11 Types of Dementia

Dementia refers to the deterioration of intellectual abilities – including memory – that interferes with an individual’s ability to function in daily life. Dementia is caused when the brain is damaged by diseases, such as Alzheimer’s disease or a series of strokes. Alzheimer’s disease is the more prevalent cause of dementia, but not the only one.

Not everyone with memory loss has dementia. For a doctor to diagnose the condition, an individual must meet certain criteria, including impaired spatial and motor skills, language, judgment, attention, memory, functioning, and orientation. If you have a family member or friend with dementia, here’s what you need to know about their condition.
Dementia refers not to a specific disease but to a range of symptoms that often occur in conjunction with a reduction in memory and other cognitive skills serious enough to impair daily functioning. Many people believe dementia is the same as “senility.” However, losing mental functioning is not simply an expected component of growing older. Alzheimer’s disease makes up approximately 60 to 80 percent of dementia instances. Vascular dementia, which can result from a stroke, constitutes the second-leading cause of dementia. A variety of other causes can contribute to the condition. For an impairment to be medically defined as dementia, two or more primary aspects of mental functioning must be negatively impacted:
  • Language and communication abilities.
  • Memory.
  • Judgment and reasoning.
  • Visual perception.
  • Focus and attention.
Individuals with dementia may experience challenges with their short-term memory, including keeping track of personal belongings like wallets and purses. In addition, they may have problems with household tasks like preparing meals. Traveling outside their own neighborhood or getting to appointments on time also may pose obstacles in daily life. Some types of dementia are considered to be progressive and involve symptoms that begin subtly and become worse over time. Anyone showing signs of altered thinking abilities should see a doctor as soon as possible for diagnosis and possible treatment.
The signs and symptoms of dementia can vary significantly depending on the form of the disorder. However, dementia typically involves problems with focus and attention, language and communication, memory, judgment and reasoning and visual perception. Alzheimer’s, the most common form of dementia, causes severe challenges with thinking, memory and behavior. Symptoms usually begin slowly and worsen over time. In 2011, the guidelines for the diagnosis of Alzheimer’s were revised to reflect that the condition is a brain disease that progresses slowly and often begins long before symptoms become noticeable. Eventually, symptoms become serious enough to interfere with or halt the ability to engage in normal daily tasks. Trouble remembering conversations can signal the presence of Alzheimer’s or another form of dementia. In addition, difficulty recalling events, activities or names often stands as an early clinical sign of the disease. Early symptoms also include depression and apathy. As the disease progresses, an individual may experience disorientation and confusion, trouble with speaking and walking, behavioral changes, reduced communication, and poor judgment.
The most frequently cited cause of dementia is Alzheimer’s disease. In addition, strokes can cause damage to blood vessels leading to vascular dementia, the second-leading type of the disorder. Many other conditions may cause or influence the development of dementia. Some potential causes – including vitamin deficiencies and problems with the thyroid – can be reversed with appropriate treatment. Additional causes include brain injuries, drug toxicity, brain tumors or infections, AIDS, alcoholism, meningitis, syphilis, Pick disease, hypothyroidism and Creutzfeldt-Jakob disease. In some instances, the underlying medical conditions that lead to dementia can be treated and some or all mental functioning lost to the disorder can be restored. In most cases, however, dementia is irreversible. Regardless of the medical problem responsible for the development of dementia, the condition results from damage to cells in the brain. The damage causes problems with the capacity of brain cells to communicate with each other, resulting in abnormalities in behavior, thinking and feelings. The brain includes a number of separate regions that bear responsibility for a variety of functions such as memory and motion. When cells in a specific portion of the brain become damaged, the functionality associated with that region becomes compromised. Different forms of dementia cause damage in different areas of the brain. Alzheimer’s disease, for instance, causes elevated levels of proteins both within and outside of brain cells that compromise cell health and impair normal cellular communication. The disease often causes the earliest damage to the hippocampus, the portion of the brain responsible for memory and learning.
With treatment, certain conditions that can cause dementia – including problems with the thyroid, vitamin deficiencies, depression, side effects of medication, and alcohol abuse – can improve. The memory and thinking problems associated with those underlying dementia causes also may become better. If you or a family member are experiencing changes in your thinking, memory or behavior, it’s important to seek treatment from a medical professional as quickly as possible. Many types of dementia cause symptoms that may begin slowly but become worse over time. Evaluation by a medical professional may determine that a treatable medical condition is behind the dementia symptoms; early diagnosis can provide the opportunity to benefit from all current treatments, including participation in studies and clinical trials when appropriate. No individual test can detect the presence of dementia. Medical professionals diagnose dementia – including Alzheimer’s disease – based on physical exams, a variety of lab tests, review of the medical history, and observation of changes in thinking and functioning associated with the different forms of dementia. Based on symptoms and other factors, a doctor may be able to diagnose dementia but unable to diagnose a specific form of the condition. In some cases, a specialist such as a neurologist may assist in diagnosis. Treatment depends on the specific form of dementia and its cause. Some types of dementia, such as Alzheimer’s, are progressive and cannot be cured; treatment then relies on slowing the progression or lessening symptoms. Examples of treatment methods include:
  • Vitamins for a specific deficiency.
  • Surgery to remove a tumor in the brain.
  • Medications to treat an infection like encephalitis.
  • Thyroid therapy for hypothyroidism.
  • Ceasing of medications that may contribute to confusion or disorientation.
  • Medication for depression.
Age and genetics are two significant risk factors for dementia that cannot be altered. In addition, cardiovascular function can play a significant role in the development of dementia. Damage to blood vessels throughout the body also can damage vessels in the brain, which can rob brain cells of nourishment and oxygen. Changes in the brain’s blood vessels have a link to vascular dementia. New research continues to uncover additional types of risk along with methods for preventing the disorder. Getting physical exercise on a regular basis may help reduce the risk of developing some forms of dementia. Research has suggested that exercise may provide direct benefit to brain cells by improving oxygen and blood flow reaching the brain. In addition, diet may have a major impact on the health of the brain due to the relationship to heart health. Current medical guidelines promote eating in a healthy manner such as the Mediterranean diet – with minimal red meat and ample fruits, vegetables, whole grains, nuts, olive oil, fish and shellfish – to protect your brain.

