What Happens In The Early Stage Of Dementia
Dementia affects everyone differently and early symptoms are often relatively mild and not always easy to notice.
Many people at the early stage of dementia stay largely independent and only need a bit of assistance with daily living. It is important to focus on what the person can do and not to take over and do things for them. Instead, try doing things with them, for example helping the person develop a routine, reminder lists and prompts, and use technology.
For more information for people living with dementia, see the Keeping active and involved page.
The early stage of dementia is when many people choose to make plans for the future, while they still have the ability to do so. This includes making a Lasting power of attorney , and advance decisions and advance statements to ensure their wishes and preferences are made clear.
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Outlook For Frontotemporal Dementia
How quickly frontotemporal dementia gets worse varies from person to person and is very difficult to predict.
People with the condition can become socially isolated as the illness progresses. They may not want to spend time in the company of others, or may behave in rude or insulting ways.
Home-based help will usually be needed at some stage, and some people will eventually need care in a nursing home.
The average survival time after symptoms start is around 8 to 10 years. But this is highly variable and some people live much longer than this.
If you or a loved one has been diagnosed with dementia, remember you’re not alone. The NHS and social services, as well as voluntary organisations and specialist support groups, can provide advice and support for you and your family.
Stage 3 Mild Changesquality Of Life: Very Little Impact
You likely will start to notice changes in your loved ones thinking and reasoning. You also will see some memory loss. You may see your loved one:
- Show some signs of forgetfulness, such as losing an item and not being able to retrace steps to find it.
- Have some difficulty finding the right words or names.
- Take more effort to remember appointments, manage money, and manage medicines.
- Have trouble paying attention all the time.
- Begin to have problems at work.
How You Can Help:
If you havent already done it, help your loved one plan for when he or she might have severe dementia. Use our tools to create a document that list his or her values and priorities at different stages of dementia.
If you have, help the health care team follow your loved ones care preferences.
You can also help with:
- Organizing appointments.
- Managing medicines, such as using a pill organizer.
- Helping to put legal and financial documents in order.
- Start to do more of the driving, if possible.
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Whats The Outlook For This Condition
FTD gradually affects more and more areas of your brain, disrupting the abilities those areas control. The average life expectancy for a person after diagnosis with FTD is 7.5 years.
While FTD isnt fatal on its own, it often causes other issues that are serious or even life-threatening. One common problem that often happens as FTD gets worse is dysphagia . Having dysphagia causes problems with eating, drinking and speaking, and increases the risk of developing pneumonia or respiratory failure.
How Does This Condition Affect My Body
FTD affects your brain’s frontal and temporal lobes in the early and middle stages of the disease. As FTD affects those lobes, you lose certain abilities because neurons in those areas stop working.
Your frontal lobe, located right behind your forehead, is responsible for the following:
- Movement.
- Changes in diet or mouth-centered behaviors.
- Loss of executive function.
Loss of inhibitions
Inhibition is when your brain tells you not to do something. Losing your inhibitions because of frontal lobe deterioration can look like any of the following:
- Loss of the filter for what you say. When this happens, you might say hurtful, rude or offensive things. For some people, this can seem like a major personality shift.
- Lack of respect for others. This often involves getting too close to people or touching them in unwelcome ways. Inappropriate sexual comments or actions are also common.
- Impulsive actions and behaviors. These are usually risky behaviors, such as reckless gambling or spending. Criminal behaviors like shoplifting are also possible.
Apathy
Healthcare providers commonly mistake apathy for depression because the two have many similarities. Apathy tends to look like the following:
- Loss of motivation.
Loss of empathy
People who have a loss of empathy may have trouble reading the emotions of others. That may look like theyre behaving in a cold, unfeeling or uncaring way.
Compulsive behaviors
Changes in diet or mouth-centered behaviors
Primary progressive aphasia
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Stage : Severe Mental Decline/moderately Severe Dementiaquality Of Life: Severe Impact
Your loved one will not remember much or any of the past and may not recognize you and other family and friends. He or she may have trouble making healthcare decisions. You may need 24-hour care in the home for day-to-day activities. You may see your loved one:
- Show strong personality changes and mood swings.
- Have delusions, such as thinking it is time to go to work when there is no job.
- Not be able to use the toilet or get dressed without help.
- Getting lost or wandering off.
- Have problems sleeping at night but sleep during the day.
- Lack of awareness of events and experiences.
- Changes in eating habits.
Help the health care team follow your loved ones care preferences. You can:
- Help with dressing, toileting, and other daily activities.
- Continue to try to connect with your loved one. Sometimes connecting in ways other than talking can help, such as listening to music or reading a story.
- Respond with patience.
What Is Frontal Lobe Dementia
The frontal lobes of the brain are located as the name suggests at the front of the brain. Loosely speaking, it contains what we call the higher functions of the brain. These are the areas of the brain responsible for emotions, understanding, speech some types of movement, planning and judgement in other words the things which make you a person, and personality. Like all dementias the people who develop symptoms face a slow loss of self and those who care for them, losing the person they care for by slow degrees.
