Dementia describes a range of brain disorders that gradually damage areas responsible for thinking, memory, judgment, and understanding. It affects more than 55 million people globally, and Alzheimer’s disease is the most common form, making up 60–80% of all cases and impacting around 6.7 million people in the U.S.
The cognitive changes in dementia are not the same as age-related forgetfulness. As the condition progresses, individuals may struggle with managing everyday tasks, maintaining hygiene, handling finances, or remembering recent conversations.
Dementia occurs when nerve cells in brain regions linked to cognitive abilities break down over time. A diagnosis is made when there is a clear decline from a person’s usual functioning in one or more areas such as:
Recent memory
Learning and retaining new information
Concentration on complex tasks
Proper use of language or naming objects
Skills involving coordination
Planning or organizing tasks
Understanding social behavior
The decline must be significant enough to impact daily independence and cannot be explained by other mental health disorders or temporary confusion due to medical conditions, medications, or substances.
Different Forms of Dementia
Dementia can arise from several underlying causes. The most common forms include:
Alzheimer’s disease:
Often begins with difficulty recalling recent events, names, or conversations.
Vascular dementia:
Caused by strokes or transient ischemic attacks that affect blood flow to parts of the brain. Symptoms depend on which regions are affected, and decline can occur in steps.
Dementia with Lewy bodies:
Common signs include hallucinations, sleep disruptions, daytime drowsiness, and movement-related issues like tremors or balance problems. Memory usually declines later than in Alzheimer’s.
Frontotemporal dementia:
Can lead to personality changes, reduced emotional response, impulsive actions, and challenges with planning or organizing. Language difficulties may also appear, such as trouble naming things or forming sentences. Memory typically becomes affected in later stages.
Some individuals may experience mixed dementia, caused by more than one factor. Dementia can also result from conditions such as traumatic brain injury, substance use, HIV infection, Parkinson’s disease, or Huntington’s disease.
How Dementia Progresses Over Time
In early stages, individuals may still manage work, driving, cooking, and other activities with assistance. As dementia advances, they become increasingly dependent on others for:
Handling bills
Grocery shopping
Personal hygiene
Dressing and bathing
They may also experience mood changes, anxiety, paranoia, hallucinations, sleep problems, agitation, inappropriate behaviors, or wandering. These symptoms raise concerns for safety, such as getting lost or making errors while cooking or driving.
As the condition spreads to other areas of the brain, difficulties with balance, swallowing, and mobility may occur. Many individuals eventually require full-time care and may become bedridden.
Treatment and Management
There is currently no cure that reverses dementia. However, certain medications approved by the U.S. FDA can help slow the progression of Alzheimer’s disease, including cholinesterase inhibitors—donepezil, rivastigmine, and galantamine—for mild to moderate stages.
Memantine is approved for moderate to severe stages, and aducanumab received approval in 2021. Research continues to explore treatments that may slow cognitive decline.
Lifestyle choices also play a role in preventing worsening, such as:
Eating a balanced diet
Staying physically, mentally, and socially active
Reducing alcohol consumption
Quitting smoking
Regular health checkups
Managing conditions like diabetes, heart disease, and hypertension
Individuals may experience additional issues such as depression, anxiety, agitation, or psychosis. These can be addressed through medications, therapeutic approaches, lifestyle changes, and behavioral techniques like:
Cognitive stimulation
Validation therapy
Reminiscence therapy
Reality orientation
Recognizing discomfort—such as hunger, pain, infection, skin irritation, or sleep issues—is important because individuals may struggle to express their needs. A calm environment, simple instructions broken into steps, and avoiding confrontational interactions can help reduce agitation.
Medications may lose effectiveness in later stages, and after discussing risks and benefits with a clinician, some may be discontinued to avoid unnecessary treatment.
Supporting Caregivers
Caring for someone with dementia can be emotionally and physically exhausting. As responsibilities increase, caregivers may feel overwhelmed, isolated, or burned out. Anxiety, depression, and sleep disturbances are common.
Taking care of oneself is essential. Caregivers are encouraged to:
Take regular breaks
Engage in enjoyable activities
Ask family or friends for help
Explore respite care or adult day programs
Seek counselling if they feel distressed
Join caregiver support groups for guidance and emotional support
If caregiving needs exceed what can be handled at home, long-term care options like assisted living or memory care facilities may provide the structured support required.
Final Thoughts
Dementia affects both the individual and everyone around them, especially as the condition progresses. Understanding the symptoms, recognizing behavioural changes, and knowing when to seek help can make a meaningful difference in the quality of life for both patients and caregivers. With the right guidance, treatment support, and caregiver resources, families can navigate this journey with greater confidence and compassion.
If you or a loved one is struggling with memory concerns or behavioural changes related to dementia, Dr. Vatsal Suchak and his team offer professional evaluation, guidance, and personalised care plans to help you manage each stage with clarity and support. Reach out to Dr. Vatsal’s clinic to get expert assistance and compassionate care tailored to your needs.
FAQs
Many people experience problems in memory or cognition due to the normal physiology of ageing. However, compared to the memory and cognitive issues of dementia, age-associated memory impairment does not affect the activities of daily life, our ability to complete our tasks, or our ability to learn new things.
On clinical assessment, if an individual is found to have impairment in cognition and memory that is more than expected for age but is severe enough to affect their daily living, they are diagnosed to have a mild neurocognitive disorder or mild cognitive impairment (MCI). Individuals with MCI are at high risk of developing dementia, and they need periodic assessment by a primary care provider or mental health provider to assess the progression of the cognitive impairment.
The symptoms of dementia vary between individuals and types of dementia. Some of the early signs include memory problems, problems with language, misplacing personal belongings, trouble with organizing and planning activities like physician appointments, mood changes, difficulties in performing familiar tasks or using everyday objects like a cell phone, being confused about time and place, and withdrawal from social activities like family gatherings.
Only a few rare subtypes of dementia run in families. These rare familial types of dementia are caused by mutations in genes inherited by family members. These types of dementia usually manifest before the age of 65. Genetic testing for these types of dementia is not recommended, as a positive test does not necessarily mean that an individual will develop dementia. Even with a history of multiple family members with dementia and a positive genetic test for a familial type of dementia, an individual may not still develop dementia. There are no specific preventative measures for dementia. The risk of developing dementia can be reduced by making healthy lifestyle choices such as:
- Eating a balanced diet.
- Avoiding tobacco or other substances.
- Limiting the consumption of alcohol.
- Being physically, mentally, and socially active.
Unfortunately, there is no treatment yet that can reverse the disease process of dementia. Medications approved by the U.S. Food and Drug Administration (FDA) can slow down the process of Alzheimer’s disease (but not other types of dementia). As the disease progresses in severity, the medications can become less effective, and they can be discontinued to reduce the burden of taking inappropriate and unnecessary medications. New medications are being studied now with the hope that they will one day be able to slow down or stop the decline in cognitive impairment.
Stress and burnout are common in caregivers for individuals with dementia, especially as the severity of dementia progresses and requires more investment in care by caregivers. Caregivers can be frustrated, depressed, and anxious about caring for their loved ones, which can take a toll on their physical and mental health. Caregiver burden and stress must be addressed when assessing individuals with dementia. They should be provided with a break from caregiving for a few hours a day to take care of themselves and their needs. Family members can also take turns providing care for the individual with dementia. Caregivers are encouraged to seek psychotherapy and counselling if they feel anxious or depressed about caring for their loved ones. Information about caregiver support groups and other caregiver resources can be obtained from the local chapter of the Alzheimer’s Association.