Understanding Dementia: Types, Early Signs, and Managing Symptoms

Medically Reviewed By Shilpa Amin, M.D., CAQ, FAAFP
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Dementia is a progressive deterioration of brain function. It typically involves memory loss and at least one other category of loss, such as language, visuospatial, or executive function. It can also affect thought processes, judgment, and behavior. Dementia is most common after the age of 65, but the Centers for Disease Control and Prevention (CDC) notes that it is not a normal part of aging. More than occasional forgetfulness, dementia makes it difficult to remember, learn, and communicate.

Dementia is not just one type of brain condition. It is a group of symptoms that many different brain conditions can cause. Alzheimer’s disease is the most common cause of dementia. 

This article will provide an overview of dementia, including early warning signs and symptoms. It will also discuss types of dementia, dementia stages, and treatment options to manage symptoms.

What is dementia?

Teenage girl embracing grandmother from behind with both looking to camera with slight smiles
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Everyone loses some brain cells as they age. This can cause symptoms such as losing some short-term memory. You might forget a name or forget where you left your keys. This can be normal and is not dementia.

Dementia results from damage to brain cells. It causes a decline in cognitive abilities, memory, language, and decision making that makes daily life challenging. People with dementia also experience changes in personality, mood, or emotions.

Sometimes, it is possible to halt or reverse the progression of dementia. This may be the case when dementia is due to medications, alcohol abuse, hormonal or chemical imbalances, vitamin deficiency, depression, infection, heart or lung disease, normal pressure hydrocephalus (fluid collection in the brain), or brain tumors. However, the most common types of dementia are not reversible.

Treatment of dementia depends upon the underlying cause. Some types of dementia may get better with treatment. These types include dementia that results from depression, a thyroid disorder, medication side effects, alcohol abuse, or a vitamin deficiency. Medications can help slow Alzheimer’s disease and control the behavioral changes that can occur.

Seek prompt medical care if you notice:

  • difficulty with memory, thinking, talking, comprehension, writing, or reading
  • confusion that is worse than usual
  • an inability to care for yourself and your daily needs
  • changes in mood, personality, or behavior
  • other symptoms that concern you

Is dementia the same as Alzheimer’s disease?

The term “dementia” refers to a group of symptoms that result from a decline in brain function. These include memory loss, difficulty learning, trouble reasoning, and personality changes.

Alzheimer’s disease is a specific condition that is the most common cause of dementia. The Alzheimer’s Association reports that Alzheimer’s disease causes about 60–80% of dementia cases.

Types of dementia

“Dementia” is a general term. It describes a decline in memory and other cognitive functions that interfere with daily activities. Most cases of dementia are progressive and irreversible. 

Progressive types of dementia

Progressive types of dementia include: 

  • Alzheimer’s disease: This is the most common type of dementia. Treatment may slow mental decline, but there is no cure. It is progressive, which means it gets worse over time. No one knows exactly what causes Alzheimer’s disease, but it appears to be a combination of genetic and environmental factors. 
  • Frontotemporal dementia (FTD): Loss of nerve cells in the frontal and temporal lobes of the brain lead to this rare form of dementia. It is an early onset form of dementia and tends to run in families.
  • Lewy body dementia: Lewy bodies are abnormal accumulations of a protein in brain cells. People with Parkinson’s disease develop Lewy bodies. Trembling, stiffness, and slow movements are characteristics of both dementia with Lewy bodies (DLB) and Parkinson’s disease with dementia (PDD). Researchers do not know what causes Lewy bodies, but they suspect both environmental and genetic factors play a role.
  • Vascular dementia: With this type of dementia, brain cells die because they do not get enough freshly oxygenated blood. Often, this is the result of a stroke. Vascular dementia may be permanent.
  • Mixed dementia: This is a combination of more than one form of dementia.

Other types of dementia

Other causes of dementia or dementia-like conditions that may be reversible include:

Symptoms of dementia

Dementia symptoms include progressive changes in thought processes, judgment, behavior, language, and memory. These symptoms interfere with daily life. This includes work performance, social interactions, and personal relationships.

Common signs and symptoms of dementia

Dementia signs and symptoms may be subtle at first and then slowly progress to become more noticeable — both by you and others around you. Common signs include:

  • changes in mood, personality, or behavior
  • changes in sleep pattern
  • confusion
  • difficulty performing complex tasks
  • difficulty with memory, thinking, talking, comprehension, writing, or reading
  • impaired reasoning
  • impaired spatial ability and orientation
  • inability to manage finances, pay bills, or balance the checkbook
  • loss of judgment
  • social withdrawal

Symptoms that might indicate a serious condition

Dementia tends to have a gradual onset with progressive worsening of symptoms. Rapid or abrupt onset of symptoms could indicate a medical emergency.

