Types of Dementia
If you or a loved one have been diagnosed with a type of dementia, there are several questions that you will have now and possibly daily. In this post, I’ll detail the four most common forms of dementia, including a definition of the disease and typical symptoms. I will also provide links to resources, which can help answer some questions as well as help you manage.
If you are a care partner for someone with dementia, your primary concern is to take care of yourself. Find a supportive community or two, take deep breaths and be proactive in decisions rather than reactive. I suggest finding training that will give you tools to be a care partner for emotional support, activities of daily living such as dressing, toileting, bathing and eating. Join a support group. Research local Adult Day Services, In-Home Care Support, and Memory Care. Be proactive in your research. As the disease progresses, a person living with dementia will need 24-hour care. Remember, when you are on an airplane, the flight attendant tells you to put your oxygen mask on first. This same rule applies here. Take care of yourself first.
Alzheimer’s Disease. Alzheimer’s Disease is the most prevalent type of diagnosed dementia. Alzheimer’s results from plaque and tangles in the brain. Plaque are clumps of beta-amyloid clusters forming in multiple parts of the brain. Plaque deposits disrupt communication between brain cells. Tangles are tau proteins that change from their original shape. These proteins damage cells by disrupting the transport system of the brain’s cells.
The hippocampus and entorhinal cortex display symptoms of memory loss. This is usually the first area of the brain to be affected. The plaque spreads to the cerebral cortex, which is responsible for language, reasoning, and social behavior. Communication and seeing someone else’s point of view will be affected by the cerebral cortex. The Parietal Cortex is responsible for navigation. When this part of the brain becomes affected, the person living with Alzheimers can begin to wander and have trouble with spatial orientation. This confusion will transfer to other objects. For example, my father drank purple Fabuloso liquid cleaner, thinking it was grape Kool-Aid. Bleach may be confused for water or lemonade. A razor may be used to brush teeth or hemorrhoid cream as toothpaste.
Frontal lobes, which are located in the front of the brain, are responsible for processing and storing information. When this part of the brain is affected, the person living with Alzheimer’s will experience personality changes, difficulty with voluntary movement like picking something up as well as problem-solving (i.e., I am cold, therefore I need a sweater). The frontal lobes are eventually damaged in most types of dementia. The Occipital Lobe which controls vision, can be affected. The auditory cortex is located in the temporal lobe. When damaged, it can make it difficult for the hippocampus to create memories from heard information.
Resources/Supports: Alzheimer’s Association. www.alz.org 24/7 Helpline 800–272–3900
Frontotemporal Dementia (FTD). FTD is the most common type of dementia for people under the age of 60. It is often referred to as Fronto Temporal Degeneration or Pick’s Disease. FTD has several subtypes, which include Behavioral Variant, Primary Progressive Aphasia (Nonfluent/Agrammatic, Semantic or Logopenic Variants), ALS and Frontotemporal Degeneration, Corticobasal Syndrome and Progressive Supranuclear Palsy. FTD is often misdiagnosed as Alzheimer’s, Depression, Parkinson’s, or a psychiatric disease. On average it can take between 3–4 years to get a proper diagnosis and can progress between 2 and 20 years.
FTD affects primarily the Fronto and Temporal Lobes. Primary symptoms are typically personality changes, difficulty with decision making and apathy. Despite language comprehension, difficulty with articulation of speaking, movement changes and other symptoms, people living with FTD often look healthy.
Resources/Support: Association for Frontotemporal Degeneration. theaftd.org Helpline: 866–507–7222.
AFTD has staffed social workers who will provide information, give guidance to manage a new diagnosis, provide emotional support and connect you to resources and support.
Lewy Body Dementia (LBD). LBD can be hard to diagnose, as Parkinson’s disease and Alzheimer’s disease can have similar symptoms. LBD results from a protein deposit in the nerve cells of the brain called alpha-synuclein. The deposits are called Lewy bodies.
Symptoms can include hallucinations typically of animals, objects and people, but less commonly could involve smells or sounds. You may also notice motor function changes; difficulty walking, rigidity and/or tremors. As the disease progresses the person living with dementia may experience behavioral changes, like repeating questions and wandering. When wandering becomes a problem, personal care will be needed. Sleep disorders are also common. Rapid eye movement (REM) sleep behavior disorder, which happens when people act out their dreams, is the symptom that really differentiates LBD from other dementias. Depression, anxiety, paranoia, falling, incontinence and fluctuating cognition are additional symptoms that may be present in LBD.
Several areas of the brain are affected when LBD is present. The brainstem nuclei are affected, creating movement difficulties; the hippocampus will have difficulty making new memories. The cerebral cortex controls thoughts, language, processing information, and perception. The limbic cortex controls emotions and behavior.
Resources/Support: Lewy Body Dementia Association (LBDA). lbda.org Helpline: 800–539–9767.
Lewy Body Dementia Association is a great resource. Take time to read their suggested treatment options.
Vascular Dementia. Vascular dementia occurs when the brain does not receive enough blood and oxygen. Vascular dementia can be caused by a stroke, brain aneurysm, cardiovascular diseases, diabetes, high cholesterol, high blood pressure or smoking. Symptoms may include getting lost in known surroundings, short-term memory loss, difficulty managing finances, concentrating or planning, delusions and hallucinations, and inability to control the bladder or bowel. You may often see complications, such as behavioral problems, falls, depression and abnormal gait. Vascular dementia is commonly associated with a left-hemisphere stroke.
Resources/Supports: Vascular Dementia — American Stroke Association.
Other Resources:
Dementia Society of America: dementiasociety.org
Teepa Snow: Teepasnow.com
Dementia Action Alliance (DAA): daanow.org
National Council of Dementia Minds: dementiaminds.org
Melody Karick, dementia educator and consultant for ForgeWorks, developed the organization’s proprietary dementia training, Challenges 2 Solution. She uses this interactive training to help businesses, churches, municipalities, first responders and families serve people living with dementia. Her certifications include Certified Dementia Practitioner, Certified Montessori Dementia Care Practitioner, Personal Care Health Administrator, Virtual Dementia Tour Certified Trainer and Positive Approach to Care. In addition, Melody leads Dementia Friendly Lancaster, a group of devoted community members, organizations and faith-based leaders as well as those who have been touched by dementia.
