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Dementia is a general term referring to cognitive decline that interferes with a person’s ability to reason, remember, make choices, and complete normal daily activities. If you are a caregiver of a veteran, having some basic knowledge of dementia can help you understand the challenges the person you care for may be facing and can help you communicate more effectively with doctors.
Types of Dementia
Alzheimer’s is the most common kind of dementia for veterans and for the general public, but it’s not the only one. Below you’ll find quick explanations of the different kinds of dementia and their causes, symptoms, and progressions.
Alzheimer’s Disease
Between 60% and 80% of dementia cases are caused by Alzheimer’s disease, according to the CDC. It typically affects those 65 and older, though there is a rarer, early-onset version of the disease that can affect those as young as 30. The hallmark of Alzheimer’s is abnormal plaques and tangles that build up in brain tissue, as well as a loss of neurons. Small instances of memory loss, confusion, and mood changes are often the first signs, and symptoms become progressively worse over time.
Lewy Body Dementia
This type of dementia is caused by abnormal deposits of the protein alpha-synuclein in the brain. These deposits are referred to as “Lewy bodies,” and they are separate from but can occur alongside the tangles and plaques associated with Alzheimer’s. Lewy bodies also occur in Parkinson’s disease, and there are Parkinson’s and non-Parkinson’s versions of this dementia. Muscle tremors and stiffness, along with hallucinations and fluctuations in recall, attention, and energy are common in Lewy Body dementia.
Vascular Dementia
Vascular dementia occurs when blood flow to the brain has been hindered by a condition or event, such as narrowed blood vessels, a stroke, or a brain hemorrhage. In the case of vascular dementia caused by a stroke, dementia can worsen dramatically if other strokes occur. This is in contrast to the gradual decline typically experienced by those with Alzheimer’s disease. Symptoms can vary depending on the exact region of the brain affected. Uncontrolled diabetes and poor cardiovascular health are both risk factors for vascular dementia.
Frontotemporal Dementia
This term refers to a wide range of disorders of the brain in which tissue damage occurs in the regions behind the forehead or by the ears. Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, is just one well-known example of this kind of dementia. Diagnosis of one of the frontotemporal dementias tends to occur when a patient is between 40 and 60, which is significantly earlier than the average Alzheimer’s diagnosis. The earliest signs are usually related to muscle function, and memory problems may show much later than in other forms of dementia.
Mixed Dementia
Often times, a patient can suffer from multiple forms of dementia. Because one form of dementia’s symptoms may be more pronounced at first, medical professionals and family members alike can initially miss the fact that the patient has mixed dementia. An example of this could be a patient in the early stages of Alzheimer’s who has suffered a ministroke that went undetected. Because the patient was already having trouble recalling things and was experiencing mild depression, this sudden increase in confusion and his trouble with making decisions may at first seem like the natural next step in Alzheimer’s rather than evidence of a new condition.
“Reversible” Dementia
Sometimes what at first appears to be Alzheimer’s or another form of dementia may actually be a temporary and treatable deficiency, a problem with medication interactions, an addiction to illicit drugs or alcohol, or a hormonal imbalance, especially of the thyroid. It could also be a brain tumor that is treatable but is interfering with brain function. These conditions are very different than the above dementias because they can be reversed with a prescription, procedure, or even a lifestyle change in some cases. Problems like these are often referred to as reversible dementias. The questions doctors ask and the tests they run are often designed to rule out some of these conditions during the diagnostic process.
Signs of Dementia
Not every dementia presents with the same symptoms, and the list of possible symptoms associated with dementia is quite long. Below you’ll find the most common symptoms, though the list is by no means exhaustive.
Common symptoms:
Trouble recalling recent events
Confusion and trouble making decisions
Hallucinations and delusions
Getting lost in familiar settings, including while driving
Changes in sleep habits
Reduced attention to personal care and grooming
Trouble finding the right word or name, or general trouble with communication
Fear, anxiety, or depression
Aggression and anger
Inappropriate speech or actions that indicate a loss of inhibitions
Loss of independence in daily tasks
Shuffling or difficulty with walking
Staring spells
Many of these symptoms can occur on their own from time to time in perfectly healthy people, and the veteran in your life being occasionally forgetful or moody doesn’t necessarily indicate that they have dementia. However, a doctor is the most qualified person to evaluate what changes in mood, memory, communication, or behavior mean in a senior. It’s a good idea to schedule regular health checkups with a VA or community doctor and to discuss any symptoms even if they seem mild.
