Does The Type Of Dementia Affect Life Expectancy
The type of dementia a person has can also affect how long they live with dementia. These figures for the number of years a person may live after a diagnosis are just averages and some people live longer than this.
This information may be upsetting to read and think about but it is very important to remember that, with the right support, people with dementia can live well at all stages.
Causes Of Vascular Dementia
Vascular dementia is caused by reduced blood flow to the brain, which damages and eventually kills brain cells.
This can happen as a result of:
- narrowing and blockage of the small blood vessels inside the brain
- a single stroke, where the blood supply to part of the brain is suddenly cut off
- lots of “mini strokes” that cause tiny but widespread damage to the brain
In many cases, these problems are linked to underlying conditions, such as high blood pressure and diabetes, and lifestyle factors, such as smoking and being overweight.
Tackling these might reduce your risk of vascular dementia in later life, although it’s not yet clear exactly how much your risk of dementia can be reduced.
Risk Factors And Prevention
Although age is the strongest known risk factor for dementia, it is not an inevitable consequence of ageing. Further, dementia does not exclusively affect older people young onset dementia accounts for up to 9% of cases. Studies show that people can reduce their risk of dementia by getting regular exercise, not smoking, avoiding harmful use of alcohol, controlling their weight, eating a healthy diet, and maintaining healthy blood pressure, cholesterol and blood sugar levels. Additional risk factors include depression, low educational attainment, social isolation, and cognitive inactivity.
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Improving Quality Of Life
In the early stages of Alzheimer’s disease, cognitive impairment is not the only determinant of quality of life. While you can’t change factors such as age at diagnosis or gender, research shows that the care that a person receives impacts life expectancy. Be sure that you explore options when it comes to creating a care plan for a loved one diagnosed with Alzheimer’s disease and take advantage of any support groups or other resources that may help.
Recent research indicates that factors associated with a lower quality of life for Alzheimer’s disease patients include patient depression and anxiety, and having to take multiple medicinesindicative of having other disease states to manage. Efforts to improve the quality of life for patients should include an assessment of these factors so they can be effectively addressed. Caregiver quality of life should also be assessed, especially as the disease progresses and the burden of caregiving increases.
The extent to which a person with the disease can maintain his or her social relationships can also play a large role. Patients should talk with their doctor or a psychologist for strategies to cope with social situations.
In addition, maintaining household responsibilities for as long as able can help improve the quality of life. In later stages, a patient’s needs may change, and it is important for a caregiver to know how to care for themselves in addition to their loved one.
Tests For Vascular Dementia
There’s no single test for vascular dementia.
The tests that are needed to make a diagnosis include:
- an assessment of symptoms for example, whether these are typical symptoms of vascular dementia
- a full medical history, including asking about a history of conditions related to vascular dementia, such as strokes or high blood pressure
- an assessment of mental abilities this will usually involve several tasks and questions
- a brain scan, such as an MRI scan or CT scan, to look for any changes that have happened in your brain
Find out more about the tests used to diagnose dementia.
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Are There Any Treatments
There are treatments that can help with the symptoms of some forms of dementia for a period of time, but there are currently no treatments that slow, halt or reverse the changes in the brain caused by the diseases. There are currently no treatments specifically for vascular dementia or frontotemporal dementia.
In the case of vascular dementia, a doctor may prescribe medication to treat underlying cardiovascular risk factors like high blood pressure or diabetes. Physiotherapy, speech therapy or occupational therapy may be offered to help with speech or movement problems. Non-drug treatments such as cognitive therapies may be available and can help some people with dementia to manage their symptoms.
Alzheimer’s Society has more information on treatments for dementia.
Time From Diagnosis To Institutionalization And Death In People With Dementia
Amsterdam UMC, Vrije Universiteit Amsterdam, Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research institute, Amsterdam, The Netherlands
Correspondence
Karlijn J. Joling, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research institute, Van der Boechorststraat 7, Amsterdam 1081 BT, The Netherlands.
Nivel, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands
Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Neurology, Alzheimer Centre Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
Amsterdam UMC, Vrije Universiteit Amsterdam, Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research institute, Amsterdam, The Netherlands
Correspondence
Karlijn J. Joling, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research institute, Van der Boechorststraat 7, Amsterdam 1081 BT, The Netherlands.
Nivel, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
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What Are The Symptoms Of Late Stages Of Alzheimers Disease
The late stages of Alzheimers disease dramatically alter the affected person, rendering them unable to perform their daily functions independently.
