About Dementia: Types, Stages and Care
Dementia is an umbrella term to describe the conditions that lead to memory impairment. Although Alzheimer’s disease is the most prevalent form of dementia, there are other types as well.
According to the World Health Organization, there are approximately 50 million people worldwide who live with dementia. An estimated 10 million new patients are diagnosed with some form of dementia annually. Although there isn’t a cure for dementia, support and resources are available to help anyone diagnosed with the progressive disease, as well as their caretakers.
Dementia care options depend on the current capabilities of the individual. For individuals with mild symptoms, in-home care options may be possible. Because dementia is progressive, residential housing with memory care services is often needed when symptoms grow in severity.
What is Dementia?
Dementia refers to disorders that affect a person’s memory. Patients with dementia experience a cognitive function decline and may have difficulty with memory skills, problem-solving and emotional regulation.
Dementia symptoms appear differently in each person. Some signs of dementia are very mild, and they’re often considered typical age-appropriate forgetfulness. Dementia symptoms in the early stages of the disorder include increased forgetfulness, losing track of time, and becoming disoriented in familiar settings. Early-stage dementia signs can last for years before symptoms increase in severity.
Dementia symptoms during the middle stages become more severe. Forgetfulness extends to recent events, and the individual may start to forget the names of friends and family members. Behavioral changes develop as the person struggles to communicate effectively. The individual becomes agitated quickly and may ask the same questions repeatedly. Monitoring is required with middle-stage dementia symptoms, as the patient can become lost around the neighborhood and even in their home. Personal care needs become more imperative at this stage as well. Dementia patients may need assistance with dressing, bathing, meal preparation, laundry, and housekeeping. At this stage, family members may consider dementia care at a specialized memory care community.
Late-stage dementia symptoms are the most severe. At this stage, dementia patients need round-the-clock assistance and care. For many, memory impairments include the inability to recognize family members and friends. The individual is unlikely aware of the correct time and place. Personal care assistance may include help with toileting, showering and eating. Mobility is significantly affected, and the person may struggle with walking on his or her own. Mood disturbances are frequent and could include bouts of aggression.
Types of Dementia
When a patient visits a doctor with suspected dementia, the physician will order a series of diagnostic tests to determine what could be causing the memory impairments. The following are the most common forms of dementia.
According to the Alzheimer’s Association, about 80 percent of all dementia cases are Alzheimer’s disease. Alzheimer’s disease patients suffer from memory impairments that are severe enough to disrupt their daily living activities. Most patients with Alzheimer’s disease are over the age of 65; however, a small percentage of patients develop early-onset Alzheimer’s disease at a younger age. The condition is progressive, with each stage lasting anywhere from months to years. After diagnosis, patients can live up to 20 years. Although the exact cause of Alzheimer’s disease remains unconfirmed, scientists believe the disease is caused by damaged nerve cells in the brain.
Vascular dementia is a disorder resulting from decreased blood flow to the brain. Memory, mood and judgment changes occur due to the lack of blood. Several conditions could cause vascular dementia, but the disorder commonly appears among those who have experienced or are recovering from strokes. Vascular dementia symptoms usually have a quicker onset than Alzheimer’s signs and occur after a stroke or series of mini-strokes.
Lewy body dementia:
Following Alzheimer’s disease, Lewy body dementia is the most common form of dementia. The name relates to a buildup of proteins (Lewy bodies) in nerve cells inside the brain. This buildup affects areas of the brain that control movement, memory, and critical thinking. The disease is progressive, with symptoms worsening over time. Individuals over the age of 60 and men are more prone to Lewy body dementia.
Huntington’s disease is a rare disorder with genetic ties. When a person has the condition, the brain’s nerve cells progressively become broken down. The disease is not associated with seniors; most individuals receive this diagnosis in their 30s and 40s. Younger adults and teens can also develop the symptoms of Huntington’s disease. The early development of Huntington’s disease causes a faster progression of the disorder. Huntington’s disease’s symptoms include involuntary jerking movements, difficulty with speech, trouble swallowing, slowed eye movements, organizational challenges, poor impulse control and difficulty retaining new information.
Parkinson’s disease is another progressive form of dementia. Symptoms start mild and grow more severe, with individuals eventually having a hard time walking or talking. Parkinson’s disease is more common in men than women, with age being a risk factor. Most individuals are over the age of 60 when diagnosed with Parkinson’s disease. Motor skills are affected by Parkinson’s disease due to neurons in the brain dying or becoming impaired. Depression, confusion and other emotional changes could occur along with motor impairments in Parkinson’s disease patients.
Stages and Progression
Most healthcare professionals use three stages to describe the signs of dementia. Other professionals use the Reisberg Scale to categorize dementia into seven stages. With the Reisberg Scale, the early stages will not have a confirmed dementia diagnosis. Not until the patient reaches Stage 4 will an early-stage dementia diagnosis be considered.
Stage 1: People with no cognitive decline and without dementia fall into Stage 1.
Stage 2: Stage 2 has no clear timeline for the dementia patient. In this stage, the person may have mild forgetfulness and have trouble remembering names and misplace objects frequently.