Types of Dementia

If your family member is living with dementia, it’s important to understand the underlying causes, symptoms and potential treatments. We’ve put together a brief primer on the various types of dementia to assist you as you investigate supportive care options.
Alzheimer’s disease accounts for up to 80 percent of cases of dementia. Depression and memory loss are often early signs, but the condition causes brain cell death, leading to confusion, mood changes, and difficulty walking and speaking. More than five million Americans have been diagnosed with Alzheimer’s disease. Learn more about Alzheimer’s disease
Creutzfeldt-Jakob disease (also known as CJD or the human version of mad cow disease), is an incredibly rare and degenerative brain disorder. Affecting only 1 in a million yearly throughout the world, approximately 300 cases are diagnosed in the United States in a year. Unfortunately, CJD is a fatal brain disease and typically runs a fast course. 90% of individuals diagnosed with CJD live less than 1 year. Though CJD is not an easy diagnosis to receive (or to watch a family member receive), there are resources and information to ease the burden and eliminate the unknowns.

About Creutzfeldt-Jakob Disease

Creutzfeldt-Jakob (CJD) is a degenerative disorder in the brain that results in dementia and, ultimately, death. CJD looks very similar to other forms of dementia (including the most common, Alzheimer’s), but progresses much faster in the patient.

Symptoms of Creutzfeldt-Jakob Disease

CJD is a rare brain disorder diagnosed in older adults. As such, older adults often experience memory slips or moments of confusion (or even personality changes) that are not anything over which to worry. Frequent expression of certain symptoms, however, should raise a red flag and result in a conversation with the family doctor. The most easily recognizable symptom that someone may have CJD is rapid symptom progression. Additionally, other symptoms include (but are not limited to) the following:
  • Persistent anxiety or depression
  • Blurred vision or sudden blindness
  • Frequent insomnia
  • Difficulty swallowing
  • Sudden and jerky movements and muscle stiffness

Brain or Physical Changes

Creutzfeldt-Jakob disease changes healthy brain tissue into abnormal or diseased tissue by causing many sponge-like lesions throughout the brain. As normal prion protein alters its structural and physical shape, the abnormal prion protein damages the brain, causing cell death, brain damage, and disease.

