Dementia signs, symptoms and diagnosis

Dementia is not an inevitable part of ageing. It’s caused when the brain is damaged by diseases, such as Alzheimer’s disease or a series of strokes. Alzheimer’s disease is the most common cause of dementia, but not the only one.

The specific symptoms that someone with dementia experiences will depend on the parts of the brain that are damaged and the disease that is causing the dementia.

Jo Poolman, team manager of AXA Health’s 24/7 health support line looks at what dementia is, the symptoms and how someone is diagnosed.

What is dementia?

Dementia is classed as a syndrome (a group of related symptoms) associated with an ongoing decline of brain functioning.¹

Symptoms may include memory loss and difficulties with thinking, problem-solving or language. A person with dementia may also experience changes in their mood or behaviour.

These changes are often small to start with, but for someone with dementia they have become severe enough to affect daily life.

What are the symptoms of the different types of dementia?

There are many different types of dementia, however Alzheimer's is the most prominent and accounts for around 60% of diagnosed cases.² 

The three most common types of dementia experienced in the UK and some of the symptoms you might experience include:

1. Alzheimer's disease

Common symptoms include:

• memory loss or impairment (commonly forgetting names of people, places and times)
• mood changes
• problems with judging distances
• problems with speech (struggling to follow a conversation or repeating themselves)
• poor concentration
• trouble with organisation or planning (difficulty in carrying out a sequence of tasks)
• problems with orientation to time place or person.³

As in all forms of dementia, this is a progressive condition, so symptoms may be mild at first but often worsen with time.

2. Vascular dementia

Vascular dementia is caused by reduced blood supply to the brain due to diseased blood vessels or a stroke, for example.

Common early symptoms of vascular dementia include:

• problems with problem solving, decision making, planning and organisation
• confusion and reduced speed of thought
• problems maintaining a concentration
• speech difficulties
• mood changes, including anger and depression.

Memory loss is not usually a main symptom in the early stages. Many people with vascular dementia are aware that their thinking and processing is impaired. This can often lead to a lot of frustration and distress on their part.⁴

3. Dementia with Lewy bodies

Around 5% of people with a diagnosis of dementia are recorded as having dementia with Lewy bodies (DLB), although the condition is under-diagnosed and often misidentified as Alzheimer’s disease.

Like Alzheimer’s disease, DLB can both cause problems with:

• memory loss,
• staying focused,
• decision-making,
• and difficulties with the way the person sees things around them. 

However, common symptoms of DLB also include hallucinations, problems staying fully awake, difficulties with movement and very disturbed sleep.⁵

Around 1 in 10 people are also diagnosed as having more than one type of dementia - or 'mixed dementia'.⁶

Getting a diagnosis

A timely diagnosis is important to help people get the support and care they need to live as well as possible with the condition. It also provides an early opportunity to make plans in advance for their care and be offered medications to manage their symptoms.

Knowing what to expect can also help to alleviate anxiety and give you a sense of control over your diagnosis.⁷

If you are experiencing any of the common symptoms of dementia your GP will carry out an assessment to see what might be causing them.

They will look at your medical history to see if any pre-existing conditions are related to your symptoms. They will ask:

• How long you’ve noticed these symptoms for?
• What sorts of problems with thinking and daily activities you’re having, and how quickly they’ve developed over time?
• They may also ask if you are having difficulties or stresses in your life that could be causing depression; as this can sometimes cause problems with memory and thinking.

It can be really useful to bring someone who knows you well to this appointment as they may be able to fill in any missing details. 

The GP may ask you to do a very short test, known as a screening test, to see if you would benefit from a more detailed assessment at a local memory service.

They will normally order blood tests to rule out other conditions, such as thyroid problems or vitamin deficiencies, and they may also need to refer you for a brain scan at the local hospital (although these are not always necessary).

Sometimes a GP is able to make a diagnosis of dementia based on these initial investigations. More commonly, however, they will refer a person for more detailed assessment by specialists at a local memory service.⁸

Self-help and treatments for dementia

There is currently no cure for dementia or any treatment that slows down the progression of the underlying diseases in the brain.

However, there are treatments that can improve symptoms and help a person to live more easily with the condition:

Getting support

A diagnosis of dementia can come as a shock, even if you have been expecting it. It’s natural to feel worried about the future but, remember, you are not alone.⁹

You can contact the Alzheimer’s Society who offer a wide range of support and information for people affected by dementia. They have dementia support services such as telephone support, local services and an online community, ready to help.

Dementia affects not only the life of the person who has it but also the lives of those close to them. Advice and support are available for all affected – the NHS, social services and voluntary organisations can all help.

Eating well

Having a healthy, balanced diet that includes a wide variety of foods from different food groups is important for our overall health and wellbeing. The NHS Eatwell Guide has lots of information to help make sure you’re getting the nutrition you need to feel at your best. 

Sleep

To encourage a healthy sleep pattern try to limit daytime naps, avoid caffeine too late in the day, incorporate exercise during the day and find ways to encourage relaxation.¹⁰

Exercise and mobility

The more mobile someone stays, the better it will be for their health and wellbeing. You don't need to join a gym or start running marathons to feel the benefit.

Moving more while doing something you enjoy can work wonders for your mind and body and really boost your feelgood factor.

>Take a look at our article for some ways you can get active in a way that suits you.

Stay as independent as possible, tackling daily tasks as you have always done

If some things become more difficult, think of ways to make them easier or ask for help. Your GP will be able to advise you about the services and treatments that are available to you.

• Keep busy - continue with the activities and hobbies you’ve always enjoyed as these can be a great comfort and stress buster.
• Keep a diary - write down the things you want to remember.
• Put labels around the house, such as on cupboards and drawers.
• Medication can help slow down the progression of dementia symptoms in some cases and there are also medications available to help manage associated conditions.¹¹

It is important that you continue to attend any of your medical appointments, and to follow up with your GP to monitor how your needs may have changed.

If you are having difficulties with this it may be that a friend or family member, or a community practitioner, could assist you with attending your appointments.

The content in this article has been developed with Alzheimer’s Society. For further information and to find out how you can access support you can visit alzheimers.org.uk

References

1. About dementia - NHS
2. Types of Dementia - Dementia UK
3. Symptoms of Alzheimer's disease - Alzheimer’s Society
4. What is vascular dementia? - Alzheimer's Society
5. Dementia with Lewy bodies (DLB) - Alzheimer’s Society
6. Mixed dementia - Dementia UK
7. How to get a diagnosis of dementia - Dementia UK
8. How to get a dementia diagnosis - NHS
9. Loneliness - Age UK
10. Sleep and dementia risk - Alzheimer’s Society
11. What are the treatments for dementia? - NHS