Dementia Symptoms

Medically reviewed by Nicholas R. Metrus, MD

Dementia is characterized by the gradual loss of mental functions including memory, thinking, and reasoning. Dementia is known as an umbrella term that covers a variety of neurodegenerative disorders that cause a decline in mental function. The most common disorder under the dementia umbrella is Alzheimer's disease. These disorders cause brain cells to stop functioning properly, affect brain cell connections, and can eventually lead to brain cell death. There are currently no cures for the disorders that cause dementia.

Dementia mostly affects people over 65 years old, but symptoms can start as early as 45. Symptoms start out gradually, usually beginning with small lapses in memory. As the symptoms worsen over time, memory lapses get more severe and the ability to communicate, reason, and perform everyday tasks becomes significantly impaired. The development of symptoms varies widely from person to person. Some types of dementia cause additional non-mental symptoms including movement problems, sleep disorders, hallucinations, and many others.

Dementia is a serious medical condition that affects millions of people worldwide. While it is normal for people to become more forgetful as they age, it is important to note that dementia and its symptoms are not part of the normal aging process. There are many people over 65 that do not develop dementia. 

Signs and Symptoms

Dementia as a whole causes a wide range of symptoms that affect a person’s everyday life. While dementia can be caused by several different neurodegenerative disorders, there are common symptoms that occur in every type of dementia. The most common signs and symptoms of dementia are:

• Memory loss (this includes forgetting names of friends and family, old memories, common everyday words, and recent events or conversations)

• Poor judgment and confusion

• Difficulty speaking and expressing or understanding thoughts

• Being confused or disoriented in familiar places, such as getting lost in a familiar neighborhood

• Repeating questions

• Taking longer to perform everyday tasks or having trouble concentrating/focusing on common tasks

How these symptoms present themselves depends on the type of dementia a person has. Neurodegenerative diseases that cause dementia affect different parts of the brain and these differences cause slightly distinct versions of dementia. The most common types of dementia are Alzheimer's disease, Frontotemporal dementia, Lewy body dementia, and vascular dementia.

Alzheimer's Disease

Alzheimer's disease is the most common cause of dementia, causing 60-80% of cases.

The exact cause of Alzheimer’s disease is unknown, but researchers currently believe that it is caused by the abnormal buildup of tau and amyloid proteins in neurons, which are the cells of the brain. When functioning normally, these proteins are responsible for the development of brain cell structure. The accumulation of abnormal forms of tau and amyloid proteins causes clumps in and around brain cells, which result in loss of brain cell communication and, ultimately, brain cell death.

Symptoms of Alzheimer’s disease vary on a case-by-case basis. They range from mild, such as getting lost and repeating questions, to severe, which include full loss of communication and complete dependence on family members for their care.

Frontotemporal Dementia

Frontotemporal dementia is caused by the accumulation of abnormal proteins in the frontal and/or temporal lobe of the brain. The frontal lobe is responsible for movement, general decision-making, and personality while the temporal lobe is responsible for speech processing and emotional processing. Approximately 25% of dementia cases are caused by frontotemporal dementia.

Symptoms of frontotemporal dementia will vary on where in the brain the accumulation of abnormal proteins is happening.

Accumulation of abnormal proteins in the frontal lobe lead to behavioral and personality symptoms like impulsiveness, inappropriate or offensive comments, and changes in personality. There can also be some movement symptoms like shaky hands or problems with balance and walking.

Accumulation of abnormal proteins in the temporal lobe can cause severe difficulty with speaking and understanding speech, and emotional symptoms like emotional flatness, not caring about others' emotions, and demonstrating extreme emotions.  

Related: How Is Frontotemporal Dementia Diagnosed? Bruce Willis' Condition, Explained

Lewy Body Dementia

Lewy body dementia is caused by the abnormal accumulation of a protein called alpha-synuclein. The abnormal build-up of this protein affects the brain's signaling molecules.