Causes and/or Risk Factors

Many scientists believe CJD begins when a prion protein located in the brain mis-folds and triggers a domino effect of mis-folding protein within the brain. There are 3 known types of Creutzfeldt-Jakob disease:
  1. Sporadic: Unfortunately, this type of CJD currently has no known cause or specific risk factors identified by researchers.
  2. Familial: This type of CJD is genetic and is believed to be due to a defect within the prion protein gene.
  3. Acquired: This type of CJD is acquired when a person is exposed to an infectious prion in contaminated meat, in contaminated tissue (such as in a transplant), or from instruments during surgery.

Diagnosis, Treatment, and Care of Creutzfeldt-Jakob Disease

CJD – as is the case with any form of dementia – is a difficult diagnosis. However, it’s paramount that a proper diagnosis be received as quickly as possible so that ensuing treatment and proper care can be promptly administered. Specifically,Creutzfeldt-Jakob disease is a fast-moving brain disorder, so it is critical that an individual receive a proper diagnosis as quickly as possible so that professionals can do whatever is possible to delay the onset of new or worsening symptoms, and, specifically in this case, prolong life. Though no one single test is used to conclusively diagnose a person with CJD, several tests in combination help doctors with a diagnosis. These tests include an electroencephalogram (EEG) to check the heart, brain magnetic resonance imaging (MRI) to check the brain, and lumbar puncture (also known as a spinal tap) to test fluid for the presence of specific proteins.
Dementia with Lewy Bodies (also known as DLB or Lewy Bodies Dementia) is the third most common type of dementia, only after Alzheimer’s disease (the most common) and vascular dementia. DLB accounts for approximately 10-25% of dementia cases. Most patients receive a Lewy Bodies Dementia diagnosis sometime after age 50, and more males receive the diagnosis than females. While many of the symptoms involve common signs associated with aging (such as bouts of confusion or sleep difficulties), it is a good idea to understand the warning signs for DLB and to discuss anything that may be suspicious with a healthcare professional as soon as possible.

About Dementia with Lewy Bodies

DLB is a type of dementia that is progressive and that leads to a sharp decline in reasoning and independent thinking/functioning. Scientists believe Lewy Bodies Dementia is the result of abnormal microscopic deposits that collect in the brain and damage brain cells over a period of time. Unlike other forms of dementia (such as Alzheimer’s disease), memory loss or impairment is not the first or most recognizable symptom of DLB. Instead, persistent confusion or delusion are linked to Dementia with Lewy Bodies, as are other symptoms.

Symptoms of Dementia with Lewy Bodies

Because Lewy bodies are present in other brain diseases and disorders (including Alzheimer’s disease and Parkinson’s disease, for instance), it is important to understand the symptoms specific to DLB (that may overlap with other diseases and disorders) and to seek a medical diagnosis as quickly as possible when DLB is suspected. Plain and simply, our brains age along with the rest of our body – meaning memory slips and occasional confusion are not necessarily anything to be particularly concerned about – but frequent expression of certain symptoms should raise a red flag and result in a conversation with the family doctor. These symptoms include, but are not limited to:
  • Changes in ability to think and/or reason
  • Levels of alertness and confusion that vary significantly from hour to hour or day to day
  • Presence of hallucinations and delusions
  • Problem(s) with balance, muscle rigidity, or posture
  • Trouble assimilating and interpreting visual information
  • Tremors

Brain or Physical Changes

Lewy bodies are abnormal deposits of the protein known as alpha-synuclein. In a DLB patient’s brain, these Lewy bodies build up in various parts of the brain that regulate important functions such as behavior, reasoning, cognition, or movement. People who present with Lewy bodies in the brain often have plaques and tangles as well, which are commonly associated with Alzheimer’s disease.

