From the Guidelines
Dementia is an umbrella term for over 100 different neurodegenerative conditions, with the most common types being Alzheimer disease, vascular dementia, Lewy body dementia, frontotemporal dementia, and mixed dementia. The various types of dementia can be broken down into:
- Alzheimer disease: the most common form, accounting for a significant proportion of cases, characterized by abnormal protein deposits in the brain, leading to memory loss, confusion, and behavioral changes 1
- Vascular dementia: the second most common type, resulting from reduced blood flow to the brain following strokes or blood vessel damage
- Lewy body dementia: involving abnormal protein deposits called Lewy bodies, often featuring visual hallucinations and movement problems similar to Parkinson's disease
- Frontotemporal dementia: typically affecting younger individuals, primarily impacting behavior, personality, and language rather than memory
- Mixed dementia: involving multiple types occurring simultaneously, most commonly Alzheimer's with vascular dementia Other less common forms of dementia include Parkinson's disease dementia, Huntington disease, and Korsakoff disease, each with distinct underlying brain pathologies and symptom patterns 1. The prevalence of dementia is estimated to be over 50 million people globally, with this figure projected to increase to 152 million by 2050, emphasizing the need for early diagnosis and symptom management to improve quality of life 1.
From the Research
Types of Dementia
- Alzheimer disease: the leading cause and prototypical form of dementia, presenting insidiously and causing progressive cognitive impairment with increasing severity over a period of years 2
- Vascular dementia: the second most common form of dementia and often co-occurs with other progressive cognitive disorders 2
- Lewy body dementias: encompass Parkinson disease dementia and dementia with Lewy bodies, which have similar features and are differentiated primarily by the order of motor and cognitive symptom onset 2, 3
- Frontotemporal dementias: occur earlier than other forms of dementia, progress rapidly, and often have a genetic component 2
- Mixed dementias: often associated with more than 1 neuropathology, usually Alzheimer disease with cerebrovascular pathology 4
Characteristics of Dementia
- Acquired loss of cognition in multiple cognitive domains sufficiently severe to affect social or occupational function 4
- Decline in cognition that is significant enough to interfere with independent, daily functioning 5
- Chronic progressive loss of cognitive function in the absence of fluctuating consciousness 2
Diagnosis and Treatment
- Diagnosis requires a history evaluating for cognitive decline and impairment in daily activities, with corroboration from a close friend or family member, in addition to a thorough mental status examination by a clinician 4
- Treatment may include nonpharmacologic approaches, such as cognitively engaging activities, physical exercise, and socialization, as well as pharmacologic approaches, such as acetylcholinesterase inhibitors and memantine 4, 6