Stage 3: At this point, mild cognitive decline is evident. On average, this stage lasts between two and seven years. The person has trouble concentrating and may forget names and places. He or she struggles with vocabulary and may have difficulty continuing at work. At this point, family members may notice the memory impairments.
Stage 4: Early-stage dementia occurs when the person has increased memory issues, difficulty concentrating, trouble managing finances, and gets lost in familiar places. The period can last an average of two years.
Stage 5: Middle stage dementia marks an increase in the severity of symptoms. The patient may forget times, dates and become confused over where they are present. At this point, daily living activity assistance is usually a requirement since the person could have trouble bathing, dressing, preparing meals and managing any medications. This stage has an average timeframe of a year and a half.
Stage 6: Although Stage 6 is still considered middle-stage dementia, symptoms will become more pronounced. The person can no longer perform daily living activities without assistance. The patient forgets the names of family members and won’t recall recent or important events. Loss of bladder control will also occur at this stage. Additional signs of dementia in the later stages include delusions, mood disruptions and difficulty speaking. The timeframe can last around two and a half years.
Stage 7: Late-stage dementia lasts between one to two and a half years. The patients suffer the loss of motor skills and won’t have the ability to walk. Assistance is needed for all activities, and the person is not likely to communicate effectively.
Causes and Risk Factors
Age is the most prevalent factor linked to dementia; the National Institute of Aging states that approximately half of all adults over the age of 85 have dementia. In addition, those who smoke or eat an unhealthy diet are more prone to developing some forms of dementia. Individuals should follow a diet that is well-balanced and low in cholesterol and sugar. Those who control their weight through physical activity and manage blood pressure effectively have a lower risk factor. According to the Mayo Clinic, those with low vitamin D levels in their blood are also at a higher risk of developing dementia.
Family history is another risk factor linked to dementia. Those with family members diagnosed with dementia have an increased risk of developing the disorder. Another genetic marker for dementia is Down syndrome. Middle-age adults with Down syndrome frequently show early dementia symptoms.
Diagnosis and Treatment
With dementia, there isn’t one type of diagnostic test used to confirm the disorder. Specialists use physical examinations, bloodwork and imaging scans. A detailed history will help the physician evaluate the patient’s current symptoms and how long impairments have occurred. A series of cognitive tests assess a person’s memory, attention span and language skills. During a neurological evaluation, the doctor considers the individual’s reflexes and balance. Imaging scans like a CT scan check for tumors or signs of bleeding in the brain. Radiologists also evaluate whether a stroke may have occurred. With a PET scan, the measurement of brain activity levels occurs, and doctors look for protein deposits in the brain—a critical sign in Alzheimer’s patients.
Although dementia isn’t curable, doctors recommend certain medications and therapies to help manage symptoms. One type of effective medicine is a group of drugs called cholinesterase inhibitors. These medications boost chemical messenger levels in the brain to help improve cognitive function. Alzheimer’s, Lewy Body dementia and vascular dementia patients often benefit from the treatment. Other types of medications prescribed to reduce the symptoms of dementia aim to reduce sleep disturbances, mood disorders and uncontrolled muscle movements.
Therapies could also be useful for the treatment of dementia symptoms. Occupational therapists work with dementia patients to make homes safer as the disease progresses. Reminiscence therapy works as a dementia treatment. During this therapy, the patient talks about their past with friends and family members. Photos, videos and other keepsakes help stimulate memories of the past. Participants are also encouraged to create memory books, audio and video recordings, and family trees during sessions.
Physicians will also remind dementia patients on the importance of self-care. Plenty of rest at night, a healthy diet and exercise will help keep their minds and bodies healthy for much longer.
Dementia Care Options
Dementia care options depend on the person’s budget and current health state. With early-stage dementia, less intrusive housing options could work for the patient. However, middle and late-stage dementia patients require more intensive levels of care.
Some dementia patients prefer to use in-home care options before moving into assisted living communities. Home care services typically include companions that help with daily living activities, transportation, meal preparation and household chores. The home health aide could also bring the individual to treatment appointments.
Assisted living is an ideal housing opportunity for those who have dementia and maintain some independence. Full-time medical services are not included, but assisted living does have staff on hand round-the-clock to provide security and health monitoring. Assisted living communities often take care of housekeeping, dining, property maintenance and more for residents.
Notably, assisted living communities can offer dedicated memory care programs. The residences are designed specifically for patients with dementia and Alzheimer’s disease. Layouts are easy to navigate, and extra security protocols are in place. Also, programming focuses on improving cognitive abilities.
For individuals with late-stage dementia, skilled nursing care is most likely needed. Nursing homes provide medical care and monitoring 24/7 and will have medical professionals on hand to supervise the patient’s progress.
Memory Care at The Heritage
Heritage provides memory care programs within a safe and welcoming community. Memory care services focus on the resident’s strengths and current abilities. Programming is customizable to stimulate a person’s mental, physical, spiritual, and emotional well-being. Contact us today to learn more about our memory care programs and services offered at our friendly residence, or request a free copy of our Guide for Finding the Right Memory Care Community.