Do Dementia Symptoms Come And Go

Symptoms Or Conditions Mistaken For Dementia

Expert reviewers, Dr Pravir Sharma, Consultant in Mental Health Care and Old Age Psychiatry and Dr Adrian Raby, General PractitionerNext review due December 2024

Dementia can sometimes be difficult to spot because it develops slowly, especially in the early stages. Its also easy for people to mistake dementia signs for another problem or health condition and to mistake the signs of a different problem for dementia.

This page gives an overview of problems that may cause similar symptoms to dementia.

A Person With Dementia Doesnt Always Fit Into One Stage

Dementia affects each person in a unique way and changes different parts of the brain at different points in the disease progression.

Plus, different types of dementia tend to have different symptoms.

For example, someone with frontotemporal dementia may first show extreme behavior and personality changes. But someone with Alzheimers disease would first experience short-term memory loss and struggle with everyday tasks.

Researchers and doctors still dont know enough about how these diseases work to predict exactly what will happen.

Another common occurrence is for someone in the middle stages of dementia to suddenly have a clear moment, hour, or day and seem like theyre back to their pre-dementia abilities. They could be sharp for a little while and later, go back to having obvious cognitive impairment.

When this happens, some families may feel like their older adult is faking their symptoms or just isnt trying hard enough.

Its important to know that this isnt true, its truly the dementia thats causing their declining abilities as well as those strange moments of clarity theyre truly not doing it on purpose.

What Are The Causes Of Lewy Body Dementia

The precise cause of LBD is unknown, but scientists are learning more about its biology and genetics. For example, we know that an accumulation of Lewy bodies is associated with a loss of certain neurons in the brain that produce two important chemicals that act as messengers between brain cells . One of these messengers, acetylcholine, is important for memory and learning. The other, dopamine, plays an important role in behavior, cognition, movement, motivation, sleep, and mood.

Scientists are also learning about risk factors for LBD. A risk factor is something that may increase the chance of developing a disease. Some risk factors can be controlled while others cannot. Age is considered the greatest risk factor. No specific lifestyle factor has been proven to increase one’s risk for LBD.

Other known risk factors for LBD include certain diseases and health conditions, particularly Parkinson’s disease and REM sleep behavior disorder, which have been linked to a higher risk of LBD.

Having a family member with LBD also may increase a person’s risk, though LBD is not considered a genetic disease. Variants in three genes APOE, SNCA, and GBA have been associated with an increased risk, but in most cases, the cause is unknown.

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Symptoms In The Later Stages Of Dementia

As dementia progresses, memory loss and difficulties with communication often become severe. In the later stages, the person is likely to neglect their own health, and require constant care and attention.

The most common symptoms of advanced dementia include:

• memory problems people may not recognise close family and friends, or remember where they live or where they are
• communication problems some people may eventually lose the ability to speak altogether. Using non-verbal means of communication, such as facial expressions, touch and gestures, can help
• mobility problems many people become less able to move about unaided. Some may eventually become unable to walk and require a wheelchair or be confined to bed
• behavioural problems a significant number of people will develop what are known as “behavioural and psychological symptoms of dementia”. These may include increased agitation, depressive symptoms, anxiety, wandering, aggression, or sometimes hallucinations
• bladder incontinence is common in the later stages of dementia, and some people will also experience bowel incontinence
• appetite and weight loss problems are both common in advanced dementia. Many people have trouble eating or swallowing, and this can lead to choking, chest infections and other problems. Alzheimer’s Society has a useful factsheet on eating and drinking

Going For An Assessment

The list of conditions and problems above isnt everything. Theres a whole range of things that can occasionally cause dementia-like symptoms for some people.

There isnt always a quick answer to the question, Is it dementia or something else? If someone has dementia-like symptoms, the most important thing to do is see their GP for a full assessment.

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The Seven Stages Of Dementia

One of the most difficult things to hear about dementia is that, in most cases, dementia is irreversible and incurable. However, with an early diagnosis and proper care, the progression of some forms of dementia can be managed and slowed down. The cognitive decline that accompanies dementia conditions does not happen all at once – the progression of dementia can be divided into seven distinct, identifiable stages.

Learning about the stages of dementia can help with identifying signs and symptoms early on, as well as assisting sufferers and caretakers in knowing what to expect in further stages. The earlier dementia is diagnosed, the sooner treatment can start.

How Is Early Dementia Diagnosed

Blood, urine, genetic tests, and brain scans are some of the medical tests that can be used in the diagnosis of dementia. Blood or urine tests can be used to exclude other causes of dementia symptoms by checking for infections, vitamins and minerals, and more.

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What Are The Different Types Of Dementia

Various disorders and factors contribute to the development of dementia. Neurodegenerative disorders result in a progressive and irreversible loss of neurons and brain functioning. Currently, there are no cures for these diseases.