It is important to seek care when these symptoms begin. With an accurate diagnosis, treatment has a chance to help slow or reverse the underlying cause. Seek prompt medical care for any of these symptoms:

  • altered judgment
  • changes in mood, personality, or behavior
  • changes in sleep pattern
  • confusion
  • difficulty with complex tasks
  • difficulty with memory, thinking, talking, comprehension, writing, or reading
  • inability to care for oneself
  • loss of social skills

Normal forgetfulness vs. dementia

Everyone has moments of forgetfulness from time to time, but when should you worry?

The National Institute on Aging lists these differences between normal forgetfulness and symptoms of Alzheimer’s disease:

Normal forgetfulness with agingSymptoms of Alzheimer’s disease
missing one monthly bill paymentongoing problems handling monthly finances
forgetting what day it is but remembering soon afterlosing track of dates or seasons
not being able to think of a certain wordnot being able to carry on a conversation
losing an item around the house occasionallyfrequently misplacing objects and not finding them
making a different decision than you may have in the pastoften displaying poor judgment and lack of reason

If you have any concerns about symptoms related to memory or cognitive ability, talk with your primary care doctor. They can evaluate your symptoms and discuss whether you may need to see a specialist, such as a neurologist, for further testing.

Stages of dementia

Alzheimer’s disease, the most common cause of dementia, usually progresses through three general stages. Not everyone goes through the stages in the same way, however, and the stages can overlap.

Brain changes can begin many years before symptoms appear. Some people progress quickly over a few years. Others can live with the disease for a couple of decades.

The stages of Alzheimer’s disease are: 

  • Mild or early stage Alzheimer’s: People can generally still function independently. Symptoms may not be obvious to people who are not close to the person. Common problems include remembering names, misplacing valuable objects, trouble planning or organizing, trouble finding the right word or name, and forgetting things you just read. Prescription medications tend to work best in this stage of Alzheimer’s.
  • Moderate or middle stage Alzheimer’s: This is the longest stage of the disease. People need more assistance with daily activities. Common problems include forgetting events and personal history, confusing words, mood changes, confusion about whereabouts, sleep problems, behavioral changes, and wandering. Bowel and bladder control may also decline.
  • Severe or late stage Alzheimer’s: People in this stage require full-time care. They no longer respond to their environment, carry on conversations, or control movement. Eventually, problems like pneumonia can become fatal.

What causes dementia?

Dementia is the result of damage to or loss of nerve cells. It can also occur when connections between nerve cells no longer function the way they should.

Many different conditions can cause dementia and dementia-like symptoms. Some conditions that cause dementia run in families and others have specific risk factors.

Disease that cause dementia

Many progressive diseases can cause dementia, including:

Other causes of dementia

A number of other conditions can cause dementia. Examples include:

Risk factors for dementia

A number of factors increase the risk of developing dementia. Not all people with risk factors will get dementia.

Some risk factors are not in your control, such as advancing age and a family history of dementia. However, researchers have found evidence of potentially modifiable risk factors for dementia, including:

The CDC reports that dementia is twice as common in older African American adults compared to white adults in the same age group. The CDC adds that Hispanic adults are 1.5 times more likely to develop dementia than similar white adults.

Researchers note that these increased risk levels may result from a combination of factors, including differences in income, education, and access to care.

Can you prevent dementia?

In general, progressive diseases, such as Alzheimer’s disease, are not preventable. However, some types of dementia, such as those due to stroke or cardiovascular disease, may be preventable.

The Alzheimer’s Association offers tips to lower your risk of dementia by:

  • controlling blood sugar, cholesterol, and blood pressure
  • eating a diet that is low in fat
  • exercising regularly and maintaining a moderate weight
  • keeping your mind active with mentally stimulating activities
  • staying socially active
  • limiting alcohol consumption
  • not smoking
  • getting quality sleep
  • treating hearing loss
  • preventing head injury

Nutrition and meal tips for dementia

People with dementia need to eat a balanced diet. With mild dementia, this is usually not a challenge. As the disease progresses, it can be hard to make sure people get the nutrition they need.

There are several reasons for this. People may no longer recognize certain foods or food may not taste or smell the way it once did. Medications and reduced physical activity can also impair appetite. People with dementia may also forget to drink enough fluids, leading to dehydration.