Stages of Dementia
Stages of dementia vary dramatically depending on the kind of dementia. However, most forms of dementia have an early, middle, and late-stage, with only a few mild symptoms appearing in the early stage, more in the middle stage, and many and severe symptoms in the late stage that lead to a total loss of independence until the end of life.
Since Alzheimer’s Disease is the most common form of dementia, we’ve provided a more detailed explanation of its stages below. This progression varies by patient and often occurs over a four-to-eight-year time period, though it can last longer.
Early Stage
In the mild early stage, a person can often still drive, work, and care for her or himself reasonably well. It may become apparent that the person is losing things, forgetting new names, or having difficulty with planning ahead or with work and social activities. It may be difficult for family members to tell if some of the forgetfulness is normal or a symptom of brain changes, and a doctor should be consulted. The person experiencing the symptoms will probably be aware of them and troubled by them. A doctor may prescribe various forms of therapy or medication.
Middle Stage
In this stage, symptoms become more obvious but are still considered moderate. This stage can last for years. The patient will need support or frequent reminders for many daily activities such as personal grooming, selecting clothes, and using the restroom. Confusion, wandering, changes in sleep, and forgetfulness about personal history is likely, and mood swings or delusions and hallucinations are also common.
Late Stage
In the late stage of Alzheimer’s, symptoms are so severe that the patient is reliant on caregivers for virtually every facet of daily life, even including walking. Muscle control will decline, the patient will be less active or even immobile and will be prone to secondary health problems like pneumonia and other infections. The patient may appear totally unaware of his or her surroundings and will rarely attempt to communicate. Late-stage care will always include around the clock assistance, which is often referred to as memory care.
Overlapping Stages
The stages of Alzheimer’s and other forms of dementia aren’t clear cut. It might be difficult to say precisely which stage a patient is in. However, the main point of the stages is that the disease becomes progressively worse, affecting more and more daily functions as time passes. For more information on the stages of Alzheimer’s, you may want to explore this helpful article from the Alzheimer’s Association.
Dementia is a general term referring to cognitive decline that interferes with a person’s ability to reason, remember, make choices, and complete normal daily activities. If you are a caregiver of a veteran, having some basic knowledge of dementia can help you understand the challenges the person you care for may be facing and can help you communicate more effectively with doctors.
Types of Dementia
Alzheimer’s is the most common kind of dementia for veterans and for the general public, but it’s not the only one. Below you’ll find quick explanations of the different kinds of dementia and their causes, symptoms, and progressions.
Alzheimer’s Disease
Between 60% and 80% of dementia cases are caused by Alzheimer’s disease, according to the CDC. It typically affects those 65 and older, though there is a rarer, early-onset version of the disease that can affect those as young as 30. The hallmark of Alzheimer’s is abnormal plaques and tangles that build up in brain tissue, as well as a loss of neurons. Small instances of memory loss, confusion, and mood changes are often the first signs, and symptoms become progressively worse over time.
Lewy Body Dementia
This type of dementia is caused by abnormal deposits of the protein alpha-synuclein in the brain. These deposits are referred to as “Lewy bodies,” and they are separate from but can occur alongside the tangles and plaques associated with Alzheimer’s. Lewy bodies also occur in Parkinson’s disease, and there are Parkinson’s and non-Parkinson’s versions of this dementia. Muscle tremors and stiffness, along with hallucinations and fluctuations in recall, attention, and energy are common in Lewy Body dementia.
Vascular Dementia
Vascular dementia occurs when blood flow to the brain has been hindered by a condition or event, such as narrowed blood vessels, a stroke, or a brain hemorrhage. In the case of vascular dementia caused by a stroke, dementia can worsen dramatically if other strokes occur. This is in contrast to the gradual decline typically experienced by those with Alzheimer’s disease. Symptoms can vary depending on the exact region of the brain affected. Uncontrolled diabetes and poor cardiovascular health are both risk factors for vascular dementia.
Frontotemporal Dementia
This term refers to a wide range of disorders of the brain in which tissue damage occurs in the regions behind the forehead or by the ears. Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, is just one well-known example of this kind of dementia. Diagnosis of one of the frontotemporal dementias tends to occur when a patient is between 40 and 60, which is significantly earlier than the average Alzheimer’s diagnosis. The earliest signs are usually related to muscle function, and memory problems may show much later than in other forms of dementia.
