Spotting the signs of dementia is the first step to diagnosis

As part of our contribution to dementia awareness week, we wanted to help ground people in the terms often used interchangeably to describe dementia

Produced by: Ian Smyth

Dementia is an umbrella term for a range of conditions that cause damage to the brain.

As part of our contribution to Dementia Action Week, we wanted to help ground people in the terms often used interchangeably to describe dementia. We want to clarify and highlight the diseases that lead to damage to the brain.

The Different Types of Dementia 

Alzheimer's disease is the most common type of dementia and accounts for around two-thirds of cases, although there are several other types of dementia. Other types include:

  • Vascular dementia

  • Lewy body dementia

  • Frontotemporal dementia (FTD)

  • Korsakoff syndrome.

We will look at these in turn and help clarify how these diseases differ, how the symptom profiles can overlap, and where they don't.

Each disease has unique characteristics and symptoms, but they can all lead to memory problems, confusion, changes in behaviour or personality, difficulty in communicating and difficulty performing everyday tasks.

Alzheimer's Disease

Alzheimer's disease is a devastating neurodegenerative disorder affecting millions of people worldwide. It is an irreversible and progressive brain disorder that slowly destroys memory and thinking abilities, eventually leading to changes in behaviour and physical decline. Over time, the symptoms of Alzheimer's disease interfere with daily life and can cause confusion, frustration, and distress for people living with the disease and their families.

Common signs of Alzheimer's disease include difficulties with:

  • Remembering recent conversations or events

  • Carrying out familiar tasks at home or work

  • Problem-solving or planning activities

  • Confusion about time or location

  • Changes in mood or personality.

A predominant feature of Alzheimer's disease is the build-up of misfolding proteins B-Amyloid and P-Tau in the brain (sometimes referred to as plaques and tangles). But there are other mechanisms at play too, and research is ongoing to enable a complete understanding of the true nature and cause. It was known as a condition of ageing; however, Alzheimer's disease is not a part of normal ageing and should be viewed as a disease to be treated and ultimately cured.

Lewy Body Dementia

Lewy body dementia is a progressive neurological disorder that affects movement, cognition, behaviour, and mood. It is the second most common type of dementia after Alzheimer's disease. Common symptoms include:

  • Cognitive decline

  • Visual hallucinations

  • Fluctuations in alertness and attention

  • Stiffness

  • Jerky movements (also known as "parkinsonism")

  • Difficulty with movement

  • Incontinence

  • Depression.

There is presently no cure for Lewy body dementia, though medications may help slow the progression of the disease.

A predominant feature of Lewy body disease is the build-up of protein deposits called Lewy bodies in nerve cells in the brain. People with Lewy bodies in their brain also have the plaques and tangles associated with Alzheimer's disease.

Vascular Dementia

Vascular dementia is a form of dementia caused by impaired blood flow to the brain. This can lead to problems with thinking, reasoning, and memory. Symptoms of vascular dementia include difficulty with:

  • Problem-solving

  • Planning

  • Decision making

  • Organisation

  • Mood changes.

People may have trouble walking or controlling their bladder or bowels in later stages. Treatment for vascular dementia includes treating underlying conditions such as high blood pressure and diabetes that may be contributing factors, medications to help improve cognitive function, physical therapy to help maintain mobility, and strategies to help manage symptoms. It is also important for people living with vascular dementia to create meaningful daily routines, pay attention to diet and nutrition, get regular exercise, and stay socially connected.

Frontotemporal Dementia

Frontotemporal dementia is a progressive neurological disorder that primarily affects the frontal and temporal lobes of the brain. It's characterised by changes in behaviour, personality, language, and movement. Symptoms can vary widely from person to person, depending on which brain areas are affected. These may include problems with:

  • Decision-making

  • Planning

  • Problem-solving

  • Social interaction

  • Understanding others' emotions.

Other symptoms may include irritability or aggression towards people or objects, low motivation and energy levels, and apathy or indifference to events around them.

Frontotemporal dementia can impact a person's ability to work and complete daily tasks, thus affecting their quality of life.

In frontotemporal dementia, the frontal and temporal lobes of the brain shrink. In addition, certain substances accumulate in the brain. What causes these changes is usually unknown.

Korsakoff Syndrome

Korsakoff syndrome is a permanent memory disorder that usually develops due to alcohol misuse or nutritional deficiencies. It is characterised by an inability to form new memories and problems recalling previously learned information. People with Korsakoff syndrome may also display:

  • Disorientation

  • Confusion

  • Difficulty concentrating and planning

  • Impaired judgment

  • Social and personality changes

  • Amnesia.

The exact cause of Korsakoff syndrome is unknown, but it is thought to be related to the damage caused by thiamine deficiency or heavy drinking. This can lead to changes in brain tissue, affecting the normal functioning of specific brain parts responsible for memory formation and storage. Treatment involves correcting underlying causes, such as reducing alcohol consumption or improving nutrition.

Nutritional supplementation may be needed to replenish thiamine levels.

Closing thoughts

We hope you find the information in this article helpful, it's challenging to capture all the facets of each disease that leads to dementia, but we encourage you to explore more so you can support those close to you who may be affected by these diseases.

Three Key Takeaways 

In the meantime, we want to leave you with three simple messages:

  • Dementia is caused by various diseases, each with its own unique pathology.

  • Dementia is not an inevitable part of ageing. Promising research and treatments are closer today than ever.

  • There is every reason for hope; there are always preventative measures people can take to support good brain health.

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