The signs and symptoms of late stages of Alzheimers disease include:
- Being unable to move around
- Difficulty speaking or expressing yourself in words
- Need help with routine activities, such as eating
- Difficulty swallowing
- Tendency to easily suffer from colds and infections
- Sleeping troubles
- Difficulty using the toilet independently
- Loss of bowel and bladder control
- Loss of awareness of the environment
- Personality or mood changes, such as aggression, anxiety, hostility, or irritability
- Repetitive interrogation
- Wandering
The Later Stages Of Dementia
It is important to remember that not everyone living with dementia will want to know what is ahead of them. However, if youre caring for someone living with dementia, it is useful to know about the later stages of the disease so you can make decisions about future care options.
In the later stages of dementia, symptoms such as poor memory, confusion and other forms of cognitive impairment are joined by more physical symptoms.
Dementia is an illness of progressive cell damage. It starts in the parts of the brain that deal with memory and slowly moves to parts of the brain that control other functions. Sadly, this will eventually cause major organs to stop working. Below you can find a summary of some of the things you can expect when caring for someone in the later stages of dementia.
Our advice page on looking after someone with dementia might also be helpful.
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Factors Associated With An Increased Risk Of Death In Dementia
Conversely, research has associated these factors with a higher risk of dying for someone with dementia.
- Delirium: The presence of delirium in people with dementia has been associated with an increased risk of death. One common cause of delirium is an infection.
- Falls and Hip Fractures: People with dementia have an increased risk of falls and hip fractures, and that risk, in turn, is associated with an increased risk of dying.
- Pressure Sores: Decubitus ulcers (also called “bed sores” increase the risk of death in those living with dementia.
- Inability to Perform ADLs: As dementia progresses, the ability to perform daily tasks such as dressing, bathing, eating or walking decrease. This decrease is associated with an increased risk of dying.
- Pneumonia: Developing pneumonia poses an increased risk of death in people with dementia.
- Age: Being 85 years old or older is associated with a significantly higher risk of death from Alzheimer’s disease.
Stage : Mild Cognitive Impairment
Clear cognitive problems begin to manifest in stage 3. A few signs of stage 3 dementia include:
- Getting lost easily
- Noticeably poor performance at work
- Forgetting the names of family members and close friends
- Difficulty retaining information read in a book or passage
- Losing or misplacing important objects
- Difficulty concentrating
Patients often start to experience mild to moderate anxiety as these symptoms increasingly interfere with day to day life. Patients who may be in this stage of dementia are encouraged to have a clinical interview with a clinician for proper diagnosis.
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Difficulties Getting A Diagnosis
A 2008 Alzheimers Society report quotes one GP saying to a female patient,
You cant have dementia, youre too young.
This quote reveals that doctors and other professionals quite often may not even consider that a person under 65 could have dementia they may be more likely to think there is nothing wrong or that the person is depressed. In many areas, it may be unclear which medical consultant is responsible for the assessment and diagnosis of young onset dementia should it be a psychiatrist working with adults with mental health problems, or should it be an old age psychiatrist who specialises in working with older adults? GPs may not know this information. For all these reasons, obtaining a diagnosis is often a particularly drawn-out and distressing process for younger people.
How Is Dementia Diagnosed
No single test can determine if your loved one has dementia. A physician will examine several factors to come up with a diagnosis, including a full medical history, physical exam, laboratory tests, and recognizing a pattern of loss of function and skills. With a high-level of certainty, doctors can diagnose a person with dementia, but its more challenging to define the exact type of dementia. Biomarkers can help make an accurate diagnosis of Alzheimers disease, which is included under the umbrella of dementia.
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Why Is Dementia Progressive
Dementia is not a single condition. It is caused by different physical diseases of the brain, for example Alzheimers disease, vascular dementia, DLB and FTD.
In the early stage of all types of dementia only a small part of the brain is damaged. In this stage, a person has fewer symptoms as only the abilities that depend on the damaged part of the brain are affected. These early symptoms are usually relatively minor. This is why mild dementia is used as an alternative term for the early stage.
Each type of dementia affects a different area of the brain in the early stages. This is why symptoms vary between the different types. For example, memory loss is common in early-stage Alzheimers but is very uncommon in early-stage FTD. As dementia progresses into the middle and later stages, the symptoms of the different dementia types tend to become more similar. This is because more of the brain is affected as dementia progresses.
