Common Forms Of Dementia
There are many different forms of dementia. Alzheimer’s disease is the most common form and may contribute to 60-70% of cases. Other major forms include vascular dementia, dementia with Lewy bodies , and a group of diseases that contribute to frontotemporal dementia . Dementia may also develop after a stroke or in the context of certain infections such as HIV, harmful use of alcohol, repetitive physical injuries to the brain or nutritional deficiencies. The boundaries between different forms of dementia are indistinct and mixed forms often co-exist.
Planning For The Future
Planning early makes it easier for someone with younger onset dementia to manage their financial, legal and medical affairs now and in the future.
If you have been diagnosed with younger onset dementia, it is important to make important decisions while you still can and while you are legally competent to sign any documents.
Things to think about include:
- your living arrangements into the future
- who can have access to your financial accounts
- having joint signatures on all financial accounts
- arranging when and how you will access your finances
- talking to a financial adviser
- sorting out superannuation, health and income insurance
- writing or updating your will
If you have been diagnosed with dementia, its important to nominate a trusted person to manage your affairs in the future. You can do this through an Enduring Power of Attorney .
A financial EPA enables a nominated person to look after your financial affairs if you become unable to do so. A medical EPA covers only medical decisions. The laws regarding EPAs vary between states and territories, so it’s important to seek legal advice before the agreement is completed, or if you are moving interstate.
Some states also have medical guardianship . This allows someone to choose a person to make medical decisions for them. For more information on guardianship and administrators, visit the My Aged Care website.
How To Spot Early Indicators That Your Loved One May Have Alzheimers Or Dementia
by Patrick J. Kiger, AARP, Updated September 27, 2021
En español | From age 50 on, its not unusual to have occasional trouble finding the right word or remembering where you put things.
But persistent difficulty with memory, cognition and ability to perform everyday tasks might be signs that something more serious is happening to a loved ones brain.
Dementia isnt actually a disease, according to the Mayo Clinic. Its a catch-all term for changes in the brain that cause a loss of functioning that interferes with daily life. Dementia can diminish focus, the ability to pay attention, language skills, problem-solving and visual perception. It also can make it difficult for a person to control his or her emotions and lead to personality changes.
More than 6 million Americans are living with Alzheimer’s dementia, according to the “2021 Alzheimer’s Disease Facts and Figures” report fromthe Alzheimer’s Association. Alzheimer’s disease is the leading cause of dementia, accounting for 60 percent to 70 percent of cases, but a range of brain illnesses can lead to the condition .
Diseases that cause dementia
These conditions are the leading causes of dementia. Many patients have mixed dementia, a combination of two or more types, such as Alzheimers and vascular dementia.
Lewy body dementia. Abnormal protein deposits in the brain, called Lewy bodies, affect brain chemistry and lead to problems with behavior, mood, movement and thinking.
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Early Onset Dementia: Symptoms Associated With Language Disorders
- Anomie or difficulty finding the right word to call objects or explain an idea.
- Use of long and vague phrases to explain things. They use lots of unspecific words to describe things instead of using the right word, eg. thing, that, it
- They take a while to get to the point, and they have a hard time finding the right words.
What Are The Symptoms Of Dementia
Early symptoms of dementia include :
- Forgetting recent events or information
- Repeating comments or questions over a very short period of time
- Misplacing commonly used items or placing them in usual spots
- Not knowing the date or time
- Having difficulty coming up with the right words
- Experiencing a change in mood, behavior or interests
Signs that dementia is getting worse include:
- Ability to remember and make decisions further declines
- Talking and finding the right words becomes more difficult
- Daily complex tasks, such as brushing teeth, making a cup of coffee, working a tv remote, cooking, and paying bills become more challenging
- Rational thinking and behavior and ability to problem solve lessen
- Sleeping pattern change
- Anxiety, frustration, confusion, agitation, suspiciousness, sadness and/or depression increase
- More help with activities of daily living grooming, toileting, bathing, eating is needed
- Hallucinations may develop
The symptoms mentioned above are general symptoms of dementia. Each person diagnosed with dementia has different symptoms, depending on what area of the brain is damaged. Additional symptoms and/or unique symptoms occur with specific types of dementia.