Causes and/or Risk Factors

A handful of risk factors increase the likelihood of developing Lewy Bodies Dementia. Some of these risk factors include:
  • Being 60 years or older
  • Being male
  • Having a member of the family with DLB or Parkinson’s disease
  • Having frequent bouts of depression

Diagnosis, Treatment, and Care of Dementia with Lewy Bodies

Because the symptoms of DLB and other diseases or disorders (such as Alzheimer’s and Parkinson’s, specifically) so closely resemble each other, Dementia with Lewy Bodies is often misdiagnosed or under-diagnosed. Research continues to develop in the field of DLB, and patients (as well as families) are encouraged to advocate where they think a misdiagnosis has occurred. Even so, DLB is not considered a rare form of dementia as approximately 1.4 million patients have been affected by it in the United States alone. Patients diagnosed with Dementia with Lewy Bodies live for an average of 8 years after symptoms present.
Frontotemporal dementia (FTD) is one of the lesser known forms of dementia diagnosed today. Also commonly known as Pick’s disease, this form of dementia is a broad term that encompasses a wide range of uncommon brain disorders that affect the frontal and temporal lobes. These areas of the brain are most often associated with language, behavior, and personality.

About Frontotemporal Dementia

The name “frontotemporal” is appropriate because it identifies the part of the brain that is damaged with this type of dementia. The frontal lobes in the brain (located behind the forehead) primarily deal with behavior, emotion, planning, and problem-solving. The left frontal lobe, specifically, controls a person’s speech. That said, frontotemporal dementia refers to a number of disorders that cause nerve cell damage leading to the loss of various functions controlled by the affected brain regions. Common affected areas include personality, language, and muscle/motor function. The main difference between FTD and Alzheimer’s disease is the age patients begin presenting with symptoms. FTD symptoms typically begin to appear between ages 45 and 65, where symptoms of Alzheimer’s disease generally occur for people over the age of 65.

Symptoms of Frontotemporal Dementia

Although it’s normal for occasional memory slips and other affects of aging to occur, frequent expressions of the following symptoms should raise a red flag and result in a conversation with the family doctor:
  • Memory loss
  • Lack or loss of empathy
  • Socially inappropriate behaviors
  • Lack of inhibition
  • Repetitive or compulsive behaviors
  • Trouble with balance
  • Difficulty with speech
  • Frequent or abrupt mood swings
  • Trouble concentrating or planning

Brain or Physical Changes

Frontotemporal dementia happens when the nerve cells located in the front or temporal lobes within the brain die. The pathways between the connected lobes change, and some of the chemical messengers that exist to transmit signals between the nerve cells become lost over time. As more nerve cells die, the frontal and temporal lobes, as well as the brain tissue, shrinks.

Causes and/or Risk Factors

Nearly one-third of the time FTD is inherited. Unfortunately, besides family history or the presence of a similar disease or disorder, no other risk factors are known at this time.

Diagnosis, Treatment, and Care of Frontotemporal Dementia

Diagnosis of FTD is based on a thorough evaluation by a medical professional familiar with the disorders. Brain scans including MRI, as well as glucose positron emission scans, are useful tests in combination with a patient history and neurological examination. As for the care of an individual who has been diagnosed with Frontotemporal dementia, speech and language therapy can be very helpful, as well as implementing various behavioral management strategies. Some of these strategies include establishing daily routines and making necessary home modifications.
Huntington’s disease (HD) is inherited and causes a progressive degeneration of the nerve cells within the brain. The disease has a widespread impact on functional abilities and generally results in trouble with movement and cognitive thinking.

About Huntington’s Disease

Huntington’s disease is a genetic disorder that is fatal and that causes a progressive, aggressive breakdown of the nerve cells in the brain. Typically speaking, the person affected by HD experiences deterioration of mental and physical abilities for which there is no current cure. It should be noted that every person with HD has a 50/50 chance of passing the faulty gene down to a child or children. Currently, approximately 30,000 people in America are symptomatic of Huntington’s disease, and more than 200,000 people remain at risk for inheriting the disease.

