The Common Types of Dementia
Having looked last time at why it is so important to obtain an early diagnosis of dementia, it can also be important to name the type of dementia that a loved one is experiencing. Naming a disease clarifies its cause and assists in developing expectations for care over the course of the disease. Naming the specific type of dementia allows care partners to better understand the causes of their loved ones’ symptoms and have at least a general set of expectations for what their caregiving future may hold. In addition, when we can see the diagnosis as an invitation to caregiver growth and resilience and not a decree of enduring despair, our ability to cope with the stress and emotions of our loved one’s dementia journey significantly increases.
When considering the terminology of dementia subtypes, remember:
1. There can be a lot of overlap among diagnostic subtypes.
2. Subtypes are thought of as a spectrum and are intended to be broad in scope.
3. Some subtypes are named based on the underlying cause of symptoms while some are named based on the type of symptoms that are present.
4. Dementia is the umbrella term for the symptoms of brain disease that lead to general declines in memory, language, reasoning, behavior, etc. The medical community uses the term neurocognitive disorder as the official term for dementia. That means that when we say, for example, that someone “has Alzheimer’s,” the clinical diagnosis is actually “Neurocognitive disorder due to Alzheimer’s disease.” In the day-to-day world of caregiving, however, no one really talks that way and just the name of the subtype is used like Alzheimer’s or Lewy Body Dementia. Remember that diagnostic terms are just labeling the cause of the person’s cognitive and behavioral symptoms.
5. Most importantly, it is crucial to remember that a diagnosis labels symptoms and not a person’s identity. Donna’s mother was never a “dementia due to Alzheimer’s and vascular dementia” She was always a person with “dementia due to Alzheimer’s Disease and vascular dementia.” Human dignity is not defined by a person’s ability to function, rather dignity is inherently and permanently present within the reality of a human person.
That said, let’s look at the most common diagnostic categories of dementia.
Dementia Due to Alzheimer’s Disease
Alzheimer’s Disease is the most common dementia diagnosis with about two-thirds of people with dementia falling into this category. Its course is one of gradual declines in a loved one’s memory and their ability to learn new information. Alzheimer’s disease appears related to changes in brain cell proteins that lead to the buildup of substances called beta-amyloid plaque and tau tangles that contribute to the gradual dying off of brain cells.
Dementia Due to Vascular Disease
Dementia due to vascular disease is diagnosed when declines in a person’s cognitive domains are related to problems in blood flow through the brain that come from strokes, ministrokes (temporary ischemic attacks, or TIAs), stenosis of the carotid arteries, cerebral aneurysms, etc. With this type of dementia, difficulties in the complex attention domain such as reduced attention span and information processing speed are common. Problems with executive functioning such as confusion, disorganization, and trouble with multitasking are also frequent. Dementia due to vascular disease often has a gradual onset, but more sudden escalations in symptoms can happen, likely due to new blood-flow disruptions in your loved one’s brain. Symptoms can often plateau during periods when blood flow is more stabilized.
Dementia Due to Frontotemporal Lobe Degeneration
Frontotemporal Lobe Degeneration or FTD appears caused by genetic and other biological factors (e.g., clumping of tau and other proteins) that contribute to deteriorations in the brain’s frontal lobe (cognitive skills) and the temporal lobe (language skills). Many people who begin to show dementia symptoms before their 60s are eventually diagnosed with FTD. Unfortunately, FTD often goes misdiagnosed for many years as changes in behavior, thinking, and personality are assumed to be occurring due to other health or mental health factors especially because difficulties with learning and memory tend to show up in later stages.
Dementia with Lewy Bodies
Lewy bodies occur in the brain when a protein called alpha-synuclein becomes abnormally folded or clumped together. These clumps lead to gradual declines, such as inconsistent attention span and lack of alertness. Other symptoms often include problems with sleep,
the presence of visual hallucinations and motor difficulties that are like those seen in Parkinson’s disease. Similar to FTD, problems with learning and memory do not typically appear until
later in the disease.
Dementia Due to Parkinson’s Disease
Parkinson’s disease is related to the clumping of the same protein that is involved
in Lewy body dementia but in a different part of the brain. The cognitive declines that
occur for someone with Parkinson’s gradually appear after the physical problems of Parkinson’s have already set in. Personality changes, emotional disturbances, hallucinations, and delusions also tend to begin in the later stages of the disease.
Other Subtypes of Dementia
Dementia can also be related to many other conditions such as traumatic brain injuries, HIV infection, Huntington’s disease, etc. If there is more than one cause, the term “mixed dementia”
is used and is sometimes referred to as “dementia due to multiple etiologies.” (Donna’s mom, for example, was diagnosed with mixed dementia – Alzheimer’s disease and vascular dementia.)
What’s in a Name?
Even though the diagnosing, or naming, of a dementia has had a challenging history over the decades, the key for caregivers remains the importance of giving our loved one’s symptoms a name. Beyond the benefits diagnosis brings to our loved ones like the opportunity for care planning and access to services, naming their symptoms has powerful psychological benefits to caregivers as well. Why? Because when something is named, our relationship to it can be reframed. With dementia, naming the condition that our loved one is experiencing opens a door that can transform us from caretaker to care partner. It can serve as a bridge that takes us from fear and resentment to commitment and acceptance. Having a name for our loved one’s struggles transforms “She’s losing it,” to “She’s a person who has developed Alzheimer’s Disease.” This reframing is the foundation for affirming our loved one’s human dignity, the discovery of deeper meaning in our caregiving roles, and a more effective ability to manage our own stress in our care partner years ahead. There are many steps to such transformation and we will touch on each in the weeks ahead. For now, if you’d like more detail about dementia subtypes, it can be found in Chapter 2 of our book A Caregiver’s Well-Being: How to Master Stress and Find Balance While Caring for Loved One’s with Dementia (ava
Leave a Reply