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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
Confusion And Forgetfulness Can Also Affect Handwriting
“Writing is not an ordinary skill,” notes Rodriguez. “People spend years developing a specific style of writing consolidating a sound motor-control system of the brain. A marked deterioration of this carefully honed skill indicates something is wrong with the brain.”
Dementia can affect handwriting for other reasons, as well. Diana Kerwin, MD, told Everyday Health that shaky or increasingly indecipherable handwriting can be caused by apraxia. “The person literally forgets how to perform the motor tasks needed to write,” she explains. “Even though the motor system is intact, the instructions from the brain to the hand are impaired and it can affect handwriting.”
“Damage to cognitive functions makes your handwriting gradually indecipherable,” says Rodriguez. “Eventually, they look more like scrawls and scribbles than writing that could be once identified as yours.”
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Discussing Dementia Symptoms With Dr Alex Bailey
In a new episode of the Age Space Podcast, we talk to Dr Alex Bailey, an old age psychiatrist working in Westminster, sharing his thoughts and advice on dementia. This includes identifying the early signs of dementia, details of memory services, supporting those with dementia to live well, psychological therapies, supporting carers and much more. Listen to the dementia explained podcast.
What to read next…
What Medications Are Available To Treat Dementia
Drugs approved for the most common form of dementia, Alzheimers disease, are discussed below. These drugs are also used to treat people with some of the other forms of dementia.
- cholinesterase inhibitors
- NMDA receptor antagonist memantine
These two classes of drugs affect different chemical processes in the brain. Both classes have been shown to provide some benefit in improving or stabilizing memory function in some patients. Although none of these drugs appear to stop the progression of the underlying disease, they may slow it down.
If other medical conditions are causing dementia or co-exist with dementia, the appropriate drugs used to treat those specific conditions are prescribed.
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The Effects Of Being Diagnosed At A Young Age
The personal and social consequences of young onset dementia can be much different than those experienced by people diagnosed with dementia later in life.
People living with young onset dementia are often still working at the time of diagnosis, are physically fit, and may have dependent children or parents at home. They may have major financial commitments, like a mortgage or student loan, that they are looking to pay off.
The diagnosis of dementia, and the changes it will bring, can only increase the stress of handling these responsibilities. With dementia now in the mix, it’s natural for a younger person just diagnosed with dementia to think, “What’s next!?” and worry about how they can meet handling their responsibilities.
Forgetting How To Do Everyday Tasks
This is different to: more typical age-related forgetfulness such as needing help to record a tv programme or how to use the settings on a microwave oven.
Your parent may start to find it hard to complete daily tasks these might include the setting of a table, driving to a familiar location or remembering the rules of their favourite game.
Forgetting how to do everyday tasks can be spotted just by observing someone or by completing a Self-Administered Gerocognitive Exam an early signs of dementia test which can be taken online.
However, this shouldnt be used as an official diagnostic tool you should always seek the advice of a GP. Other examples of forgetting how to do simple everyday tasks can include:
- Closing the fridge door
- Making a cup of tea or coffee
- Locking / closing the front door
- Managing a budget
Your parent may start to find it difficult to complete tasks they used to be able to do with ease. For example, if they used to be a fantastic baker, they may now find it hard to bake the sponge cake theyve made over and over again.
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You Can’t Remember Anyone’s Name
Recalling information is another issue many people with dementia can struggle with, so consider it a red flag if you can no longer remember people’s names.
“When at a social gathering, you forget names of people you just met,” Dr. Schreiber says. Or you might not be able to remember a friend’s name when telling a story.
If you’ve always been bad with names then this shouldn’t be a cause for concern. But if you find yourself blanking on a more regular basis, it may be time to get yourself checked.
Changes In Behaviour Judgement And Moods
Becoming quiet, withdrawn or restless or frustrated or angry can be early signs of dementia. Someone may develop repetitive behaviour for example, they ask the same question over and over again, do the same thing repeatedly or make multiple phone calls to the same person. They may become insecure and anxious or start hiding and losing items. They may withdraw from social activities or give up hobbies and interests they have enjoyed.
