Dementia
What will happen?
Most types of dementia cannot be cured. The symptoms will get worse over time. The only exception is dementia that happens suddenly after a stroke. Treatment can sometimes help this kind of dementia, but not always.
Your doctor probably won't be able to tell you how quickly the condition will get worse or how soon the disease will affect
your day-to-day life.
Everyone's different. Some people get worse gradually over several years. Others get worse suddenly, over a few months. Some have long periods
when they don't get any worse, followed by short periods when they do.
1
2 But eventually most people with dementia will need help to do everyday things, like getting washed and dressed.
Source:
Corey-Bloom J.
The natural history of Alzheimer's disease.
In: O'Brien J, Ames D, Burns A. Dementia. 2nd edition. Arnold, London, UK; 2000.
Corey-Bloom J.
The natural history of Alzheimer's disease.
In: O'Brien J, Ames D, Burns A. Dementia. 2nd edition. Arnold, London, UK; 2000.
Source:
Bird TD.
Alzheimer's disease and other primary dementias.
In: Braunwald E, Hauser SL, Fauci AS, et al (editors). Harrison's principles of internal medicine. 15th edition. McGraw Hill, New York, U.S.A.; 2001.
Bird TD.
Alzheimer's disease and other primary dementias.
In: Braunwald E, Hauser SL, Fauci AS, et al (editors). Harrison's principles of internal medicine. 15th edition. McGraw Hill, New York, U.S.A.; 2001.
Getting the right treatment and support can make a difference.
3 For example, treatment with one of the drugs that helps with forgetfulness and confusion may mean that someone with
Alzheimer's or another type of dementia can stay at home longer before needing full-time care in a nursing home.
Source:
Gwyther LP.
Family issues in dementia: finding a new normal.
Neurologic Clinics. 2000; 18: 993-1010.
Gwyther LP.
Family issues in dementia: finding a new normal.
Neurologic Clinics. 2000; 18: 993-1010.
Alzheimer's disease
People who have Alzheimer's disease slowly lose their memory and ability to think clearly. As the disease gets worse, they get more confused and start acting differently. Several changes happen in the brain that stop it working properly. Small lumps called amyloid plaques grow in the parts of the brain used for memory and thinking. And bundles of twisted threads called 'neurofibrillary tangles' form inside brain cells. These stop brain cells communicating with each other, and they can cause cells to die. Also, in Alzheimer's disease, the brain does not have enough chemical messengers (neurotransmitters), and holes or gaps appear where brain cells have died.
People who have Alzheimer's disease slowly lose their memory and ability to think clearly. As the disease gets worse, they get more confused and start acting differently. Several changes happen in the brain that stop it working properly. Small lumps called amyloid plaques grow in the parts of the brain used for memory and thinking. And bundles of twisted threads called 'neurofibrillary tangles' form inside brain cells. These stop brain cells communicating with each other, and they can cause cells to die. Also, in Alzheimer's disease, the brain does not have enough chemical messengers (neurotransmitters), and holes or gaps appear where brain cells have died.
As the disease gets worse, people with dementia can become difficult to understand.
4 Many people also behave differently. They become restless and easily upset. They may try to wander from home. Some people
become aggressive, and shout and lash out. Many people feel depressed or lose interest in life.
Source:
Richter JM. Roberto KA. Bottenberg DJ.
Communicating with persons with Alzheimer's disease: experiences of family and formal caregivers.
Archives of Psychiatric Nursing. 1995; 9:279-85
Richter JM. Roberto KA. Bottenberg DJ.
Communicating with persons with Alzheimer's disease: experiences of family and formal caregivers.
Archives of Psychiatric Nursing. 1995; 9:279-85
Others have delusions (they imagine that something is happening when it isn't) or hallucinations (they see things that aren't
there). There are drugs that can help some people who have these symptoms.
5
Source:
Eastwood R. Reisberg B.
Mood and behaviour.
In: Panisset M. Stern Y. Gauthier S. Clinical diagnosis and management of Alzheimer's disease. 1st edition. Martin Dunitz, London, UK; 1996.
Eastwood R. Reisberg B.
Mood and behaviour.
In: Panisset M. Stern Y. Gauthier S. Clinical diagnosis and management of Alzheimer's disease. 1st edition. Martin Dunitz, London, UK; 1996.
