Dementia Forms: Understanding the Diverse Faces of the Condition
In the United States, over 6 million individuals currently live with Alzheimer's disease, a number projected to double and reach more than 12 million by 2050.1 It's crucial to distinguish between Alzheimer's and dementias; while Alzheimer's is a specific disease, dementia refers to a syndrome, with symptoms that are connected to multiple brain diseases, like Alzheimer’s disease.
Dementia is not a one-size-fits-all condition; it manifests in various forms, impacting individuals uniquely and for different reasons. The complexity of these variations emphasizes the importance of recognizing and understanding the diverse nature of dementia.
A Base Level Introduction to Dementia:
Dementia is a medical condition where cognitive abilities gradually decline, affecting daily functioning. People with dementia may experience changes in memory, communication, and behavior. The symptoms vary, including memory loss, difficulty recognizing objects, and challenges in performing familiar tasks. These cognitive changes result from issues in the brain's cortex, involving problems with connections, inflammation, and altered metabolism.2 Understanding these aspects helps us grasp the complexities of dementia and how it impacts individuals.
Today, we'll explore the most common forms of dementia, their distinct characteristics, symptoms, and impacts.
Understanding the Diverse Faces of the Condition
Alzheimer's Disease: Alzheimer's Disease (AD) is the primary cause of dementia, accounting for 60% to 80% of cases. It stems from the buildup of beta-amyloid plaques and neurofibrillary tangles in the brain, the main biomarkers. This accumulation leads to neuronal injury and death, worsening symptoms as it spreads through the brain.2 Genetics, particularly the APOE4 gene, plays a role in AD development, with increased risk.3 While AD onset is often unnoticed, initial signs include short-term memory loss, such as getting lost and repeating questions, progressing to difficulty recognizing faces and impulsive behavior, and at it’s worse the inability to communicate.4
Vascular Dementia: Vascular dementia is the second most common type attributed to 20% of cases and happens when the brain doesn't get enough oxygen due to conditions blocking or reducing blood flow. Strokes, caused by issues with blood vessels, are the main reason for vascular dementia. Symptoms vary based on where the brain is affected.2 After a major stroke, you might see the inability to recall past events, misplaced items, difficulty learning and making judgement, and vision loss.2,4 Multiple small strokes lead to a slow decline in functioning over time.
Lewy Body Disease: Lewy body dementia (LBD) makes up 5% to 15% of all dementias. Over 80% of those with LBD develop parkinsons, occurring up to a year after dementia onset, first showing in muscle rigidity and the loss of facial expressions and coordination.2 This type of dementia is caused by unusual deposits of a protein called alpha-synuclein (Lewy bodies) formed inside brain cells. REM sleep disorders (like insomnia) are more common in early LBD stages and can show through excessive daytime sleepiness.2 When it comes to cognitive abilities, Lewy body dementia (LBD) brings about fluctuating cognitive performance. Individuals may experience periods of improved memory, episodes of disorganized speech, and periods of decreased attention.2,4
Frontotemporal Dementia: Frontotemporal dementia (FTD) encompasses disorders like Pick's disease, impacting the frontal and temporal lobes. It often results from abnormal tau protein accumulation in brain cell neurons. FTD tends to manifest at a younger age (40-75 years) and is marked by early-onset personality changes and behavioral disturbances.2 Individuals may experience mood swings, difficulty planning, impulsiveness, and physical symptoms like shaky hands and balance issues.2,4 Changes in eating behavior, such as pickiness or overeating, can also serve as signs of FTD.5
It's crucial to recognize that various factors, including genetics, hormonal changes, lifestyle, and nutrition, can contribute to the development of dementia. However, empowering ourselves with proactive measures can significantly reduce the likelihood or delay the onset of a dementia diagnosis.
Read this article for the Top 13 Things You Can Do Now to Reduce Your Risk of Cognitive Decline.
When it comes to practices and lifestyle habits we can adopt early on in our life, nutrition becomes a simple approach to begin with, and one of the most powerful for risk reduction. A recent study found that adhering to the guidelines of the Mediterranean and MIND diets can potentially result in a brain age that is approximately 12 years younger compared to those who do not follow these dietary principles.6 These diets prioritize limiting processed foods and instead emphasize whole, natural foods. When combined with regular exercise, good sleep habits, continuous learning, and socialization, they contribute not only to a better quality of life but also significantly reduce the risk of cognitive decline.
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- Alzheimer’s Facts and Figures Report | Alzheimer’s Association. (n.d.). Retrieved December 13, 2023, from https://www.alz.org/alzheimers-dementia/facts-figures
- Duong, Silvia et al. “Dementia: What pharmacists need to know.” Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPC vol. 150,2 118-129. 7 Feb. 2017, doi:10.1177/1715163517690745
- Alzheimer’s: Is it in your genes? - Mayo Clinic. (n.d.). Retrieved September 11, 2023, from https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers-genes/art-20046552
- Understanding Different Types of Dementia | National Institute on Aging. (n.d.). Retrieved December 13, 2023, from https://www.nia.nih.gov/health/alzheimers-and-dementia/understanding-different-types-dementia
- Ahmed RM, Irish M, Kam J, et al. Quantifying the Eating Abnormalities in Frontotemporal Dementia. JAMA Neurol. 2014;71(12):1540–1546. doi:10.1001/jamaneurol.2014.1931
- Neurology Mar 2023, 10.1212/WNL.0000000000207176; DOI: 10.1212/WNL.0000000000207176