Frontal lobe dementia is also known as frontotemporal dementia , or frontotemporal degeneration, it is an overarching term for several categories of a loss of brain function. The changes to the brain are caused by an abnormal build-up of tau proteins, which stop the brain cells from functioning properly, so they die. In frontal lobe dementia parts of the frontal and temporal lobes of the brain are damaged. It was previously known as Picks disease after the doctor Arnold Pick who identified and first documented the symptoms in a patient over a hundred years ago in 1892.
Unlike the most widely diagnosed form of dementia, Alzheimers disease, frontal lobe dementia occurs at a much younger age and is partly genetic. That means while there is no certainty that if you have had a close blood relative with FLD you will get it too, your chances of developing it are much higher than for other members of the population.
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Who Does It Affect
Frontotemporal dementia is an age-related condition, but it happens sooner than most age-related conditions that affect your brain. Most people develop FTD conditions between the ages of 50 and 80, and the average age when it starts is 58.
Overall, FTD appears to affect males and females equally. However, the three conditions under FTD dont affect people assigned male at birth and people assigned female at birth equally. Males are more likely to develop bvFTD and svPPA, and females are more likely to develop nfvPP and corticobasal degeneration. FTD is also a condition that can run in families, with about 40% of cases happening in people with a family history of FTD.
Stages And Progression Of Lewy Body Dementia
Claudia Chaves, MD, is board-certified in cerebrovascular disease and neurology with a subspecialty certification in vascular neurology.
If you or someone you know has recently been diagnosed with Lewy body dementia, you might be wondering what to expect as the disease progresses. Is there a fairly typical progression like Alzheimerâs disease where it begins in early stages that are fairly uniform, then moves to middle stages and then to late stages? In Lewy body dementia, the answer is a bit more complicated.
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What Are The Stages Of Frontotemporal Dementia
James M. Ellison, MD, MPH
Swank Center for Memory Care and Geriatric Consultation, ChristianaCare
- Expert Advice
Learn about the symptoms associated with the early, middle, and late stages of frontotemporal dementia.
On the surface, Joseph, Barbara, and Lloyd may not seem to be experiencing related changes. Each of them, though, turned out to be in the early stage of frontotemporal dementia . FTD is the diagnosis for about 5 percent of people with major neurocognitive disorders . About 70 percent of cases begin before age 65, so it is a more common dementia among the young old. FTD involves degeneration of the frontal and temporal lobes of the brain. The frontal lobes are important regulators of behavior and the temporal lobes assist in our understanding and expression of language. The symptoms of FTD, therefore, include major changes in behavior, impairment of language, or both.
What Are The Symptoms Of Frontotemporal Dementia
Symptoms of FTD start gradually and progress steadily, and in some cases, rapidly. They vary from person to person, depending on the areas of the brain involved. These are common symptoms:
- Behavior and/or dramatic personality changes, such as swearing, stealing, increased interest in sex, or a deterioration in personal hygiene habits
- Socially inappropriate, impulsive, or repetitive behaviors
- Impaired judgment
- Agitation
- Increasing dependence
Some people have physical symptoms, such as tremors, muscle spasms or weakness, rigidity, poor coordination and/or balance, or difficulty swallowing. Psychiatric symptoms, such as hallucinations or delusions, also may occur, although these are not as common as behavioral and language changes.
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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.
What Are The Final Stages Of Dementia
As seniors progress to late stage dementia, full-time care may become necessary, whether you choose memory care or professional dementia care at home. The symptoms of the final stages of Alzheimers include behavioral and personality changes, inability to perform ADLs, and severe cognitive decline.
Dementia stage 6: severe cognitive decline
Stage 6 marks a need for caregiver help to perform basic daily activities such as dressing, eating, using the toilet, and other self-care. Seniors with late stage dementia may have difficulty regulating sleep, interacting with others, or behaving appropriately in public settings.
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Ftd Syndromes Differ With Ad In Baseline Characteristics And Natural History
We found several key differences between FTD syndromes and AD at baseline. First, as we had previously shown , we confirmed that the MMSE score is higher in FTD. However, behavior, social cognition, and executive functions, the main domain impaired in bvFTD, are not properly assessed by the MMSE, which somewhat undermines the assumption that the general cognitive status is better preserved in FTD syndromes. The higher IADL-4 score in FTD compared to AD contrasted with past studies that retrieved either lower or equal autonomy. However, IADL-4 only assesses restriction in four activities that are best associated with future dementia risk , thus preventing a direct comparison of our results with studies that employed the full ADL. The younger age and the better preservation of memory and visuo-motor functions may explain the lesser impairment found in FTD as compared to AD. Impaired functional capacity in bvFTD is primarily due to behavioral symptoms and impaired social cognition, and the routine instrumental activities of the IADL-4 may not be the most representative of the loss of autonomy in FTD syndromes. Among the FTD syndromes, the lvFTD patients had the most preserved autonomy, as found in previous studies .
How Does Ftd Differ From Alzheimers Disease
Different symptoms.
