About dementia

A portrait of a woman who looks pensiveWhat is dementia?

Dementia is a broad umbrella term used to describe a range of progressive neurological disorde
rs. There are many different types of dementia and some people may present with a combinati
on of types. Regardless of which type is diagnosed, each person will experience their dementia
in their own unique way.

Symptoms of dementia can include

Memory problems – short term memory is often affected and new information is difficult to ret
ain for a person with dementia. People with dementia can get lost in seemingly familiar places
and may experience confusion with names. Families may notice that their loved one is increasin
gly forgetful and loses items regularly. However, we all forget a name or face once in a while
and this is nothing to worry about. When noticed on a more frequent basis it is advisable to se
ek medical advice.

Cognitive ability – people with dementia may experience confusion in environments which are u
nfamiliar to them. They may have difficulty orientating in time and place, for example, getting
up in the middle of the night to go to work, despite being retired. Their ability to focus on s p
ecific tasks may be affected, concentration may be difficult to sustain. These symptoms may be
noticed in activities such as shopping, where there maybe confusion over goods and payment.
Their ability to reason may also be affected. For many people with dementia they get a sense
of restlessness and prefer to keep moving than sitting still.

Communication – problems with communicating may be noticed. People with dementia may re
peat themselves often or have difficulty finding the right words. Reading an d writing may beco
me challenging for a person with dementia. They may experience changes in personality and b
ehaviour, mood swings, anxiety and depression. As a result, people with dementia may lose int
erest in engaging with others socially. Often following and engaging in conversation can be dif
ficult and tiring and so a formerly outgoing person may become quieter and more introverted.
Self-confidence will be affected.

Dementia can be a combination of one or all of the above symptoms, which have been occurri
ng for a period of time and are progressively getting worse. In familiar places it is easier to hi
de some of the difficulties experienced by people with dementia; plus the symptoms can be see
n gradually over time and are initially easily explained away.

Any concerns about forgetfulness or confusion should always be discussed with your GP. There
may be many reasons for these symptoms and it is always best to get them checked.

Types of dementia

Alzheimer’s disease

Alzheimer’s disease is the most common type of dementia in the UK. Symptoms of Alzheimer’s
disease affect five main areas – memory, cognitive ability, insight, language and spatial awarene
ss. Symptoms may include: poor memory function, particularly in relation to time; inability to re
call recent events; general forgetfulness characterised by losing things, inability to recall message
s or repeating oneself. Typically, memory problems are concealed by an increased dependency
on routine and familiar environments. Cognitive ability may be impaired in a number of ways i
ncluding, poor organisational skills, and an inability to perform every day and familiar tasks; imp
aired decision making and affected conversation – conversation can appear slow or muddled- a
nd difficulty following a television programme may be noticed. Decision making is also affected
and poor judgements may be made. Those with early stage Alzheimer’s disease may show less
initiative and have fewer original ideas. It may be noticed that there is an increasing depende
ncy on relatives.
Language is also affected. As Alzheimer’s disease progresses there may be increasing difficulty i
n naming objects, the occasional misuse of words may be noticed. These difficulties may also i
mpact on number problems – miscalculation is common and the ability to manage financial affa
irs may be impaired. Alzheimer’s disease tends to develop quite slowly over time. As Alzheime
r’s progresses people experience increasing confusion when out, and can easily become disorient
ated. People with Alzheimer’s disease can encounter difficulty in performing everyday tasks like
dressing.

Find out more about Alzheimer’s disease

Vascular dementia

Vascular dementia is the second most common type of dementia to be diagnosed. Vascular de
mentia, also sometimes known as multi-infarct dementia (MID), is the result of small strokes whi
ch cause pockets of cell damage in the brain. As a result vascular dementias often follow a m
ore stepwise deterioration followed by a period of relative recovery. This differs from the progr
ession of Alzheimer’s disease which is more gradual. Memory may not be as affected by vascul
ar dementia as with Alzheimer’s, but language and communication can be more affected. It is
possible to have a combination of Alzheimer’s disease and vascular dementia. This is known as
mixed dementia.

Find out more about vascular dementia

Frontotemporal dementia

Frontotemporal dementia is a gradually progressive condition which predominantly affects behavi

our and personality. The regions of the brain which are most affected are those in the front of
the brain, just behind the forehead. Frontotemporal dementia is sometimes called frontal lobe
or Pick’s disease. This form of dementia is more commonly, but not exclusively, foun d in youn
ger people, between ages 45 and 65. It is a relatively uncommon form of dementia and can b
e difficult to diagnose. Frontotemporal dementia can cause disinhibition and inappropriate beha
viour, particularly in public. Eating patterns can also be affected, with people suddenly ‘bingein
g’ on food. This form of dementia may be confused with depression, psychosis or obsessive co
mpulsive disorder.

Find out more about Frontotemporal dementia

Dementia with Lewy Bodies

In dementia with Lewy bodies, cognitive impairment can fluctuate and movements are particularl
y affected, with poor motor control. A person with Lewy bodies might shuffle as they walk and
be more prone to falls. Tremors may be noticed, similar to those experienced by people who
have Parkinson’s disease. Due to the nerve cell damage of Lewy bodies, hallucinations are ofte
n present in those with this type of dementia. These hallucinations can be both visual and audi
tory. Memory is often less affected than with other types of dementia, but a person might exp
erience sudden bouts of confusion which can change on an hourly basis. Swallowing can also
be affected as can sleep patterns. People with Lewy bodies tend to fall asleep easily during th
e day, but then experience disrupted sleep at night, often having intense dreams or nightmares.
As with all dementias, Lewy bodies is progressive and symptoms will worsen over time.

Young onset dementia

Young onset dementia can be particularly problematic. The diagnosis is often unexpected and t
he resulting loss of income (sometimes double as a partner may give up work to care for their
loved one) is difficult to manage. Children may be younger and also take on caring roles as th
e disease progresses.

Prevalence and incidence rates of dementia in the UK

Dementia is a global concern but is predominantly seen in wealthier countries, where people are
likely to live into very old age. The Alzheimer’s Society (2015) reports there are over 850,000
people living with dementia in the UK today. Of these, approximately, 40,000 are people with y
oung onset dementia, which affects people under the age of 65. As a person ages, so does th
e risk of them developing dementia. It is estimated that the number of people living with dem
entia in the UK by 2025 will rise to over 1 million. Whilst rates of diagnosis have improved, it i
s widely believed that dementia is still significantly underdiagnosed.

It is important that an accurate diagnosis is correctly made as early as possible to ensure that a
ppropriate advice, support and treatment is given and plans for the future can be made.

Reduce the risk of developing dementia

Boy speaking with his grandad

There are several risk factors associated with developing dementia, age being the greatest, as p
eople age so does the likelihood of developing dementia. Dementia can affect both men and
women. In the current population, women are more likely to develop Alzheimer’s and men are
more likely to develop vascular dementia. We cannot rule out the risk of developing a dementi
a entirely, but we can develop a healthy lifestyle which mitigates some of that risk. What’s good
for the heart is good for the brain. Giving up smoking, eating a healthy diet, regular exercise
and reducing alcohol intake are all ways in which we can adopt a healthy lifestyle. Keeping soc
ially active, reducing cholesterol and lowering blood pressure also have a positive impact on hea
lth and wellbeing.