This is what we know from the research:
- The worse symptoms are at the beginning of the disease, the sooner someone will need help looking after himself or herself
- People who have symptoms such as hallucinations or depression get worse more quickly than people who don't.
Source:
Gwyther LP.
Family issues in dementia: finding a new normal.
Neurologic Clinics. 2000; 18: 993-1010.
Gwyther LP.
Family issues in dementia: finding a new normal.
Neurologic Clinics. 2000; 18: 993-1010.
Someone with dementia might realize that their partner or caregiver notices "problems" that they do not. This can leave them
feeling uncertain about themselves and the world.
6 They can feel anxious and angry, and lash out at those around them, especially in the later stages of the disease when they
feel they have no control over their life.
Source:
Phinney A.
Living with dementia from the patient's perspective.
Journal of Gerontological Nursing. 1998; 24: 8-15.
Phinney A.
Living with dementia from the patient's perspective.
Journal of Gerontological Nursing. 1998; 24: 8-15.
People with early dementia may wish to plan for the future. They may want to discuss options for treatment with their relatives.
Some people write an
advance directive. This lets others know what treatment and care they want in the future.
5 People with dementia can lose the ability to keep track of money. So, it's important to decide who should help with decisions
about money and health care.
dementia advance directive
An advance directive for dementia is a legal document that you sign before the disease has made it difficult for you to think clearly and make decisions. It can include a living will, which says you prefer to be allowed to die by natural means and not be kept alive by artificial measures. It can also include a power of attorney, which identifies a person who will make decisions about your health care and finances.
An advance directive for dementia is a legal document that you sign before the disease has made it difficult for you to think clearly and make decisions. It can include a living will, which says you prefer to be allowed to die by natural means and not be kept alive by artificial measures. It can also include a power of attorney, which identifies a person who will make decisions about your health care and finances.
Source:
Eastwood R. Reisberg B.
Mood and behaviour.
In: Panisset M. Stern Y. Gauthier S. Clinical diagnosis and management of Alzheimer's disease. 1st edition. Martin Dunitz, London, UK; 1996.
Eastwood R. Reisberg B.
Mood and behaviour.
In: Panisset M. Stern Y. Gauthier S. Clinical diagnosis and management of Alzheimer's disease. 1st edition. Martin Dunitz, London, UK; 1996.
However, the news isn't all bad. A few years ago, doctors could offer treatments only for individual symptoms. So, if someone with dementia had
depression, their doctor might have given them an
antidepressant. But today, doctors have drugs that have been specially designed to address the chemical changes that happen in the brain
in dementia. Scientists are trying to improve on these drugs all the time as they find out more about how the brain works
and what goes wrong in Alzheimer's and other dementias.
depression
Depression is a mental illness in which your mood is low and you feel sad much of the time. It can range from a mild illness through to a severe one in which you lose interest in life and may be suicidal.
Depression is a mental illness in which your mood is low and you feel sad much of the time. It can range from a mild illness through to a severe one in which you lose interest in life and may be suicidal.
antidepressant
Antidepressants are medicines used to treat depression and sometimes other conditions. They work by changing the levels of chemicals in your brain called neurotransmitters. There are three main types of antidepressants, which work in different ways: selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs).
Antidepressants are medicines used to treat depression and sometimes other conditions. They work by changing the levels of chemicals in your brain called neurotransmitters. There are three main types of antidepressants, which work in different ways: selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs).
Some people live for 20 years after being diagnosed with Alzheimer's disease or another type of dementia, but others live
only a few months. On average, people can expect to live for about five or six years after they find out they have Alzheimer's.
1 People who have
Lewy body dementia live for an average of six years after they are diagnosed.
7 There is no good information about how long people with
vascular dementia live after they are diagnosed.
Source:
Corey-Bloom J.
The natural history of Alzheimer's disease.
In: O'Brien J, Ames D, Burns A. Dementia. 2nd edition. Arnold, London, UK; 2000.
Corey-Bloom J.
The natural history of Alzheimer's disease.
In: O'Brien J, Ames D, Burns A. Dementia. 2nd edition. Arnold, London, UK; 2000.