The five most common forms of dementia are:

• Alzheimers disease, the most common dementia diagnosis among older adults. It is caused by changes in the brain, including abnormal buildups of proteins, known as amyloid plaques and tau tangles.
• Frontotemporal dementia, a rare form of dementia that tends to occur in people younger than 60. It is associated with abnormal amounts or forms of the proteins tau and TDP-43.
• Lewy body dementia, a form of dementia caused by abnormal deposits of the protein alpha-synuclein, called Lewy bodies.
• Vascular dementia, a form of dementia caused by conditions that damage blood vessels in the brain or interrupt the flow of blood and oxygen to the brain.
• Mixed dementia, a combination of two or more types of dementia.

Types Of Lewy Body Dementia And Diagnosis

LBD refers to either of two related diagnoses dementia with Lewy bodies and Parkinson’s disease dementia. Both diagnoses have the same underlying changes in the brain and, over time, people with either diagnosis develop similar symptoms. The difference lies largely in the timing of cognitive and movement symptoms.

In DLB, cognitive symptoms develop within a year of movement symptoms. People with DLB have a decline in thinking ability that may look somewhat like Alzheimer’s disease. But over time, they also develop movement and other distinctive symptoms of LBD.

In Parkinson’s disease dementia, cognitive symptoms develop more than a year after the onset of movement symptoms . Parkinson’s disease dementia starts as a movement disorder, with symptoms such as slowed movement, muscle stiffness, tremor, and a shuffling walk. These symptoms are consistent with a diagnosis of Parkinson’s disease. Later on, cognitive symptoms of dementia and changes in mood and behavior may arise.

Not all people with Parkinson’s disease develop dementia, and it is difficult to predict who will. Many older people with Parkinson’s develop some degree of dementia.

Caregivers may be reluctant to talk about a person’s symptoms when that person is present. Ask to speak with the doctor privately if necessary. The more information a doctor has, the more accurate a diagnosis can be.

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The Facts Of Rapid Onset Dementia Life Expectancy

Dementia refers to a group of conditions characterized by the loss of cognitive functioning, such as memory, thinking, and reasoning. For some individuals with this disease, the progression is slow, taking years to reach an advanced stage. However, for others, dementia can develop and progress rapidly. The speed of progression primarily depends on the underlying cause of the disease. If you have a loved one that has been diagnosed with rapid onset dementia, you may feel overwhelmed and unsure of the future. Learn more about the rapid onset dementia life expectancy and what steps you should take.

The Middle Stage Of Dementia

In the middle stage of dementia, symptoms become more noticeable and the person will need more support in managing daily life. This stage of dementia is often the longest. On average it lasts about two to four years.

The progression and stages of dementia

In the middle stage of dementia, symptoms become more noticeable and the person will need more support in managing daily life. The person may now need frequent reminders and some help to wash and dress .

Some people with dementia will benefit from a paid carer coming into their home. Or some may move into housing with dementia support on site .

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Dementia Stages: How Fast Dementia Progresses Stages Of Dementia And More

Dementia is a progressive impairment of cognitive function caused by damage to the brain. Over time, a person with dementia will have increased difficulty with memory, understanding, communication, and reasoning.

Healthcare providers frequently speak about a persons dementia in terms of stages. This can be helpful for communicating with family or other healthcare providers regarding the persons illness, and it is important for determining an appropriate care plan.

How Fast Does Dementia Progress?

It is important to note that dementia progresses at different speeds for every person, and for different types of dementia. The most well-known form of dementia, Alzheimers disease, is just one specific type of dementia, and tends to have the slowest progression of all types. Some factors that affect the rate of progression include:

• Age
• Repeated infections

What are the Stages of Dementia?

There are a few different systems used to grade dementia — at the most basic there is early, moderate, and end. Many providers use the system developed by Dr. Barry Reisberg of New York University which includes 7 stages. The Reisberg scale is also known as the GDS or Global Deterioration Scale for Assessment of Primary Degenerative Dementia. This scale focuses primarily on cognitive abilities.

Dementia Stages in the Reisberg Scale

Dementia Stages in the FAST Scale

Dementia Stages in the CDR Scale

Coping With Cognitive Changes

Some medications used to treat Alzheimer’s disease also may be used to treat the cognitive symptoms of LBD. These drugs, called cholinesterase inhibitors, act on a chemical in the brain that is important for memory and thinking. They may also improve hallucinations, apathy, and delusions. The U.S. Food and Drug Administration has approved one Alzheimer’s drug, rivastigmine, to treat cognitive symptoms in Parkinson’s disease dementia. Several other drugs are being tested as possible treatments for LBD symptoms or to disrupt the underlying disease process.

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‘can Covid Symptoms Come And Go’

Like so many aspects of COVID-19, were still learning a lot about its symptoms and how they progress. If youve tested positive for COVID-19, started feeling better, and then developed symptoms again, you may wonder if thats normal. Can COVID-19 symptoms come and go like that?