Symptoms of Huntington’s Disease

People who have been diagnosed with HD describe the symptoms as having ALS, Alzheimer’s, and Parkinson’s disease at the same time. These symptoms include the following:
  • Changes in personality
  • Mood swings and depression
  • Impaired judgment
  • Increased forgetfulness
  • Unsteady gait
  • Involuntary movement
  • Slurred speech
  • Difficulty swallowing
  • Significant weight loss
  • Brain or Physical Changes
The physical changes that commonly result from Huntington’s disease are as follows:
  • Rigidity of muscles that affects gain
  • Significant changes to fine motor skills (that could be noticeable in handwriting)
  • Tremors
  • Slight involuntary movements
  • Seizures

Causes and/or Risk Factors

Huntington’s disease is caused by a defect that is inherited by a single gene (also known as an autosomal dominant disorder). If a parent has Huntington’s disease, every child from that parent has a 50% chance of inheriting the gene responsible for the genetic disorder.

Diagnosis, Treatment, and Care of Huntington’s Disease

A preliminary diagnosis of Huntington’s disease most often comes after a physical exam, review of family medical history, answers to a list of specific questions, and psychiatric and neurological exams. Additionally, the doctor may order a set of brain imaging tests in order to further assess the brain’s function or structure. These tests could include MRI (magnetic resonance imaging) or CT (computerized tomography) scans that offer a detailed look into the brain. Specifically, the doctor or medical professional will be looking for certain structural changes in particular spots of the brain believed to be affected by Huntington’s disease. These tests may also be used in order to rule out the disease or to find any other condition(s) that may be creating the symptoms.
As we age, changes occur that can be easily mistaken for something more sinister. Periodic forgetfulness or mild mood swings, for instance, are nothing over which to become too concerned. When the symptoms get more severe or “don’t feel right,” it is time to talk to a doctor. Best case scenario? Your doctor may find a less significant cause for whatever ailment troubles you. Worst case scenario? Your doctor identifies dementia. That said, the earlier the dementia is treated by a medical professional, the better the long-term situation. In the case of Mild Cognitive Impairment (MCI), you may become aware that something is wrong or that your mental function is slipping. Friends and family may also notice and/or comment on the change. Thankfully, this change isn’t typically severe enough to interfere with daily life.

About Mild Cognitive Impairment

MCI is a stage that exists between an expected decline in cognitive function due to aging and a decline due to suspected dementia. Mild Cognitive Impairment is generally a concern with a person present with judgment, language, memory, and thinking problems that appear greater or more severe than are associated with age-related change.

Symptoms of Mild Cognitive Impairment

Common symptoms of MCI include, but are not limited to:
  • Increased forgetfulness (including significant dates, commitments, or events)
  • Consistent loss of a “train of thought”
  • Struggle making decisions or interpreting instructions
  • Increased impulsivity or use of poor judgment
  • Increased depression, irritability, anxiety, or apathy

Brain or Physical Changes

The brain and/or physical changes associated with mild cognitive impairment are typically more mild than those associated with dementia. With mild cognitive impairment, as plaque builds up throughout the brain, the hippocampus shrinks and the ventricles (or fluid-filled sacks) become enlarged.

Causes and/or Risk Factors

At this time, there is no known single cause of Mild Cognitive Impairment, which makes sense since there is no current single outcome either. Symptoms of MCI often remain stable for years. Sometimes they progress to other types of dementia – including Alzheimer’s disease – and sometimes they actually improve. Some evidence would suggest that MCI sometimes results from other forms of dementia. That said, there are certain risk factors associated with mild cognitive impairment including the following:
  • Depression
  • Diabetes
  • High blood pressure
  • High cholesterol levels
  • Increased age
  • Lack of exercise
  • Lack of mental and/or social stimulation
  • Smoking

Diagnosis, Treatment, and Care of Mild Cognitive Impairment

At this time, no specific tests exist to aid medical professionals in determining a diagnosis of Mild Cognitive Impairment. A doctor most often runs various tests that rule out other diagnoses. Also at this time, no drugs or treatments for MCI specifically have been approved by the Food and Drug Administration. That said, scientists and researchers are actively studying MCI, and many studies are being done to learn more about the disorder. The goal at this time remains to help patients identify the disorder, improve their symptoms, and delay any progression of the disorder to dementia. In lieu of MCI-specific drugs, some doctors choose to prescribe the same drugs (cholinesterase inhibitors) for Alzheimer’s disease. Most often, this happens if the patient presents with memory loss.
With mixed dementia, abnormal protein deposits (often associated with Alzheimer’s disease) are seen to coexist with problems linked to vascular dementia. Additionally, changes to the brain that are typically associated with Alzheimer’s disease coexist with Lewy bodies. Sometimes, although it is rare, a person may present with brain changes that are linked to Alzheimer’s disease, dementia with Lewy bodies, and vascular dementia. Because of the overlap of symptoms, medical professionals are uncertain how many adults actually have mixed dementia. It is certainly possible that a person could be diagnosed with only one form of dementia when in reality he or she has mixed dementia.

