Treatments for dementia

Dementia is an umbrella term for multiple types of progressive diseases that affect memory and cognitive function. The type of dementia an individual is diagnosed with depends on which area of the brain the disease is affecting. Knowing which dementia you or a loved one has can determine your symptoms, rate of progression and the best treatment options for advanced planning.

With the right type of support, living well with dementia is more than possible. Today, we’ll explore the different types of dementia and their symptoms to help you learn more about your diagnosis.

Cortical and Subcortical Dementia

Medical professionals sometimes categorise dementia into cortical and subcortical dementia, which both affect the brain in different ways:

● Cortical dementia:
Cortical dementia is typically associated with the brain’s grey matter, which is the characteristic outer structure of the brain. These outer structures play a crucial role in processing information and in functions such as language and memory. Types of cortical dementia include Alzheimer’s, frontotemporal dementia, Binswanger’s disease and Creutzfeldt-Jakob disease.

• Subcortical dementia: Subcortical dementia initially affects structures located below the cortex, specifically in the innermost parts of the brain, known as the white matter. These inner structures are responsible for controlling the speed of thought processes and emotions. Types of subcortical dementia include Huntington’s disease, Parkinson’s dementia, and AIDS dementia complex.

The Most Common Types of Dementia

To date, research has discovered over 100 types of dementia. This is because dementia is an umbrella term for a group of symptoms caused by progressive brain damage. As the brain becomes damaged in different places, symptoms vary and therefore result in different types of dementia.

The most common types of diagnosis in the UK include:

Alzheimer’s Disease

Alzheimer’s is the most commonly diagnosed type of dementia in the UK, with 60-80% of those living with dementia having Alzheimer’s.

Common symptoms of Alzheimer’s include:

• Memory problems, such as regularly forgetting recent events or names
• Repetitive language, statements and questions
• Increased difficulty with tasks and activities that require organisation
• Confusion in unfamiliar places
• Trouble finding the right words
• Becoming withdrawn or anxious

With Alzheimer’s disease, abnormal proteins called plaques and tangles simultaneously damage the internal and external structures of brain cells. Over time, the damage caused by abnormal proteins disrupts the chemical connections between brain cells, rendering them unable to communicate information throughout the brain and body. Eventually, this causes the brain cells to die.

Vascular Dementia

Vascular dementia occurs when the narrowing or blockage of blood vessels restricts the blood flow and oxygen supply to the brain. With a limited oxygen supply, the cells in the brain are not able to breathe, causing them to become damaged or die. The symptoms of vascular dementia can occur suddenly, following one large stroke, or they can develop over time, after a series of smaller strokes.

Symptoms of vascular dementia include:

• Similar symptoms to Alzheimer’s
• Stroke-like symptoms, including muscle weakness or temporary paralysis on one side of the body
• Movement problems, such as difficulty walking or trouble with gait
• Thinking troubles, including difficulty with attention, planning and reasoning
• Mood changes, including depression and emotional outbursts

Vascular dementia can also be caused by a disease affecting the small blood vessels deep in the brain, which is known as subcortical vascular dementia.

Dementia with Lewy Bodies (DLB)

Dementia with Lewy bodies is caused by abnormal protein structures called Lewy bodies (alpha-synuclein) that appear in nerve cells in the brain. Researchers don’t yet have a full understanding of why Lewy bodies appear, but DLB is linked to low levels of important chemicals (mainly acetylcholine and dopamine) that carry messages between nerve cells, causing a loss of connections between them. Lewy bodies disrupt the cells’ ability to transmit information around the brain and body, causing them to die.

Symptoms specific to DLB include:

• Periods of being alert or drowsy
• Fluctuating levels of confusion
• Becoming slower with physical movements
• Repeated spells of fainting or falling
• Sleep disturbances

Frontotemporal Dementia (FTD)

With frontotemporal dementia, the build-up of abnormal proteins inside the nerve cells in the front and side areas of the brain interrupt the communication between cells, reducing the information sent around the brain and body, eventually causing the cells to die.

Two-thirds of people with FTD are diagnosed with behavioural variants. Unlike Alzheimer’s, the early stages of behavioural FTD doesn’t affect day-to-day memory or perception. Instead, changes in personality and behaviour become noticeable.

There are two further types of frontotemporal dementia, both of which affect the language functions of the brain.

These difficulties with language become apparent slowly, often over a couple of years:

● Aphasia: Language loss with common symptoms including difficulties in speech production such as stuttering or mispronunciation, grammatical errors and impaired understanding.

● Semantic dementia: Although speech may be fluent, the vocabulary begins to decline and symptoms include confusion regarding the meaning of familiar words, difficulty in finding the right word or recognising familiar objects.

● Motor disorders: About 10–20 percent of people with FTD also develop a motor disorder, which causes difficulties with movement. These motor disorders include motor neurone disease, progressive supranuclear palsy and corticobasal degeneration. These three conditions share similar symptoms such as twitching, stiffness, slow movements and loss of balance or coordination.

As the FTD progresses, more of the brain becomes damaged and the differences between the types of FTD become less obvious. Later stages of FTD begin to share symptoms with Alzheimer’s disease, such as confusion, disorientation, memory loss and changes in behaviour.

Mixed Dementia

With mixed dementia, more than one type of dementia occurs simultaneously in the brain. The most common types of dementia to occur at the same time are Alzheimer’s disease (caused by abnormal proteins called plaques and tangles, which destroy nerve cells in the brain) and the blood vessel changes associated with vascular dementia.

Several types of dementia can often coexist in the brain, such as Alzheimer’s, vascular dementia, and dementia with Lewy bodies. Symptoms will be mixed from the separate types of dementia, making it slightly more difficult to diagnose.

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Frequently Asked Questions About the Types of Dementia

How many types of dementia are there?

There are over 100 types of dementia identified to date. The most common include Alzheimer’s disease, vascular dementia, dementia with Lewy bodies, and frontotemporal dementia. Each type affects the brain differently and can cause distinct symptoms.

What type of dementia is most common in the UK?

Alzheimer’s disease is the most common type of dementia in the UK, accounting for around 60–80% of cases. It’s characterised by progressive memory loss, confusion and difficulties with language and problem-solving.

How do doctors tell the difference between the types of dementia?

Doctors diagnose the type of dementia by assessing symptoms, medical history, brain scans and cognitive tests. Blood flow changes, protein build-up and affected brain areas help specialists determine whether the cause is Alzheimer’s, vascular, Lewy body or frontotemporal dementia.

Can someone have more than one type of dementia?

Yes. This is called mixed dementia, when two or more types, such as Alzheimer’s and vascular dementia, occur together. Mixed dementia can make diagnosis and treatment more complex, as symptoms often overlap.