for behavioral changes. However, if your PCP suggests seeing a specialist like a neurologist or a geriatrician, it’s essential to follow that recommendation for a more in-depth evaluation and potential dementia diagnosis.
How Is Dementia Diagnosed?
Pinpointing dementia can be tricky because it’s an umbrella term for various diseases. There’s no single definitive test. However, a doctor can employ a multi-pronged approach:
Cognitive Tests assess memory, language, and thinking skills to gauge potential dementia and its severity.
Brain Scans: CT or MRI scans can reveal strokes, bleeding, or other abnormalities, while PET scans might show protein deposits linked to specific dementias.
Lab Tests: Blood work helps rule out other causes for symptoms, like vitamin deficiencies or thyroid problems. This ensures a more accurate dementia diagnosis.