Symptoms of Mixed Dementia

The symptoms of mixed dementia vary, depending on which region or regions of the brain have been affected and depending on the type of brain changes that are involved. Also, the symptoms often look similar to Alzheimer’s disease or other forms of dementia. In some cases, the symptoms of mixed dementia clearly suggest that multiple types of dementia are present in a person’s body and brain. The most common combination in mixed dementia is Alzheimer’s disease and vascular dementia, but other combinations exist as well.

Brain or Physical Changes

As the name suggests, mixed dementia indicates a combination of diseases or disorders (including neurodegenerative and vascular disease-related processes). Therefore, multiple types of brain changes can present in the person affected. Sometimes mixed dementia is the result of, or results in, stroke. Sometimes Lewy bodies are present in the brain. Medical professionals currently believe that vascular changes are the most common brain change in mixed dementia.

Causes and/or Risk Factors

Although a “mixed dementia” diagnosis is still fairly rare, scientists and researchers believe it should be given more attention as more people may have mixed dementia than receive the actual diagnosis. Additionally, since vascular changes are the most common brain change in mixed dementia, doctors believe controlling certain risk factors that affect the heart and the blood vessels could protect the brain from the vascular changes that lead to mixed dementia. Some of these risk factors could include the following:
  • Body weight
  • Blood pressure
  • Cholesterol levels
  • Diabetes

Diagnosis, Treatment, and Care

Unfortunately, a confirmed diagnosis of mixed dementia can only come after an autopsy of the brain. Many – if not most – individuals whose autopsy confirms mixed dementia were actually diagnosed with a single form of dementia prior to death. And perhaps no surprise, most often, the single form of dementia diagnosed is Alzheimer’s disease. It would make sense that since many patients with mixed dementia are actually diagnosed with a single form of dementia, many patients receive treatment and prescribing decisions based on that single form of dementia. As such, no current drugs are approved by the Food and Drug Administration for mixed dementia.
Normal Pressure Hydrocephalus (NPH) typically affects people between the ages of 60 and 70 and happens when cerebrospinal fluid accumulates in excess within the ventricles of the brain. And, despite the excess fluid, the term includes the words “normal pressure” because, in a spinal tap, the cerebrospinal fluid pressure often registers as “normal.” Because NPH has symptoms that overlap with multiple forms of dementia, medical professionals can’t be certain how many people suffer from the brain disorder.

About Normal Pressure Hydrocephalus

NPH is a gradually progressive disorder that is caused by a build-up of cerebrospinal fluid. Normal Pressure Hydrocephalus is often associated with an abnormal gait, incontinence, and dementia.

Symptoms of Normal Pressure Hydrocephalus

It’s known that our brains age and change along with the rest of our body – meaning memory slips and occasional confusion are not necessarily anything to be overly concerned about – but frequent expression of certain symptoms should lead to a conversation with the family doctor. NPH typically presents with the following three symptoms:
  • Shuffling (this is often the first symptom that concerns close family and friends)
  • Urinary incontinence
  • Memory loss (also recognized as forgetfulness or lack of attention span)
  • Brain or Physical Changes
With Normal Pressure Hydrocephalus, the brain ventricles grow (as a result of the excess fluid) and can damage or disrupt brain tissue, eventually resulting in the symptoms associated with NPH.

Causes and/or Risk Factors

Most cases of NPH are considered idiopathic, meaning no known cause exists. In rare cases, NPH may develop as a result of head injury, brain surgery, tumor/cysts, bleeding during surgery, or subarachnoid hemorrhage.

