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 Alzheimer’s 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.
How Is Dementia Treated
Treatment of dementia depends on the underlying cause. Neurodegenerative dementias, like Alzheimers disease, have no cure, though there are medications that can help protect the brain or manage symptoms such as anxiety or behavior changes. Research to develop more treatment options is ongoing.
Leading a healthy lifestyle, including regular exercise, healthy eating, and maintaining social contacts, decreases chances of developing chronic diseases and may reduce number of people with dementia.
Current Practice In Diagnosing Dementia
The remainder of this information will provide an overview of the diagnosis process and a guide to what happens after diagnosis.;
It is important to remember that there is no definitive test for diagnosing Alzheimers disease or any of the other common causes of dementia. Findings from a variety of sources and tests must be pooled before a diagnosis can be made, and the process can be complex and time consuming. Even then, uncertainty may still remain, and the diagnosis is often conveyed as possible or probable. Despite this uncertainty, a diagnosis is accurate around 90% of the time.;
People with significant memory loss without other symptoms of dementia, such as behaviour or personality changes, may be classified as having a Mild Cognitive Impairment . MCI is a relatively new concept and more research is needed to understand the relation between MCI and later development of dementia. However, MCI does not necessarily lead to dementia and regular monitoring of memory and thinking skills is recommended in individuals with this diagnosis.;;
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Putting Things In The Wrong Place
This is different to: more normal age-related behaviours such as losing things but being able to retrace the steps to find them.
Losing things or putting things in strange places, and then being unable to retrace steps to find them again, is on the official observation list for early signs of dementia.
Sometimes someone else might be accused of stealing which may occur more frequently over time. ;For example, your dad may insist that a friend keeps stealing his money, whereas its in its regular hiding place.
Other examples that may indicate potential dementia symptoms could include:
- Teabags in the fridge and leaving the milk out
- Toothbrush in the washing basket
- Remote control in the cutlery drawer
- Dirty laundry in the dishwasher
Misplacing or losing items is more common in Alzheimers Disease, rather than vascular dementia. Find out more about the different types of dementia.
Importance Of Obtaining A Diagnosis For Dementia
The diagnosis of dementia requires a complete medical and neuropsychological evaluation. The process is first to determine whether;the person has a cognitive problem and how severe it is. The next step is to determine the cause in order to accurately recommend treatment and allow patients and caregivers to plan for the future.
A medical evaluation for dementia usually includes the following:
The process of diagnosing dementia has become more accurate in recent years, and specialists are able to analyze the large amount of data collected and determine whether;there is a problem, the severity, and, often, the cause of the dementia. Occasionally, there may be a combination of causes, or it may take time to monitor the individual to be sure of a diagnosis. Determining whether the cause is a reversible or irreversible condition guides the treatment and care for the affected person and family.
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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
Recognising When Someone Is Reaching The End Of Their Life
Read about some of the signs that a person with dementia is nearing their death, and how you can support yourself as a carer, friend or relative.
It is important to know when a person with dementia is nearing the end of their life because it can help in giving them the right care. However it can be difficult to know when this time is.
This uncertainty can have a big impact on how the persons family feel, and may also affect how they feel themselves.
There are symptoms in the later stages of dementia that can suggest the person is reaching the final stage of their illness. These include:
- bowel and bladder incontinence,
- being unable to walk or stand, problems sitting up and controlling the head, and becoming bed-bound.
It is likely that a person with dementia is nearing the end of their life if they have these symptoms, along with other problems such as frailty, infections that keep coming back, and pressure ulcers .;
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Staring With Reduced Gaze And Trouble Reading
Reduced gaze is the clinical term for the dementia symptom that alters peoples ability to move their eyes normally. We all move our eyes and track with them frequently, says Rankin. But people showing early signs of dementia;look like theyre staring a lot. Rankin adds that, they try to read and they skip lines. This is one of the signs of dementia that the patient might not completely be aware of, although people around them probably will be.
What To Do If A Loved One Is Suspicious Of Having Dementia
- Discuss with loved one.;Talk about seeing a medical provider about the observed changes soon. Talk about the issue of driving and always carrying an ID.
- Medical assessment.;Be with a provider that you are comfortable with. Ask about the Medicare Annual Wellness exam.
- Family Meeting.;Start planning, and gather documents like the Health Care Directive, Durable Power of Attorney for Health Care, Estate Plan.
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Not Understanding What Objects Are Used For
Now and again, most people find themselves desperately searching for the right word. In fact, failing to find the word you are thinking of is surprisingly common and not necessarily a sign of dementia, says Rankin. But losing knowledge of objects not just what they are called, but also what they are used for ;is;an early dementia symptom. Oddly enough, people who are losing this knowledge can be very competent in other areas of their lives.
Pneumonia Fever Eating Problems Common
Pneumonia, fever, and an eating problem were the most common complications in the final months of life, and 41% of patients had at least one aggressive treatment including hospitalization, a visit to the ER, intravenous treatment, or a feeding tube.
âThere is a lack of recognition that dementia is a terminal illness and this has a big impact on the quality of care patients receive,â Mitchell says. âWe found that a high percentage of patients had distressing symptoms toward the end of life.â
More than 5 million Americans suffer from Alzheimerâs dementia, and this figure is expected to triple over the next four decades as baby boomers reach old age. Alzheimerâs is the most common cause of dementia.
In the late stages of the disease, patients are often bedridden and can no longer communicate their needs, recognize close family members, or perform basic functions like feeding themselves and going to the bathroom.
In an editorial published with the study, geriatrician and dementia researcher Greg A. Sachs, MD, of the Indiana University Center for Aging Research, recalls his maternal grandmotherâs struggle with advanced Alzheimerâs disease.