They may show poor judgement, for example putting summer clothes on in cold winter months, not knowing when a kettle is full or overfilling cups when making cold and hot drinks, putting a kettle on the hob or leaving a cooker on or tap running. Someone with dementia may become very emotional and experience rapid mood swings or become quieter and less emotional than usual.
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What Causes Younger Onset Dementia
Many different types of dementia can affect younger people. Each type has its own symptoms and is caused by a specific type of change in the brain. Some causes of early onset dementia are:
- Alzheimers disease
- problems with blood flow to the brain
- deterioration to the front part of the brain
- chronic overuse of alcohol over many years
You Get Lost More Often
Losing navigational skills, and the ability to create a mental map of your environment, can be one of the early signs of dementia. In fact, in 2019, University of Cambridge researchers developed a virtual-reality navigation test that has proven to be better at identifying early Alzheimers disease than FDA-approved neuropsychological tests currently considered to be a gold standard for early diagnosis.
We built a running track in our backyard so Steve could jog safely every day without getting lost, says Eva.
Once Chow was properly diagnosed, his anxiety about his symptoms decreased and he became calmer. Eva is the model caregiver because she wants to do whats best for Stephen and encourages him to do things, says Tartaglia. This has included joining Alzheimer Society of Toronto programs and support groups for people with early-onset dementia, practising daily meditation and getting regular aerobic exercise.
But perhaps most importantly, with Evas encouragement, Chow began to share his dementia diagnosis with the people in his life. I felt better after I told my family and friends, he says. They were very supportive, and it took a load off my shoulders. I learned that you should tell people what youre noticing sooner rather than later and not keep it to yourself.
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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.
Talking With A Doctor
After considering the persons symptoms and ordering screening tests, the doctor may offer a preliminary diagnosis or refer the person to a Cognitive Dementia and Memory Service clinic, neurologist, geriatrician or psychiatrist.Some people may be resistant to the idea of visiting a doctor. In some cases, people do not realise, or else they deny, that there is anything wrong with them. This can be due to the brain changes of dementia that interfere with the ability to recognise or appreciate the changes occurring. Others have an insight of the changes, but may be afraid of having their fears confirmed.One of the most effective ways to overcome this problem is to find another reason for a visit to the doctor. Perhaps suggest a check-up for a symptom that the person is willing to acknowledge, such as blood pressure, or suggest a review of a long-term condition or medication.Another way is to suggest that it is time for both of you to have a physical check-up. Any expressed anxiety by the person is an excellent opportunity to suggest a visit to the doctor. Be sure to provide a lot of reassurance. A calm, caring attitude at this time can help overcome the person’s very real worries and fears.Sometimes, your friend or family member may refuse to visit the doctor to ask about their symptoms. You can take a number of actions to get support including:
- talking with other carers who may have had to deal with similar situations
- contacting your local Aged Care Assessment Team
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Changes In Mood Or Emotion
The person may be more anxious, frightened or sad, and so at risk of depression. It is also common to become more irritable perhaps in frustration at lost abilities or easily upset. A person can often be more withdrawn, lack self-confidence and lose interest in hobbies or people.
Changes in behaviour are not common in early-stage dementia, other than in FTD. A person with behavioural variant FTD may lose their inhibitions and behave in socially inappropriate ways. They may also act impulsively and lose empathy for others.
Significant physical changes at this stage tend to be limited to DLB, where problems with movement are similar to Parkinsons disease. If someone with vascular or mixed dementia has a stroke, this can lead to weak limbs on one side.
Need help finding dementia information?
Everybody forgets things from time to time. But if you or other people are noticing that memory problems are getting worse, or affecting everyday life, it could be a sign of dementia.
Difficulty Completing Normal Tasks
A subtle shift in the ability to complete normal tasks may indicate that someone has early dementia. This usually starts with difficulty doing more complex tasks like balancing a checkbook or playing games that have a lot of rules.
Along with the struggle to complete familiar tasks, they may struggle to learn how to do new things or follow new routines.
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What Causes Dementia To Progress So Quickly
Dementia symptoms are typically mild at first and progress over time to moderate and then severe, over several years. The speed as which dementia progresses varies between individuals, but some factors can cause dementia to progress more quickly. These include the persons age, the type of dementia, and other long term health problems. Dementia tends to progress more slowly in people over 65 compared to younger people below 65.