Diagnosis, Treatment, and Care of Normal Pressure Hydrocephalus

Multiple clinical tests are used to evaluate the potential presence of Normal Pressure Hydrocephalus. Imaging studies, specifically, are critical in diagnosing NPH. Patients for whom NPH is suspected should undergo cerebrospinal fluid (CSF) removal, which provides both prognostic and diagnostic value. CSF removal requires an outpatient procedure and can go a long way in assessing the situation and creating potential solutions. Note: Large-volume drainage that results in improved symptoms indicates a likely diagnosis of NPH. Tests for NPH will likely include an interview, a physical, and a neurological exam. Specifically, during the physical exam, the medical professional may:
  • Ask questions about the patient’s walking
  • Observe the patient walking
  • Assess mental cognition by asking a series of questions
  • Assess attention, emotional state, language skills, reactionary time, and reasoning
  • Discuss urinary habits (including frequency, urgency, and the presence of incontinence)
Parkinson’s disease dementia is a degenerative impairment of thinking and reasoning skills that often affects people who have been diagnosed with Parkinson’s disease.

About Parkinson’s Disease Dementia

Parkinson’s disease is a common neurological disorder diagnosed in as much as 2% of adults age 65 and older. As a person’s brain continues to change (as a result of Parkinson’s disease), mental functions such as memory, concentration, and judgment become impaired. A person with Parkinson’s disease often struggles to ascertain the steps needed in order to complete a specific task or tasks. It is estimated that between 50 and 80% of people with Parkinson’s disease eventually end up with dementia as the disease continues to progress. On average, the timeframe from onset of Parkinson’s symptoms to a dementia diagnosis is 10 years.

Symptoms of Parkinson’s Disease Dementia

Parkinson’s disease dementia is a decline in reasoning (or thinking skills in general) that presents in a person who has previously been diagnosed with Parkinson’s disease. Symptoms include:
  • Changes in concentration, judgment, and/or memory
  • Trouble understanding and interpreting visual cues or information
  • Muffled speech
  • Delusions, hallucinations, or general paranoia
  • Varying degrees of depression
  • Increased anxiety or irritability
  • Sleep disturbances or disorders

Brain or Physical Changes

In Parkinson’s disease dementia, nerve cells progressively degenerate which leads to irreversible chemical changes in the brain. Within the brain of a person with Parkinson’s disease, abnormal deposits of Lewy bodies are present. Lewy bodies are linked to several brain disorders, such as Lewy body dementia. Because of this, Parkinson’s disease/Parkinson’s disease dementia are often confused with other forms of dementia. As a further complication, people with Parkinson’s disease often present with plaques and tangles in the brain, a common symptom of Alzheimer’s disease.

Causes and/or Risk Factors

Certainly the greatest risk factor for Parkinson’s disease dementia is having Parkinson’s disease. In addition to that, certain risk factors at the time of a Parkinson’s disease diagnosis increase the likelihood that the person will also end up with a dementia diagnosis. Those risk factors include (but are not limited to) already having the following:
  • Mild cognitive impairment
  • Hallucinations
  • Extreme daytime drowsiness
  • Gait disturbance (specifically known as PIGD)
  • Issues with balance and/or falling

Diagnosis, Treatment, and Care of Parkinson’s Disease Dementia

As is the case with most forms of dementia, no one single test (or even series of tests) exist to confirm Parkinson’s disease dementia. Typically speaking, however, a diagnosis is given when a person who was originally diagnosed with Parkinson’s disease presents with dementia symptoms a year (or more) after diagnosis.
Posterior cortical atrophy (PCA – also known as Benson’s syndrome) is a specific form of dementia that is considered a variant of Alzheimer’s disease. Over time, the disease is known to cause atrophy of the part of the brain known as the cerebral cortex. This atrophy of the posterior part of the brain results in the progressive disruption of complex visual processing.

About Posterior Cortical Atrophy

PCA is a gradual, progressive degeneration of the cortex, the outer layer of the brain, in the back of the head. Researchers and scientists are currently unsure if Posterior cortical atrophy is a variant of Alzheimer’s disease or if PCA is a stand-alone disease. Many people who present with PCA have other signs or symptoms shared with Alzheimer’s disease (located elsewhere in the brain). Further, many of the brain changes look very similar to other diseases (including Creutzfeld-Jacob disease and/or Lewy body dementia). Onset of PCA occurs most often in people between the ages of 50 and 65.