Mixed Dementia
Often times, a patient can suffer from multiple forms of dementia. Because one form of dementia’s symptoms may be more pronounced at first, medical professionals and family members alike can initially miss the fact that the patient has mixed dementia. An example of this could be a patient in the early stages of Alzheimer’s who has suffered a ministroke that went undetected. Because the patient was already having trouble recalling things and was experiencing mild depression, this sudden increase in confusion and his trouble with making decisions may at first seem like the natural next step in Alzheimer’s rather than evidence of a new condition.
“Reversible” Dementia
Sometimes what at first appears to be Alzheimer’s or another form of dementia may actually be a temporary and treatable deficiency, a problem with medication interactions, an addiction to illicit drugs or alcohol, or a hormonal imbalance, especially of the thyroid. It could also be a brain tumor that is treatable but is interfering with brain function. These conditions are very different than the above dementias because they can be reversed with a prescription, procedure, or even a lifestyle change in some cases. Problems like these are often referred to as reversible dementias. The questions doctors ask and the tests they run are often designed to rule out some of these conditions during the diagnostic process.
Signs of Dementia
Not every dementia presents with the same symptoms, and the list of possible symptoms associated with dementia is quite long. Below you’ll find the most common symptoms, though the list is by no means exhaustive.
Common symptoms:
Trouble recalling recent events
Confusion and trouble making decisions
Hallucinations and delusions
Getting lost in familiar settings, including while driving
Changes in sleep habits
Reduced attention to personal care and grooming
Trouble finding the right word or name, or general trouble with communication
Fear, anxiety, or depression
Aggression and anger
Inappropriate speech or actions that indicate a loss of inhibitions
Loss of independence in daily tasks
Shuffling or difficulty with walking
Staring spells
Many of these symptoms can occur on their own from time to time in perfectly healthy people, and the veteran in your life being occasionally forgetful or moody doesn’t necessarily indicate that they have dementia. However, a doctor is the most qualified person to evaluate what changes in mood, memory, communication, or behavior mean in a senior. It’s a good idea to schedule regular health checkups with a VA or community doctor and to discuss any symptoms even if they seem mild.
Stages of Dementia
Stages of dementia vary dramatically depending on the kind of dementia. However, most forms of dementia have an early, middle, and late-stage, with only a few mild symptoms appearing in the early stage, more in the middle stage, and many and severe symptoms in the late stage that lead to a total loss of independence until the end of life.
Since Alzheimer’s Disease is the most common form of dementia, we’ve provided a more detailed explanation of its stages below. This progression varies by patient and often occurs over a four-to-eight-year time period, though it can last longer.
Early Stage
In the mild early stage, a person can often still drive, work, and care for her or himself reasonably well. It may become apparent that the person is losing things, forgetting new names, or having difficulty with planning ahead or with work and social activities. It may be difficult for family members to tell if some of the forgetfulness is normal or a symptom of brain changes, and a doctor should be consulted. The person experiencing the symptoms will probably be aware of them and troubled by them. A doctor may prescribe various forms of therapy or medication.
Middle Stage
In this stage, symptoms become more obvious but are still considered moderate. This stage can last for years. The patient will need support or frequent reminders for many daily activities such as personal grooming, selecting clothes, and using the restroom. Confusion, wandering, changes in sleep, and forgetfulness about personal history is likely, and mood swings or delusions and hallucinations are also common.
Late Stage
In the late stage of Alzheimer’s, symptoms are so severe that the patient is reliant on caregivers for virtually every facet of daily life, even including walking. Muscle control will decline, the patient will be less active or even immobile and will be prone to secondary health problems like pneumonia and other infections. The patient may appear totally unaware of his or her surroundings and will rarely attempt to communicate. Late-stage care will always include around the clock assistance, which is often referred to as memory care.
Overlapping Stages
The stages of Alzheimer’s and other forms of dementia aren’t clear cut. It might be difficult to say precisely which stage a patient is in. However, the main point of the stages is that the disease becomes progressively worse, affecting more and more daily functions as time passes. For more information on the stages of Alzheimer’s, you may want to explore this helpful article from the Alzheimer’s Association.
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