FTD brings a gradual, progressive decline in behavior, language or movement, with memory usually relatively preserved.
It typically strikes younger.
Although age of onset ranges from 21 to 80, the majority of FTD cases occur between 45 and 64. Therefore, FTD has a substantially greater impact on work, family, and finances than Alzheimers.
It is less common and still far less known.
FTDs estimated U.S. prevalence is around 60,000 cases , and many in the medical community remain unfamiliar with it. FTD is frequently misdiagnosed as Alzheimers, depression, Parkinsons disease, or a psychiatric condition. On average, it currently takes 3.6 years to get an accurate diagnosis.
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How Is Delirium Different From Dementia
Delirium is different from dementia. But they have similar symptoms, such as confusion, agitation and delusions. If a person has these symptoms, it can be hard for healthcare professionals who dont know them to tell whether delirium or dementia is the cause. When a person with dementia also gets delirium they will have symptoms from both conditions at once.There are important differences between delirium and dementia. Delirium starts suddenly and symptoms often also vary a lot over the day. In contrast, the symptoms of dementia come on slowly, over months or even years. So if changes or symptoms start suddenly, this suggests that the person has delirium.Dementia with Lewy bodies is an exception. This type of dementia has many of the same symptoms as delirium and they can vary a lot over the day.
Other symptoms of dementia
Dementia can cause a number of different symptoms. Here we explain some of these changes and suggest practical ways to manage them.
- taking multiple medications
- having already had delirium in the past.
Differences Between Ftd And Other Dementias
FTD differs markedly in several ways when compared to other dementias, especially Alzheimerâs disease:
- FTD is characterized by cerebral atrophy in the frontal and anterior temporal lobes of the brain, while Alzheimerâs affects the hippocampal, posterior temporal, and parietal regions.
- The neurofibrillary tangles, senile plaques, and Lewy bodies present in the brains of Alzheimerâs and other dementia patients are absent.
- Alzheimerâs patients experience severe memory loss. While FTD patients exhibit memory disturbances, they remain oriented to time and place and recall information about the present and past.
- FTD patients, even in late stages of the disease, retain visuo-spatial orientation, and they negotiate and locate their surroundings accurately.
- Intellectual failure in FTD is distinctly different from that of Alzheimerâs patients. Results of intelligence tests are normal in those with FTD until the point in the disease when disinterest results in lower scores.
- Life expectancy is slightly longer for FTD.
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Where To Live With Dementia
Eventually, caregiving for someone with dementia wont be appropriate anymore. The needs of a person with progressive dementia become overwhelming, and moving into a full-time residence with trained staff becomes necessary. You should plan for this well before it becomes necessary, by visiting communities and asking the right questions.
Depending on your loved ones stage of illness, different living options are available:
Assisted Living in Early StagesAssisted living residences combine room and board with medical and personal care, and are often sufficient for someone in the early stages of Alzheimers disease or related dementia. Full-time supervision means residents are safe, with living units like private studios or apartments so someone with mild dementia can still feel a sense of independence.
Services offered in assisted living include meals, help with activities of daily living , social activities, and transportation to and from doctors appointments. Before moving in, the residence will assess your loved one to make sure its a good fit.
Memory care residences have physical designs that are appropriate for people with dementia. Someone with Alzheimers, for instance, may become upset when encountering a wall, so memory care buildings have circular hallways. Because people with dementia are prone to wander, memory care residences have increased security and supervision, and special locks on doors.
Did You Know?
How Does Ftd Progress
The progression of symptoms in behavior, language, and/or movement varies by individual, but FTD brings an inevitable decline in functioning. The length of progression varies from 2 to over 20 years.
As the disease progresses, the person affected may experience increasing difficulty in planning or organizing activities. They may behave inappropriately in social or work settings, and have trouble communicating with others, or relating to loved ones.
Over time, FTD predisposes an individual to physical complications such as pneumonia, infection, or injury from a fall. Average life expectancy is 7 to 13 years after the start of symptoms . The most common cause of death is pneumonia.
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Stage : Severe Dementia Due To Alzheimers Disease
In the final stage of Alzheimers, mental functions continue to decline and the individual experiences difficulties with movement and physical abilities. They require assistance with most tasks. Many begin to sleep through most of the day and wander at night, although some individuals seem to require very little sleep. As the disease progresses, the individual will spend the majority of their time in bed.
Individuals in this last stage of Alzheimers generally:
- Require assistance with most activities including eating, dressing, grooming, bathing and toileting
- Experience a loss of coherent speech. They come to the point where they can no longer carry on a conversation that makes sense. Eventually, they may not speak at all or may occasionally utter a word or phrase.
- Undergo an increasing decline in physical abilities. They become unable to walk without assistance, then to being unable to sit or hold up their head without support. Muscles can become rigid causing pain when moved. Many individuals with Alzheimers form contractures They develop infantile reflexes such as sucking and laying in a fetal position. They become totally incontinent and eventually lose the ability to swallow.
They may experience more personality and behavior changes including:
- Anxiety
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