Over time, the disease causing the dementia spreads to other parts of the brain. This leads to more symptoms because more of the brain is unable to work properly. At the same time, already-damaged areas of the brain become even more affected, causing symptoms the person already has to get worse. Eventually most parts of the brain are badly damaged by the disease. This causes major changes in all aspects of memory, thinking, language, emotions and behaviour, as well as physical problems.
Stage : Moderately Severe Cognitive Decline
Stage 5 is when your loved one is likely to need help with routine tasks, like dressing or bathing. They may require a home caregiver or to move to a memory care community. Other symptoms include:
- Confusion/forgetfulness
- Memory loss of personal details and current events
- Reduced mental acuity and problem-solving ability
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Provide Support For Family And Friends
Keep any family or friends informed about what is happening in a gentle, sensitive and supportive way. This will help reassure them that the person is getting the care they need. You could consider signposting them to appropriate services, such as an Admiral Nurse or local Alzheimers Society. It can also help to give them an opportunity to talk about what is happening.
Caregiving In The Early Stages
Although most of your loved ones immediate medical needs can be managed on their own in the early stages, you may need to assist with tasks associated with memory or problem-solving. You may need to remind them of their doctors appointments and to set up the next appointment, along with taking their medications on time and getting refills as needed. You may need to assist them in managing their finances and keeping up with social and work obligations. At times, they may also need help remembering places, people, words, and names. In the early stages, you will want to encourage them to:
- Maintain their independence
- Establish a routine to delay the disease from worsening
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Care In The Later Stages Of Dementia
There are medicines used in the early stages of dementia that manage some of the behavioural symptoms. In the later stages some of these medicines can do more harm than good causing severe side effects that can increase confusion and frailty. It also becomes harder to diagnose and manage some of the normal illnesses that older people get such as Urinary Tract Infections . UTIs can exaggerate some symptoms of dementia and increase confusion sometimes know as delirium.
Pain is also something that can be present in the later stages of dementia, but can be harder to diagnose if the person isnt able to communicate it. For all of these reasons, its important to stay vigilant when looking after someone with dementia, and to talk to the GP if you are worried about anything.
There are dementia living aids and products that can help you to care for someone living with dementia. Something like a simple dementia clock or personal alarm can make the world of difference to your life and the live of the person you care for.
What You Can Do For Your Loved One
As an individual with dementia declines, you can help them by providing a loving and supportive presence. Sit with them. Hold their hand. Play music they enjoy.
One of the greatest gifts you can give your loved one is helping to get their affairs in order. Ensure that financial and healthcare powers of attorney are put in place, so you can make decisions when your loved one is no longer able. Look into funeral arrangements before you need them, so you dont need to make important decisions in a time of crisis.
Talk to your loved ones physician about the possibility of palliative care support in the home and hospice care when your loved one is ready.
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How Can I Support Someone With Dementia Towards The End Of Life
Knowing the person will make it easier to provide person-centred care that is focused on what they need and want. It can help to know about their likes, dislikes and their wishes for how they want to be cared for. If the person isnt able to tell you about themselves, speak to their family, friends or other people who know them well.
Its a good idea to find out if the person has a copy of This is me , a document that records information about themselves. If you cant speak to the person, ask those close to them if they have a copy. They may have these details recorded in their care plan.
There are many ways to support someone with dementia at the end of life.
How Hospice Can Help With End
In addition to helping you in recognizing the signs of dying in the elderly with dementia, bringing in hospice care will help with the physical and emotional demands of caregiving. Nurses will be able to adjust medication and care plans as the individuals needs change. Aides can help with bathing, grooming, and other personal care. Social workers can help organize resources for the patient and family. Chaplains and bereavement specials can help the family with any emotional or spiritual needs. Additionally, family members can contact hospice at any time, and do not need to wait until it is recommended by the patient’s physician.
To learn more about the criteria for hospice eligibility or to schedule a consultation, please contact Crossroads using the blue Help Center bar on this page for more information on how we can help provide support to individuals with dementia and their families.
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How Does Alzheimers Disease Cause Death
Alzheimers disease is a degenerative brain disease in which brain cells destroy themselves. The condition results in a decline in memory, behavior and mental abilities.
It is not Alzheimers disease that kills a person. Death usually results from an inability to perform routine activities, such as eating, paying attention while walking, using the toilet and using the toilet. This inability to take care of oneself leaves the affected person plagued with problems, such as malnutrition, dehydration, falls, and infections , which lead to death.
Pneumonia is a common cause of death in people with Alzheimers disease. Swallowing problems cause ingested food particles to enter the airways and lungs instead of the esophagus. This ingested food causes pneumonia in the lungs.