Here are some tips from the Alzheimer’s Association for helping someone with dementia at meal time:

  • Allow for extended eating times and do not worry about neatness. Bibs and aprons can make for easier cleanup and lids with straws help prevent beverages from spilling.
  • Keep meals social by eating together or with others.
  • Limit distractions, such as TV, and use simple table settings with only necessary utensils. Avoid patterns and stick to solid, contrasting colors to make plates, napkins, and silverware easier to see.
  • Offer small cups of liquids throughout the day and foods with high water content, such as fruits, soups, and milkshakes.
  • Plan several smaller meals throughout the day instead of three large ones.
  • Serve foods that are easy to chew and pick up, such as finger foods. 
  • Limit the need to make choices by serving only a couple of foods at once.

Food safety is important too. A person with dementia may not be able to tell whether food or drinks are too hot. Check the temperature of food and drinks before serving them. Also be aware of signs of choking and know what to do in an emergency.

If weight loss becomes a concern, talk with your doctor about a supplement. Your care team may also be able to refer you to a nutritionist or dietician who can provide guidance on maintaining nutrition while managing dementia symptoms.

How doctors diagnose dementia

To diagnose dementia, your doctor will take a medical history, perform an exam, and order testing. Questions your doctor may ask you or someone close to you include:

  • What symptoms are you experiencing?
  • How long have you noticed these symptoms?
  • Are your symptoms constant or do they come and go?
  • Are your symptoms getting worse?
  • Do your symptoms cause you to avoid certain activities because they are too mentally challenging?
  • Have you noticed any changes in emotions like sadness?
  • Do you have any physical symptoms, such as a tremor?
  • Do you have a family history of dementia or Alzheimer’s disease?
  • What other medical conditions do you have?
  • What medications do you take?

During the physical exam, your doctor will evaluate your neurological health. This may involve checking your reflexes, balance, and movement. Your doctor will also want to rule out any conditions that are treatable. 

Tests your doctor may use to diagnose dementia include:

  • blood tests to check for signs of infection or inflammation and levels of hormones, vitamins, and blood chemicals
  • cognitive and neuropsychological tests, which include testing memory, attention, problem-solving, judgment, language, and math skills
  • genetic testing for certain causes of dementia
  • imaging exams of the brains, such as CT or MRI scans, to look for signs of tumors, stroke, or other brain problems
  • psychiatric evaluations to rule out mental health problems, such as depression

Treatments for dementia

In general, treatment depends upon the cause of dementia. For reversible causes, this may involve changing medications, correcting imbalances or deficiencies, or treating medical conditions.

Medications to slow the progression of symptoms

Medications cannot slow the progression of dementia, but they may help to temporarily stabilize symptoms. These drugs include:

  • cholinesterase inhibitors, such as donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon), which increase the availability of a chemical that is required for nerve signaling in the brain
  • NMDA receptor antagonists, such as memantine (Namenda), which decrease the overexcitement of certain receptors in the brain that may contribute to the degenerative process

Medications to manage behavioral changes

Medications are available to help address some of the behavioral changes that may occur with dementia, including:

Complementary treatments

Complementary treatments may help some people to better deal with dementia. People may use these treatments, sometimes referred to as alternative therapies, in conjunction with traditional medical treatments.

These treatments are not a substitute for traditional medical care. Be sure to tell your doctor if you are using alternative treatments. They may interact with your prescribed medical therapy.

Complementary treatments may include:

  • acupuncture
  • massage therapy
  • nutritional dietary supplements, herbal remedies, tea beverages, and similar products
  • yoga

Palliative and hospice care

In late stage dementia, caregivers and care teams may choose to focus treatment on comfort and quality of life. This may include offering sensory connections, such as through light massage or playing soothing music.

Healthcare professionals who specialize in palliative or hospice care can work with family members to provide the care a person with severe dementia needs while also offering support to loved ones. They can also offer emotional guidance through the grief process.

Guidance for dementia caregivers

There is no cure for progressive dementia. Eventually, people with dementia will lose their independence. They will need help caring for themselves.

At first, family members are often able to provide the necessary care. Simple reminders, structured routines, and simplified tasks can make life easier. Providing cues and context can help people with dementia remember other people and events. However, the behavioral and personality changes that result from dementia can be distressing for family caregivers.

If you are a caregiver for someone with dementia, support is vital. Several resources are available for caregivers, such as respite care and adult daycare. Support groups are also helpful. It can be comforting to meet others in similar situations who understand your feelings and challenges. 

At some point, people with progressive dementia will need specialized care. People usually do best in a long-term care facility that specializes in memory care.

Talk with your loved one and your doctor in the early stages of the disease. This gives you time to explore your options so you do not feel rushed to find residential care when you need It. It can also give you peace of mind to know you have options if you begin to feel overwhelmed.

