Although cognitive impairment may be treated and easily cured, dementia can be progressive and incurable. It’s only by properly diagnosing the cause of the cognitive impairment as early as possible that its effects can be treated and in some cases reversed or even cured. For more information see 10 Common Causes of Cognitive Impairment in Seniors & the 10 Things a Doctor Should Review at an Appointment.
Much the same as cancer comes in many forms such as skin, colon or lung cancer, dementia (which describes a collection of symptoms, rather than a disease) comes in many forms, as well. While Alzheimer’s Disease is by far the most commonly known cause of dementia, research tells us that there can be nearly 100 different causes.
If your loved one is diagnosed with dementia, your first question will probably be, “Is there a cure?” Let’s be honest. Probably not. However, there are simple lifestyle changes—such as eating a healthy diet, not smoking, and keeping blood pressure and cholesterol in check—that may slow its progression and/or reduce the impact of dementia.
Here are the 10 most common forms of dementia:
1. Alzheimer’s Disease. The most common form of dementia, Alzheimer’s Disease is responsible for 60 to 80 percent of dementia cases and is the sixth leading cause of death in the United States. While the greatest known risk factor for Alzheimer’s is increasing age (with the largest number of sufferers over age 65), early-onset Alzheimer’s affects approximately 200,000 Americans under the age of 65.
Unfortunately, it is a progressive disease with no current cure where symptoms gradually worsen over a number of years. In its early stages, memory loss can be mild, but late-stage Alzheimer’s patients eventually lose the ability to carry on a conversation or respond to their environment. For further information, see Warning Signs of Alzheimer’s and Other Forms of Dementia.
Individuals diagnosed with Alzheimer’s live and average of eight years, but survival can range from four to twenty years depending upon age and other health conditions.
2. Vascular Dementia. The second most common form of dementia, vascular dementia is caused by a reduced flow of blood to the brain. This deprives the brain of the nutrients and oxygen that it needs to function normal. This particular form of dementia can result from a number of conditions that restrict the blood flow to the brain, including stroke, diabetes, uncontrolled high cholesterol and hypertension.
The symptoms of vascular dementia can differ significantly from those of Alzheimer’s. It can include problems with thinking, changes in personality or problems with movement. Patients with vascular dementia are encouraged to treat the underlying issues that may have caused the problem in the first place.
3. Mixed Dementia. Sometimes, dementia can be caused by more than one medical condition. When this happens, it is called Mixed Dementia. The most common form is that caused by a combination of Alzheimer’s and Vascular Dementia.
4. Lewy Body Dementia or Dementia with Lewy Bodies (DLB). Accounting for about 10-15% of dementia cases, DLB has symptoms similar to Alzheimer’s. However, it can also include visual hallucinations, sleep disorders and lack of attention. Parkinson’s disease-type symptoms such as slowed movements, muscle stiffness and tremors are also common.
Little understood by the scientific community, this type of dementia is characterized by abnormal protein deposits in nerve cells in the brain stem. Like Alzheimer’s, symptoms progressively worsen over time and, given its complex and little understood nature, treatment can be difficult.
Experts believe that both DLB and Parkinson's disease dementia (see below) are two different expressions of the same underlying problems with the brain. This, as the Alzheimer’s Association notes, “Many people with Parkinson's eventually develop problems with thinking and reasoning, and many people with DLB experience movement symptoms, such as hunched posture, rigid muscles, a shuffling walk and trouble initiating movement.”
Symptoms of DLB may include:
With no cure to slow or stop the damage caused by DLB, treatment focuses on helping control symptoms with anti-depressants and other medication.
5. Frontotemporal Dementia. Also known as FTD, frontal lobe dementia and Pick’s Disease, Frontotemporal Dementia accounts for less than 5% of all dementia cases, but it is the second most cause of dementia in those under 65.
A relatively rare form of dementia, FTD damages the brain cells in the frontal and temporal lobes. This affects the individual’s behavior and personality before any loss in memory or speech problems.
According to the Alzheimer’s Association, there are several key differences between FTD and Alzheimer’s Disease:
Unfortunately, there is currently no cure and the progression cannot be slowed. Any treatment can only look to help manage symptoms.
6. Korsakoff Syndrome. Related to a deficiency in Vitamin B1 (thiamine), Wernicke-Korsakoff Syndrome most commonly occurs in alcoholics, though it can also be caused by malnutrition, cancer, abnormally high thyroid levels, long-term dialysis and long-term diuretic therapy (used to treat congestive heart failure).
The Alzheimer’s Association notes that it “is often, but not always, preceded by an episode of Wernicke encephalopathy, which is an acute brain reaction to severe lack of thiamine. Wernicke encephalopathy is a medical emergency that causes life-threatening brain disruption, confusion, staggering and stumbling, lack of coordination, and abnormal involuntary eye movements.
“Because the chronic memory loss of Korsakoff syndrome often follows an episode of Wernicke encephalopathy, the chronic disorder is sometimes known as Wernicke-Korsakoff syndrome.”