Symptoms of Posterior Cortical Atrophy

Unlike Alzheimer’s disease (and other forms of dementia), someone with Posterior cortical atrophy does not necessarily have a noticeably reduced memory, though a person’s memory is sometimes affected during later stages of PCA. Additionally, also unlike some forms of dementia or other brain disorders or diseases, the symptoms of PCA often vary pretty extensively from person to person. The symptoms change as the brain degenerates. Some of the common symptoms include the following:
  • Trouble reading
  • Difficulty in judging distance
  • Trouble distinguishing between objects that are moving and standing still
  • Frequent disorientation
  • Hallucinations
  • Issues in completing simple mathematical calculations
  • Trouble spelling simple words
  • Increased anxiety

Brain or Physical Changes

Often, in patients with Posterior cortical atrophy, the part of the brain that is affected shows neurofibrillary tangles and amyloid plaques, which is similar to what is found in patients with Alzheimer’s disease, only in a different area of the brain. For other people with PCA, the changes to the affected area of the brain look more like other diseases (such as Crutzfeld-Jacob disease or Lewy body dementia, for example). As the name suggests, with all cases of PCA, the outer layer of the brain (called the cortex) gradually and progressively degenerates over time.

Causes and/or Risk Factors

Unfortunately, scientists and researchers remain unsure of the cause of PCA at this time. Additionally, no known genetic mutations have been identified as linked to PCA.

Diagnosis, Treatment, and Care of Posterior Cortical Atrophy

It is common for a person with Posterior cortical atrophy to first receive a misdiagnosis, due to the rarity and unique presentation of this form of dementia. It is also common for people with PCA to first seek out the opinion of an ophthalmologist, since some of the first symptoms include trouble reading/processing and could be perceived (either by the individual or the friends/family of the individual) as an eye problem.
Vascular dementia (also called “multi-infarct dementia”) is the second most diagnosed form of dementia. It is not nearly as well-known or understood as Alzheimer’s disease, which is the most common form of dementia. Vascular dementia is not easy to diagnose, so medical professionals are unsure how many people truly suffer from it.

About Vascular Dementia

In Alzheimer’s disease, nerve cells in the brain break down. In Vascular dementia, the vessels that supply the blood to the brain become increasingly blocked or narrowed. As the brain fails to receive the right amount of blood – and therefore the oxygen and nutrients necessary for survival – strokes often take place. Unfortunately, these strokes are considered “silent strokes” and don’t necessarily draw attention to themselves until enough strokes cause sudden or significant disability. Also, because Alzheimer’s disease and Vascular dementia are two totally different forms of dementia, it is possible for a person to be diagnosed with both.

Symptoms of Vascular Dementia

Depending on the severity of the damage done to the blood vessels (as well as the part of the brain that has been affected) memory loss may not be significant. Additionally, symptoms may be most severe soon after a stroke. Specifically, post-stroke changes may include varying degrees of the following symptoms:
  • Confusion
  • Disorientation
  • Trouble speaking (or likewise trouble being understood)
  • Loss of vision

Brain or Physical Changes

All forms of dementia are serious and should be caught and responded to as quickly as possible. Vascular dementia is no different, but responding to symptoms early and working with medical professionals to prevent further damage can actually mean prolonged length and quality of life. In some cases, people who have been diagnosed with vascular dementia appear to improve for certain periods of time.

Causes and/or Risk Factors

Some risk factors of vascular dementia can and should be controlled in an effort to curb the risk. Those risks include the following:
  • Diabetes
  • High blood pressure
  • High cholesterol
  • Smoking
  • Diagnosis, Treatment, and Care of Vascular Dementia
The main components of a vascular dementia diagnosis are as follows:
  • Collecting a thorough medical history
  • Evaluating independent function with regard to daily activities
  • Receiving input and feedback from family or friends with regard to their observations
  • Conducting a neurological exam (including brain imaging)
  • Assessing function of balance, coordination, movement, nerves, reflexes, and senses
  • Taking bloodwork