“This is a very important question because knowing the type of dementia a person has enables the correct treatment,” says Allison Perrin, MD, is a geriatric medicine physician at the Stead Family Memory Center at Banner Alzheimer’s Institute.
She explains the term dementia describes gradual difficulty in keeping up with day-to-day activities due to changes in the brain. These difficulties include paying bills, shopping and cooking. While Alzheimer’s disease is the most common cause of dementia, there are other causes as well.
Common dementia types
- Lewy body dementia (LBD)
LBD is combines many of the physical changes seen in Parkinson’s disease – slow movement, rigid muscle tone and shuffling gait – with cognitive changes similar to those found in Alzheimer’s disease. Visual hallucinations (seeing things that are not there) can also occur. Other symptoms may include visual spatial problems (ability to tell where an object is in space); difficulty with reasoning and planning; changes in cognitive symptoms, and autonomic (involuntary) nervous system changes like constipation or dizziness when standing up. Since LBD patients tend to be more sensitive to some medications, they are generally given lower doses and closely monitored.
- Vascular dementia (VD)
VD is caused by an event such as the type of stroke (ischemic) in which a blood clot blocks blood flow in an artery and damages the part of the brain it fed. The degree and type of memory loss depends on the part of the brain affected. Not all strokes lead to dementia. However, multiple “events” can add up over time and result in gradual mental decline. Doctors diagnose VD through brain scans, which show the location of the damage. The best way to treat VD is through medications to prevent clots. It is also important to control stroke risk factors such as diabetes, high blood pressure and cholesterol.
- Frontotemporal dementia (FTD)
The main features of FTD include loss of language function and behavioral changes such as using foul language, poor manners, socially inappropriate behavior, poor hygiene, and physical and/or sexual aggression. Most FTD patients are unaware of their behavior issues. FTD, usually affects adults younger than 65. The frontal lobe of the brain that controls behavior and/or the temporal lobe that is responsible for language are the areas of the brain affected. Treatment consists of controlling behavioral symptoms with medications.
It is important for a physician to determine the type of dementia a patient has before initiating treatment, since the nuances of each dementia, medications used and treatment vary. An accurate diagnosis requires evaluating clinical history, physical exams and cognitive testing.