The symptoms of dementia in Korsakoff Syndrome include confusion, permanent gaps in memory, impaired short-tem memory and hallucinations. The Alzheimer’s Association notes that, “Memory problems may be strikingly severe while other thinking and social skills are relatively unaffected.
“For example, individuals may seem able to carry on a coherent conversation, but moments later be unable to recall that the conversation took place or to whom they spoke.
“Those with Korsakoff syndrome may "confabulate," or make up, information they can't remember. They are not "lying" but may actually believe their invented explanations. Scientists don't yet understand why Korsakoff syndrome may cause confabulation.”
7. Parkinson’s Disease Dementia. Like Alzheimer’s, Parkinson’s Disease is a chronic, progressive neurological condition. While not everyone who has Parkinson’s Disease will develop dementia, it can occur in 50 to 80 percent of patients, affecting reasoning, memory, speech, judgment and plan the steps needed to complete a task.
Much the same as Lewy Body Dementia, the brain changes linked to Parkinson’s Disease Dementia are caused by Lewy Body deposits. Another complicating factor is that many of those with both Lewy Body Dementia and Parkinson’s Disease Dementia also have the signature plaques and tangles in their brains linked to Alzheimer’s Disease.
Common symptoms of Parkinson’s Disease Dementia include:
According to the Alzheimer’s Association:
Parkinson's disease dementia is diagnosed when a person who has originally been diagnosed with Parkinson's based on their movement symptoms begins to exhibit dementia after a year or more.
Dementia with Lewy bodies is diagnosed when:
8. Normal Pressure Hydrocephalus (NPH). Normal Pressure Hydrocephalus is caused by an accumulation of cerebrospinal fluid in the brain’s cavities. This results in added pressure on the brain, interfering with its ability to function normally.
Most commonly affecting people in their 60s and 70s, the classic symptoms of NPH may include:
While there is no single test to detect NPH, not everyone who has it exhibits the symptoms and symptoms may overlap those of Alzheimer’s or other dementias, it is recommended that someone with suspected NPH undergo examination by a neurologist with extensive experience in brain disorders. If diagnosed, doctors may install a shunt into the brain to drain excess spinal fluid.
While most people suspected of having NPH do not improve with treatment, Normal Pressure Hydrocephalus can sometimes actually be corrected. A television commercial from 2008 is still astounding in it’s depiction of one man’s recovery from this form of dementia.
9. Huntington’s Disease
A progressive brain disorder caused by a single defective human gene, Huntington’s Disease is inherited and currently incurable. At this time, treatment can only focus on managing symptoms, which generally include:
As there is no cure and no way to slow or stop the brain damage it causes, treatments can only focus on its managing symptoms of:
As a result, people with Huntington's are encouraged to keep all their medical appointments and not to get discouraged if it takes their health care team some time to find the best drugs and the most effective doses to manage their symptoms.
10. Traumatic Brain Injury (TBI) or Chronic Traumatic Encephalopathy (CTE)
According to the Centers for Disease Control and Prevention, there are approximately 1.5 million people in the U.S. who suffer from a traumatic brain injury each year. Of these numbers, 50,000 people die from TBI each year and 85,000 people suffer long-term disabilities. In fact, more than 5.3 million people live with disabilities caused by TBI in the U.S.
Of these injuries, one of the major causes, particularly among seniors, is falls [Fear of Falling]. Each year, according to the CDC, some 2.5 million people ages 65 and older visit the emergency department (ED) because of falls—more than any other age group.
When a TBI occurs, doctors will classify it as mild, moderate or severe, depending on whether the injury causes unconsciousness, how long that unconsciousness lasts and the severity of symptoms. While most TBIs are classified as mild as they're not life threatening, they can still have serious, long-term effects.
The impact of a moderate to severe TBI can impact literally dozens of different functions within the body by affecting:
Chronic Traumatic Encephalopathy or CTE has seen great interest by the media lately after forensic neurologist Bennet Ormalu, M.D., connected it to repeated concussions in football with his autopsy on Mike Webster, the Hall of Fame center for the Pittsburgh Steelers. This awareness was further heightened by the movie “Concussion,” which dramatized his discovery.
Caused by repeated blows to the head, people with CTE may not experience symptoms until years or even decades after the brain injuries occur. These may include:
Because CTE is a relatively new form of dementia that has been recognized, there are no tests to determine if someone has CTE and presently no cure. If it is suspected, a thorough medical history, mental status testing, neurological exams and brain imaging can be used to rule out other possible causes.
A definitive diagnosis can only be made through autopsy, which may show a buildup in the brain of an abnormal form of protein called tau, which is also a hallmark of Alzheimer’s Disease.
Summary
Unfortunately, once a diagnosis of dementia is made, there is generally no cure and the disease will only get progressively worse. Their behavior may worsen and what is currently manageable may only become more challenging. There is help available, however. Click here for a free copy of When Words Are Not Enough. Tips and Tricks to Communicate with a Loved One Who Has Dementia.