What is dementia?

Alzheimer’s is the most common cause of dementia, and is characterised by the shrinking of the outer layer of the brain or cortex – the region of the brain involved in memory, language and judgement. In the early stages, short term memory loss will occur, with long term loss as the disease progresses.

People may also exhibit vagueness in conversation, loss of enthusiasm for activities, forgetting people or places or difficulty processing questions and instructions. You may also see emotional predictability and deterioration of social skills. Symptoms vary and progress differently for each person – and their abilities can also change from day to day.

Alzheimer’s Association provides fantastic resources to guide caregivers throughout the various stages and symptoms of Alzheimer’s. Dealing with the early stages of memory loss can be confronting for someone with the disease.

The Association provides the following guidance for carers:

• Clarify memory lapses simply and briefly so as not to overwhelm and offer corrections as suggestions – for example, ‘I think she is your granddaughter Julie.’
• Show photos and other thought-provoking items.
• Travel with the person to where he or she is in time.

Vascular dementia

Vascular dementia is a broad term which is used to describe dementia that’s associated with blood circulation to the brain. There are a number of types of vascular dementia, but together they represent the second most common cause of dementia. Multi Infarct dementia (the most common type of vascular dementia) is caused by a series of strokes which damage the cortex of the brain (the area associated with learning, memory and language).

It can also cause depression, mood swings and epilepsy – however an individual with vascular dementia is likely to retain parts of their personality for longer than someone with Alzheimer’s, for example. Binswanger’s Disease, another common type, can cause slowness and lethargy, difficulty walking, emotional ups and downs and lack of bladder control early on. Because the damage is caused by strokes, you might notice the progression of dementia in stages, with a period of stability between.

Smoking, high blood pressure and cholesterol and diabetes can be risk factors associated with this disease. According to Alzheimer’s UK, if the underlying cardiovascular diseases that have caused vascular dementia can be controlled, it may be possible to slow down the progression of the dementia. If possible, some form of exercise and a diet with plenty of fruit, vegetables and oily fish, but not too much fat or salt.

If a person has physical difficulties following a stroke, rehabilitation with a physiotherapist, Occupational Therapist (OT) or speech therapist can assist. Talking therapies such as Cognitive Behaviour Therapy can also assist with anxiety or depression.

Lewy Body disease

This cause of dementia shares many symptoms with Alzheimer’s, and is caused by the degeneration of nerve cells in the brain. The symptoms of Lewy Body disease can include confusion, difficulty with concentration and attention and difficulties judging distances, often resulting in falls.

Visual hallucinations, tremors and stiffness similar to that seen in Parkinson’s disease and fluctuation in mental state can also occur – and two of these must be present to reach a diagnosis.

It is particularly difficult to diagnose, however it is generally agreed that early diagnosis of the condition makes it easier for families to plan and improve quality of life for people with LBD. In this video from Dementia Australia, Robin, who has LBD, talks frankly about the condition and about the changing behaviours he experienced.

The Lewy Body Dementia Association has created a helpful chart describing the difference in symptoms between those with LBD and Alzheimer’s or Parkinson’s disease dementia.

Frontotemporal dementia

Frontotemporal dementia or FTD is the name given to dementia when it is due to progressive damage to the frontal and/or temporal lobes of the brain. These are the areas that are associated with mood, social behaviour, attention, judgement and self control, as well as processing and understanding what we hear and see.

The symptoms can result in reduced intellectual abilities and changes in personality, emotional responses and behaviour, including increased impulsivity. Within this, there is a broad spectrum; some people can become apathetic, while others become disinhibited. Language and ability to recognise objects can also be impacted. This type of dementia does not cause memory loss, however individuals are likely to be unaware of how their behaviour affects them and those around them.

For family members, understanding FDT and why their loved one is behaving in certain ways can help with coping strategies to work around the behaviours. Adapting to behaviours, rather than trying to change them is the recommended approach. Speech therapy and an OT can also assist with communication and every day functioning.

While it can take time to make a diagnosis of dementia, a better understanding of what to expect can help families to plan for the right dementia support at each stage.

Also read: Making a home safer for someone with dementia.

Do you need some support for you or a loved one? You can search for and book Independent Support Workers in your local area through Mable.