Her final months in a nursing home included repeated courses of antibiotics for infections and restraints to control her agitation. Her condition so distressed Sachsâ mother that she stopped taking her children when she visited.
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What Are The Early And Later Signs And Symptoms Of Dementia
Early signs of dementia may include:
- Simple forgetfulness
- Problems performing tasks or activities that were previously done without effort.
- Difficulty with learning new material is frequently one of the earliest signs of dementia.
Many patients with early Alzheimer’s disease or other types of dementia are unaware that they have any problem. As the disease progresses, behavioral changes can become evident.
- Patients have difficulty performing basic tasks, such as getting dressed or using the bathroom.
- Some patients begin to forget pieces of information about themselves, including their address or telephone number, or even their date of birth.
- They may have difficulty understanding what is occurring around them.
- Some patients have problems remembering to eat and may develop pronounced weight loss.
- In the late stages of dementia, patients often cannot recognize family members and their ability to communicate effectively is markedly impaired.
- They are no longer able to effectively care for themselves and require assistance for all activities of daily living.
- Over time, patients can forget how to walk or even how to sit up.
The stages of dementia are loosely grouped into mild, moderate, and severe categories by some doctors. However, there is another system of staging for dementia.
Stage : Age Associated Memory Impairment
This stage features occasional lapses of memory most frequently seen in:
- Forgetting where one has placed an object
- Forgetting names that were once very familiar
Oftentimes, this mild decline in memory is merely normal age-related cognitive decline, but it can also be one of the earliest signs of degenerative dementia. At this stage, signs are still virtually undetectable through clinical testing. Concern for early onset of dementia should arise with respect to other symptoms.
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Difficulty Finding The Right Words
Another early symptom of dementia is struggling to communicate thoughts. A person with dementia may have difficulty explaining something or finding the right words to express themselves. Having a conversation with a person who has dementia can be difficult, and it may take longer than usual to conclude.
Dying From Dementia With Late
The death of your loved one can be a hard concept to wrap your head around and accept. But knowing what to expect can help you when your loved one has late-stage dementia. It might help to know what will happen in the future so that you can be prepared emotionally and logistically.
This article discusses how dementia progresses and what to expect during late-stage dementia.
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Stage : Mild Cognitive Decline
Stage 3 is where dementia or Alzheimers disease symptoms can become more noticeable to friends and family. This stage will not have a major impact on your loved ones everyday life, but signs can include:
- Trouble with complex tasks and problem-solving
- Memory loss and forgetfulness
- Asking the same question repeatedly
- Diminished work performance
- Denial
How To Spot Early Indicators That Your Loved One May Have Alzheimers Or Dementia
by Patrick J. Kiger, AARP, Updated May 4, 2021| 0
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 a 2021 report by the 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.
Vascular dementia. The second most common type of dementia is caused from damage to the vessels that supply blood to the brain. It tends to affect focus, organization, problem-solving and speed of thinking more noticeably than memory.
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What Are The Signs And Symptoms Of Dementia
Signs and symptoms of dementia result when once-healthy neurons, or nerve cells, in the brain stop working, lose connections with other brain cells, and die. While everyone loses some neurons as they age, people with dementia experience far greater loss.
The symptoms of dementia can vary and may include:
- Experiencing memory loss, poor judgment, and confusion
- Difficulty speaking, understanding and expressing thoughts, or reading and writing
- Wandering and getting lost in a familiar neighborhood
- Trouble handling money responsibly and paying bills
- Repeating questions
- Not caring about other peoples feelings
- Losing balance and problems with movement
People with intellectual and developmental disabilities can also develop dementia as they age, and recognizing their symptoms can be particularly difficult. Its important to consider a persons current abilities and to monitor for changes over time that could signal dementia.
What Affects The Speed Of Progression
The speed at which dementia progresses varies a lot from person to person because of factors such as:
- the type of dementia for example, Alzheimers disease tends to progress more slowly than the other types
- a persons age for example, Alzheimers disease generally progresses more slowly in older people than in younger people;
- other long-term health problems dementia tends to progress more quickly if the person is living with other conditions, such as heart disease, diabetes or high blood pressure, particularly if these are not well managed
- delirium a medical condition that starts suddenly .
There is no way to be sure how quickly a persons dementia will progress. Some people with dementia will need support very soon after their diagnosis. In contrast, others will stay independent for several years.
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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.
Isnt Dementia Part Of Normal Aging
No, many older adults live their entire lives without developing dementia. Normal aging may include weakening muscles and bones, stiffening of arteries and vessels, and some age-related memory changes that may show as:
- Occasionally misplacing car keys
- Struggling to find a word but remembering it later
- Forgetting the name of an acquaintance
- Forgetting the most recent events
Normally, knowledge and experiences built over years, old memories, and language would stay intact.
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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.
Signs Of Dying In The Elderly With Dementia
Dementia is a general term for a chronic or persistent decline in mental processes including memory loss, impaired reasoning, and personality changes. Alzheimers disease is the most common form of dementia, accounting for 60-80% of all cases of dementia. It is also the 6th leading cause of death in the United States, and over 5 million Americans are currently living with Alzheimers disease.
Alzheimers disease and most progressive dementias do not have a cure. While the disease inevitably worsens over time, that timeline can vary greatly from one patient to the next.
Caring for a loved one can be challenging and stressful, as the individuals personality changes and cognitive function declines. They may even stop recognizing their nearest and dearest friends and relatives. As dementia progresses, the individual will require more and more care. As a family caregiver, its important to be able to recognize the signs of dying in elderly with dementia. Hospice can help by offering care wherever the individual resides, providing physical, emotional and spiritual care to the patient and support their family.
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