Based on what we know right now, yes, COVID-19 symptoms can go up and down during the recovery period.

Some illnesses, like the common cold, run a pretty straight course: Your nose becomes stuffy, you feel fatigued, and then over the course of a few days your nose dries up and your energy returns. But people with COVID-19 report that their symptoms can go from good to bad overnight as they recover. They may be free from fever for a couple of days and then develop a new, low-grade fever. Or their cough may seem to be getting better, only to get much worse a day later.

As far as we know right now, these developments are normal, and most people do get better within a couple of weeks after their symptoms began, even if their symptoms spike and drop during the recovery period.

However, a few people seem to develop a chronic case of COVID-19. Sometimes described as long-haulers, these people cycle through the symptoms of COVID-19 for weeks on end. Some people report needing additional care for as much as 6 months after their initial diagnosis and subsequent recovery.

Can Alzheimer Come And Go

Alzheimer symptoms can be confusing. Nearly everyone who cares for someone with Alzheimer has seen the signs for years. And then it seems that suddenly things get really bad, it lasts for weeks and then may stop again. And your mother/father/partner seems to be back to being the one you have always known. And then after a couple of weeks, it starts again. Maybe your loved one starts seeing things, hearing things They seem to be stable and then slip back into a state where everything seems unreal.

Alzheimer once it has been officially diagnosed does not go away, but the symptoms can come and go and the condition can manifest itself differently depending on the person. Alzheimer symptoms and signs progress at different rates. There are different stages, but it doesnt ever go away.

Dementia progresses rapidly for some people, while it takes years to reach an advanced stage for others. People with mild dementia may still be able to function independently, with memory lapses that have a minimal impact on daily life, such as forgetting words or where things are located.

Alzheimer symptoms are divided in different phases

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Steve Thompson Recalls Signs Of His Early

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Previously, smaller-scale research, looking at elderly subjects, found that a slower gait may be an early sign of cognitive decline. The journal Neurology explained that this might be down to the right hippocampus shrinking as this part of your brain is associated with memory.

Knowing The Stages Of Dementia Helps You Plan

Even if the stages arent exact and symptoms can still be unpredictable, being able to plan ahead is essential.

The truth is that Alzheimers and dementia care is expensive and time-consuming. Being financially prepared for increasing care needs is a necessity.

On an emotional level, having an idea of what symptoms to expect helps you find ways to cope with challenging behaviors.

It also gives you a chance to mentally prepare yourself for the inevitable changes in your older adult.

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How Can Healthcare Professionals Help At This Stage

Healthcare professionals can explain these changes so you understand what is happening.

Healthcare professionals can also take steps to reduce the persons pain or distress, often using medication.

If the person cant swallow, then medication can be provided through patches on the skin, small injections or syringe pumps that provide a steady flow of medication through a small needle under the persons skin. Speak to a GP or another health professional about this.

Talking Point

Facts About Alzheimer Disease

Alzheimer disease is becoming more common as the general population gets older and lives longer. Alzheimer disease usually affects people older than 65. A small number of people have early-onset Alzheimer disease, which starts when they are in their 30s or 40s.

People live for an average of 8 years after their symptoms appear. But the disease can progress quickly in some people and slowly in others. Some people live as long as 20 years with the disease.

No one knows what causes Alzheimer disease. Genes, environment, lifestyle, and overall health may all play a role.

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Vascular Dementia Signs And Symptoms

Vascular dementia affects different people in different ways and the speed of the progression also varies from person to person. Some symptoms may be similar to those of other types of dementia and usually reflect increasing difficulty to perform everyday activities like eating, dressing, or shopping.

Behavioral and physical symptoms can come on dramatically or very gradually, although it appears that a prolonged period of TIAsthe mini-strokes discussed aboveleads to a gradual decline in memory, whereas a bigger stroke can produce profound symptoms immediately. Regardless of the rate of appearance, vascular dementia typically progresses in a stepwise fashion, where lapses in memory and reasoning abilities are followed by periods of stability, only to give way to further decline.

What Are Specific Care Needs At Each Stage

An individual may not require care assistance after the initial diagnosis of dementia, but that will change as the disease progresses and symptoms become worse. There are about 16 million unpaid caregivers of people with dementia in the United States. While many caregivers are providing daily help for family members, they also hire someone to help. There are many options of care assistance, such as in-home care, adult day care, and nursing home care. There is also financial assistance available.

Early Stage DementiaAs mentioned above, in the early stage of dementia a person can function rather independently and requires little care assistance. Simple reminders of appointments and names of people may be needed. Caregivers can also assist with coping strategies to help loved ones remain as independent as possible, such as writing out a daily to-do list and a schedule for taking medications. Safety should always be considered, and if any tasks cannot be performed safely alone, supervision and assistance should be provided. During this period of dementia, its a good idea for caregivers and loved ones to discuss the future. For example, a long-term care plan should be made and financial and legal matters put in place.

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