A person with dementia will also need help with healthcare, finances, and security. They should plan for the future, designating a trusted individual with the legal capacity to make decisions regarding their financial and health-related issues. 

Potential complications of dementia

As dementia progresses, symptoms become more severe and can place someone at greater risk of serious illness or injury. Complications of dementia include:

  • falls
  • fecal incontinence (inability to control stools)
  • infections
  • poor nutrition due to a decreased desire to eat
  • sleep disturbances
  • swallowing problems that can lead to aspiration pneumonia
  • urinary incontinence

Does dementia shorten life expectancy?

For people with any form of progressive dementia, life expectancy is shorter than normal. However, it is hard to estimate how quickly a person with dementia will decline.

For Alzheimer’s disease, the average life expectancy is 4–8 years after diagnosis. However, it is possible to live for 20 years with the disease. Survival for Lewy body dementia is shorter, with an average life expectancy after diagnosis of 4.1 years.

Other frequently asked questions

Here are some other questions people have asked about dementia.

How do you move a parent with dementia to assisted living?

The Alzheimer’s Association recommends considering the financial, emotional, and lifestyle issues before moving a parent with dementia. It is best to first involve the parent or family member with dementia to give them control over their situation. Get involved with your local dementia support group to consider the best living arrangements.

How do you talk to a parent with dementia?

Ensure you speak clearly, using short sentences, and give them time to respond without pressure. The Alzheimer’s Society details how to communicate with loved ones and why it is important.

What causes Lewy body dementia?

The presence of abnormal proteins in the brain called Lewy bodies cause Lewy body dementia. Lewy bodies are typically present in the deep layers throughout the brain, especially in the anterior frontal and temporal lobes, cingulate gyrus, and insula.

What is the difference between dementia and Alzheimer’s?

Dementia is the general term used for diseases that impact memory. Alzheimer’s is a specific disease that impairs cognitive function as well as memory.

Summary

Dementia is the name for a group of symptoms that result from a decline in brain function. Someone with dementia may experience impaired memory, declining cognitive ability, and trouble with decision making. They may also go through mental and emotional changes that alter their personality.

Dementia is more common among older adults, but it is not a normal part of aging. Dementia can result from several progressive conditions that are irreversible, including Alzheimer’s disease, Huntington’s disease, and Lewy body dementia.

Other causes of dementia may be temporary and reversible, such as dementia that results from alcohol use disorder, head injury, or stroke.

Treatments are available that can help slow the progression of symptoms or manage changes in behavior. However, as dementia progresses, the person will need full-time care.

Resources are available for dementia caregivers to provide proper support for their loved one and to find respite care when needed.

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Medical Reviewer: Shilpa Amin, M.D., CAQ, FAAFP
Last Review Date: 2022 May 4
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Alzheimer's and dementia. (n.d.) https://www.alz.org/alzheimer_s_dementia
  2. Can I prevent dementia? (n.d.). https://www.alzheimers.gov/life-with-dementia/can-i-prevent-dementia
  3. Chen, C. et al. (2018). Racial and ethnic differences in trends in dementia prevalence and risk factors in the United States. https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC6197734/
  4. Communicating and dementia. (n.d.). https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/symptoms/communicating-and-dementia
  5. Dementia information page. (2022). https://www.ninds.nih.gov/Disorders/All-Disorders/Dementia-Information-Page
  6. End-of-life care for people with dementia. (2022). https://www.nia.nih.gov/health/end-life-care-people-dementia
  7. Food and eating. (n.d.). https://www.alz.org/help-support/caregiving/daily-care/food-eating
  8. How dementia progresses. (n.d.) https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/how-dementia-progresses
  9. Livingston, G. et al. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7392084/
  10. Memory, forgetfulness, and aging: What's normal and what's not? (2020). https://www.nia.nih.gov/health/memory-forgetfulness-and-aging-whats-normal-and-whats-not
  11. Moving a person with dementia into a caregiver's home. (2017). https://www.alz.org/media/greatermissouri/moving_a_person_with_dementia_into_a_caregiver_s_home.pdf
  12. Mueller, C. et al. (2019). Survival time and differences between dementia with Lewy bodies and Alzheimer’s disease following diagnosis: A meta-analysis of longitudinal studies [Abstract]. https://www.sciencedirect.com/science/article/pii/S1568163718302319
  13. What is dementia? (2019). https://www.cdc.gov/aging/dementia/index.html
  14. What is Lewy body dementia? Causes, symptoms, and treatments. (2021). https://www.nia.nih.gov/health/what-lewy-body-dementia-causes-symptoms-and-treatments