Worried about dementia?
What is dementia?
Dementia is not a single disease but rather it’s an umbrella term used to describe symptoms from diseases or conditions that cause a decline in mental ability. As well as affecting memory, dementia is also associated with mood changes, confusion and problems with communication, perception, reasoning and understanding. There is no cure for dementia and symptoms will get worse over time. However, there are several effective treatments that can help people to cope better with their symptoms and improve their quality of life.
How common is dementia?
Dementia is extremely common – and becoming more common as more of us are living longer into old age. In London alone, around 64,600 people are living with dementia, with over 17,000 new cases reported each year. Although it is far more common among people aged over 65, it can occur in younger people, in which case it is termed ‘early onset dementia’.
What are the types of dementia?
There are many types of dementia, usually named after the conditions that cause them. Some types of dementia include:
This is the most common type of dementia. Damage in the brain occurs when small clumps of protein, known as ‘plaques’, begin to build up around brain cells. The cells around the plaques die. The condition also disrupts the normal chemicals in the brain that transmit messages between cells. Named after Dr Alois Alzheimer, who observed the disease in 1901, Alzheimer’s disease affects about 500,000 people in the UK.
This arises as a result of problems with the blood supply to the brain. Arteries bringing blood to the brain start to become blocked, leading to small strokes that cause parts of the brain to die as they are no longer receiving enough oxygen.
Dementia with Lewy bodies
This is caused when abnormal protein structures, known as ‘Lewy bodies’, develop inside the brain. Symptoms can be similar to those of Parkinson’s disease.
This is caused by damage to the front of the brain - the frontal and temporal areas begin to shrink. Unlike other types of dementia, fronto-temporal dementia usually develops in people who are under 65. It is much rarer than other types of dementia.
Several other conditions can cause memory loss or confusion, including urinary infections (which may require antibiotics) and thyroid disease (also treatable). Depression can cause symptoms that may be confused with dementia – these symptoms may improve with treatment for the depression.
For more on the types of dementia, see the Alzheimer’s Society website.
What are the signs and symptoms of dementia?
As we get older, many of us notice that our memory isn’t as sharp as it used to be. It can be difficult to tell whether this is just part of life – especially if we’re tired, stressed or depressed - or if it is due to an underlying condition that can cause dementia.
The types of dementia often show only slight differences in symptoms so that it can be difficult to tell them apart on the basis of symptoms alone. However, three main types of symptoms can appear:
It may get harder to understand, remember, think, learn new things, talk or make judgements. These are known as cognitive problems.
You may notice it becomes difficult to do complicated tasks. As time goes on, it gets harder to do day-to-day tasks of looking after yourself - washing and dressing, for example. These are functional problems.
You may suffer from emotional problems – your mood can change, you may lose control of your emotions, stop doing things you enjoy and stop seeing people.
Symptoms of Alzheimer’s disease
Typical symptoms of early Alzheimer’s disease include:
Regularly forgetting recent events
Forgetting the names of friends or family
Becoming disorientated or getting lost
Having difficulty finding the right words
Getting confused about the time of day
Changes in mood or behaviour, such as feeling irritable or loss of confidence
Symptoms of Vascular dementia
Vascular dementia can appear as many different symptoms, depending on which area of the brain is affected - these symptoms may develop suddenly or gradually over months:
Becoming slower in thinking
Regularly losing things or putting them in odd places
Disorientation, especially away from your normal surroundings
Difficulty finding the right words
Change in personality and mood
Wandering during the night
Difficulty walking or a change in gait (the way you walk).
Symptoms of Dementia with Lewy bodies
Symptoms of this type of dementia include:
Periods of confusion or low attention (marked fluctuation in mental ability)
Hallucinations – seeing people or animals that aren’t there
Symptoms similar to Parkinson’s disease such as slower movement, difficulty walking, stiffness in the limbs and shaking and trembling of the arms and legs
Symptoms of Fronto-temporal dementia
As this type of dementia affects the parts of the brain involved in behaviour and emotional response, changes in these responses may be among the early symptoms, which include:
Personality changes, such as rudeness, inappropriate behaviour, aggression
Becoming less sensitive to other people, often seeming cold and unfeeling
Marked difficulty in language
Other conditions can easily be confused with dementia. For this reason it is important to get a medical assessment as soon as possible. See 'getting a medical assessment' (below) for more information.
Getting a medical assessment
If you’re worried about your memory or other symptoms that might suggest dementia, or if you think someone you know has these problems, it’s worth seeking advice. If it is dementia, it's good to know early so you can prepare. Your GP should be your first port of call. Make an appointment and pop in for a check-up.
Your GP is likely to carry out a simple memory test and do a physical examination. As well as asking you to describe your symptoms, the doctor may also speak with your partner or carer about your symptoms. It may be helpful to keep a diary to note particular incidents that have concerned you.
If the GP suspects dementia, he or she may refer you to a memory clinic or a specialist – who may be a psychiatrist, geriatrician, neurologist or clinical psychologist. The specialist team may carry out more detailed memory testing and may send you for a brain scan.
Assessment for dementia
The most commonly used memory test is the MMSE (mini mental state examination). This includes a series of questions leading to a score that can give an idea of how severe your symptoms are. As well as memory, the MMSE can also assess concentration, language and communication skills, ability to plan and to understand instructions.
As dementia usually gets worse over time, the test may be repeated, perhaps every 6 to 12 months, to see if there are any changes in memory. Other tests, including a blood test or a brain scan – such as a CT (computed tomography) scan or a MRI (magnetic resonance imaging) scan, may be arranged. Together these tests will help doctors find out about any problems in memory or thinking.
Find out more about the MMSE and other assessments for dementia.