Lewy body dementia is known for causing visual hallucinations and affecting sleep patterns, causing insomnia and excessive daytime sleepiness. Lewy body dementia also causes movement problems including muscle rigidity and reduced facial expressions.

Lewy body dementia can occur alongside Parkinson's disease, which is known as Parkinson's disease dementia. Parkinson's is a neurodegenerative disorder characterized by issues with motor skills, such as tremors, slow or interrupted movements, rigidity, and muscle stiffness. When it cooccurs with dementia, cognitive symptoms usually begin around a year after motor symptoms.

Vascular Dementia

Vascular dementia is caused by sudden changes in the brain’s blood and/or oxygen supply. This is often caused by a stroke, high blood pressure, and blood clots in the brain. About 15% of dementia cases are caused by vascular dementia.

Vascular dementia can cause hallucinations or delusions. The severity of vascular dementia symptoms depends on the amount of damage to the brain.

Other Types of Dementia

There are many other conditions that can cause dementia. Some of these conditions include:

• Huntington’s disease: A rare, inherited condition that causes the nerve cells in the brain to break down over time

• Creutzfeldt-Jakob disease (CJD): A progressive neurodegenerative disorder believed to be caused by a prion, an abnormal protein in the brain

• Chronic traumatic encephalopathy (CTE): A brain disorder that is more likely caused by repeated head injuries, which is especially common in athletes who play contact sports

• HIV-associated dementia: Occurs when human immunodeficiency virus (HIV) spreads to the brain

• Heavy alcohol use over prolonged periods of time: Long-term consumption of large quantities of alcohol can affect the neurons in your brain, even reducing their size

• Concussion: A type of traumatic brain injury (TBI) causes by a blow or jolt to the head
  

Symptoms In Men/Women

Many studies have tried to determine the differences in the prevalence of dementia by sex and gender.

Some studies have shown that women over 45 have a 1 in 5 risk of developing Alzheimer’s disease dementia, while men have a 1 in 10 risk. On average, 62% of people with Alzheimer’s are women.

However, other studies suggest that the higher incidence of dementia in women might be a result of women living longer than men. For example, a 2018 study showed that the rates of dementia in men and women are similar up to the age of 80. The study then showed an increased incidence of Alzheimer’s disease in women 85 years and older. More research is needed to determine all the contributing factors, but higher life expectancy among women likely plays a role.

Additionally, there have been reported sex-related differences in the type of dementia diagnosed. A 2021 study states that while more cases of Alzheimer’s dementia are seen in women, cases of vascular dementia are more prevalent in men.

More studies are needed to address potential gender- and sex-related differences in dementia.

Health recognizes that not everyone who is female was born with female reproductive organs and that not everyone who is male was born with male reproductive organs. Health also recognizes that people may not identify as any one sex or gender. The information in this article is based on how researchers present their results, and the gender- and sex-based language used most accurately reflects their research design and outcomes.

When to See a Healthcare Provider

There are certain early symptoms that can warrant scheduling an appointment with your healthcare provider to discuss a dementia diagnosis. If you are in your early 60’s, reach out to your healthcare provider if you are experiencing any of the following:

• Difficulty remembering dates, events, and recently learned information

• Asking the same questions over and over

• Forgetting to keep track of monthly bills

• Difficulty in concentrating on activities that you are used to performing (driving, buying groceries)

• General confusion with time and places

• Having trouble following conversations and having trouble remembering words

• Not being able to retrace your steps
  

Related: Exercise, Doing Chores, and Socializing Can All Help Lower Dementia Risk, Study Shows

A Quick Review

Dementia is an umbrella term that is used to define the gradual loss of memory, thinking, and reasoning capability that most commonly occurs in people over the age of 65. Common symptoms are memory loss, confusion, and difficulty understanding and expressing one's thoughts.

Symptoms of dementia start gradually and worsen significantly over time. These symptoms are caused by neurodegenerative disorders like Alzheimer’s, Lewy body dementia, and frontotemporal dementia, which cause damage to brain cells.

Seek a medical assessment if you or a loved one are currently experiencing symptoms of dementia.

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