Lewy body dementia
People with Lewy body dementia slowly lose their memory and ability to think clearly. Most people also get symptoms of Parkinson's disease. This means they may move more slowly and become rather stiff and rigid in the way they do things. People with this type of dementia get small, round clusters of proteins inside their brain cells. These are called Lewy bodies. They stop important chemicals in the brain from working normally. Lewy body dementia can also cause small lumps in the brain called amyloid plaques. They're made of protein and bits of dead cells. The lumps grow in the parts of the brain used for memory and thinking. They may stop messages from passing between brain cells.Lewy body dementia is the second most common cause of dementia after Alzheimer's disease.
People with Lewy body dementia slowly lose their memory and ability to think clearly. Most people also get symptoms of Parkinson's disease. This means they may move more slowly and become rather stiff and rigid in the way they do things. People with this type of dementia get small, round clusters of proteins inside their brain cells. These are called Lewy bodies. They stop important chemicals in the brain from working normally. Lewy body dementia can also cause small lumps in the brain called amyloid plaques. They're made of protein and bits of dead cells. The lumps grow in the parts of the brain used for memory and thinking. They may stop messages from passing between brain cells.Lewy body dementia is the second most common cause of dementia after Alzheimer's disease.
Source:
Lobo A, Launer LJ, Fratiglioni L, et al.
Prevalence of dementia and major subtypes in Europe: a collaborative study of population-based cohorts.
Neurology. 2000; 54 (supplement 5): S4-S9.
Lobo A, Launer LJ, Fratiglioni L, et al.
Prevalence of dementia and major subtypes in Europe: a collaborative study of population-based cohorts.
Neurology. 2000; 54 (supplement 5): S4-S9.
vascular dementia
This type of dementia happens when blood vessels near your brain get damaged, so your brain doesn't get enough blood. Some of the cells in your brain die, which causes symptoms such as confusion and memory problems. Vascular dementia can happen suddenly if you have a stroke. Or it can come on gradually if you have a series of little strokes (this is called multi-infarct dementia).
This type of dementia happens when blood vessels near your brain get damaged, so your brain doesn't get enough blood. Some of the cells in your brain die, which causes symptoms such as confusion and memory problems. Vascular dementia can happen suddenly if you have a stroke. Or it can come on gradually if you have a series of little strokes (this is called multi-infarct dementia).
People with Alzheimer's or another type of dementia gradually lose the ability to look after themselves. And their personality
changes. It can be heartbreaking to watch a person close to you change in this way. You might learn to cope with one situation,
but then it changes. You then need to gather your strength to cope with a new set of symptoms.
There will probably be a time when you need to think about getting help. This could be at home or in a nursing home. These
can be difficult decisions to make and you may need a lot of help to decide what's best. It's probably wise to think about
these things sooner rather than later, so that you'll have plenty of time to look around and make the right choice.
There are some good support networks for people with dementia and their families. You may want to contact one of these to
help you decide what kind of help you need, and to find out what options are available in your area.
You can get information about these organizations from the National Institute of Neurological Disorders and Stroke.
Sources for the information on this page:
- Corey-Bloom J.The natural history of Alzheimer's disease.In: O'Brien J, Ames D, Burns A. Dementia. 2nd edition. Arnold, London, UK; 2000.
- Bird TD.Alzheimer's disease and other primary dementias.In: Braunwald E, Hauser SL, Fauci AS, et al (editors). Harrison's principles of internal medicine. 15th edition. McGraw Hill, New York, U.S.A.; 2001.
- Gwyther LP.Family issues in dementia: finding a new normal.Neurologic Clinics. 2000; 18: 993-1010.
- Richter JM. Roberto KA. Bottenberg DJ.Communicating with persons with Alzheimer's disease: experiences of family and formal caregivers.Archives of Psychiatric Nursing. 1995; 9:279-85
- Eastwood R. Reisberg B.Mood and behaviour.In: Panisset M. Stern Y. Gauthier S. Clinical diagnosis and management of Alzheimer's disease. 1st edition. Martin Dunitz, London, UK; 1996.
- Phinney A.Living with dementia from the patient's perspective.Journal of Gerontological Nursing. 1998; 24: 8-15.
- Lobo A, Launer LJ, Fratiglioni L, et al.Prevalence of dementia and major subtypes in Europe: a collaborative study of population-based cohorts.Neurology. 2000; 54 (supplement 5): S4-S9.
This information was last updated on Mar 05, 2009
This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.
© BMJ Publishing Group Limited 2009. All rights reserved.
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