Dementia: Types, Causes, Stages, and Care

dementia care in Nepal

Dementia: Types, Causes, Stages, and Care

Dementia was extremely rare before the 20th century because, in pre-industrial civilization, fewer people lived to see old age. It wasn't until the mid-1970s that dementia was given the name we know it by. We now know that dementia is a symptom of an illness, not a natural aspect of aging.

Most people with Dementia are in their final decades, but it's essential to know that not everyone older gets dementia. Dementia can happen to anybody, however, it is likely to be common after the age of 65. Dementia is progressive, meaning that symptoms may appear minor at the beginning but worsen over time. Dementia affects everyone differently.

In this blog, we will discuss dementia, types of dementia, causes for dementia, stages of dementia, and dementia care.

What is Dementia?

Dementia is a broad term that refers to a loss of mental abilities such as thinking, memory, attention, logical reasoning, and others. Dementia isn't a medical condition nor a single disease. Instead, it's a collection of symptoms brought on by different illnesses.

The capabilities of a person with dementia can fluctuate from day to day, or even within the same day. What is sure is that the person's capabilities will weaken; this may occur quickly over a few months or gradually over several years.

Types of Dementia

Most of the dementias are progressive, and a person's ability to function gradually weakens as time goes by. Some of the most common forms of dementia are as follows:

Alzheimer's Disease

Alzheimer's disease is the most common type of dementia among older people. It usually takes several years to develop. Early stages may be mistaken for moderate amnesia, which is a natural aspect of growing older. 

The inability to develop new memories for recent events is frequently one of the first indicators. Difficulty in finding the proper words, difficulties in making decisions, evaluating distance, and finding the route to familiar areas are all difficult tasks.

What's going on in the brain?

The continuous growth of malformed protein clumps slowly damages nerve cells in the brain.

Lewy Body Dementia (or Dementia with Lewy Bodies)

With Dementia with Lewy Bodies, movements may be altered causing people to scramble while they walk and increase their risk of falling. Some of the symptoms are similar to those seen in people with Parkinson's disease. Lewy body disease patients may have times of extreme confusion.

They may experience hallucinations, in which they see or hear things that aren't there. Swallowing and sleep patterns might also be disturbed - people with Lewy body Disease may find it easy to fall asleep during the day but suffer while sleeping at night.

What's going on in the brain?

'Lewy Bodies' are aberrant protein aggregates that accumulate in the brain over time. Protein deposits in the brain disrupt nerve cell connections, causing alterations in movement, thinking, behavior, and attentiveness.

Vascular Dementia

Another common type of dementia with a less well-known name is Vascular Dementia. It can happen unexpectedly, such as after a stroke that affects major blood vessels. A succession of tiny strokes or damage to blood vessels in the brain can also cause it to progress slowly or over time. 

The signs and symptoms of Vascular Dementia might be difficult to distinguish with Alzheimer's Disease. Memory loss, Disorientation, Communication challenges, and changes in the way a person moves are all possible symptoms depending on which area of the brain is injured.

What's going on in the brain?

Brain cells can be damaged when blood supply to the brain is reduced due to shrinkage or blockages in blood vessels. Symptoms of vascular dementia might appear suddenly or gradually over time.

Fronto-temporal Dementia

Fronto-temporal dementia (FTD) can affect one's behavior, personality, and ability to communicate. FTD has been connected to neuromuscular disorders in some circumstances.

Early symptoms of FTD may alter depending on which part of the brain is damaged. Difficulties communicating or comprehending people can be a prominent symptom in the early stages, as can changes in personality, eating patterns, lack of personal awareness (e.g. personal cleanliness), or lack of social awareness (e.g. being tactless) are the symptoms seen as the situation gets worsen. It is most frequent in persons between the ages of 45 and 65, but it can also affect people in their later years.

What's going on in the brain?

FTD affects the frontal lobes and temporal lobes of the brain (over the ears). If the frontal lobes are compromised, the person will struggle with motivation, planning and organization, emotion regulation, and maintaining socially appropriate behavior. The person will have trouble speaking and/or understanding language if the temporal lobes are compromised.

Early/Younger Onset Dementia

Dementia affects people of all ages, but it is more common in people over 65. The majority of patients with early-onset dementia are in their forties or fifties. In younger adults, doctors are less likely to suspect dementia. As a result, obtaining a diagnosis can be challenging.

Dementia can run in families, therefore those who develop it at an early age may have a strong family history of dementia. Genetics may have played a part in the progression of their illness. People who have Parkinson's disease, Multiple Sclerosis, Huntington's disease, HIV, or AIDS are more likely to have early-onset dementia.

Causes For Dementia

Degenerative Neurological Disorders are the most common causes of dementia. Many of these disorders are linked to an abnormal protein build-up in the brain. As a result of the build-up, nerve cells perform less well and eventually die. Different parts of the brain shrink as nerve cells die. Major Causes of dementia include:

  • Traumatic Brain Injuries resulting from vehicle accidents falls, concussions, and other causes
  • CNS (Central Nervous System) Infections are infections that affect the whole nervous system. Meningitis, HIV, and Creutzfeldt-Jakob disease are among them.
  • Use of alcohol or drugs for a long time
  • Hydrocephalus, a condition in which there is a buildup of fluid in the brain

Dementia can also be caused by the following factors:

  • Tumors
  • Blood clots below the outer coating of the brain are known as Subdural Hematomas
  • A collection of fluid in the brain known as normal-pressure Hydrocephalus
  • Vitamin B12 deficiency, for example, is a metabolic disease.
  • Hypothyroidism, a condition in which thyroid hormone levels drop
  • Hypoglycemia, a type of low blood sugar
  • Neurocognitive Disorders linked to HIV (HAND)

Why is Dementia Progressive?

In the early stage of all dementias, only a small fraction of the brain is affected. The abilities that depend on the injured portion of the brain are impacted, thus there are fewer symptoms at this stage. Each type of dementia affects a particular brain location.

As a result, the symptoms of the various types vary. Early-stage Alzheimer's disease, for example, is characterized by memory loss, whereas early-stage FTD is characterized by a lack of memory. 

The symptoms of the several types of dementia are likely to become more similar as dementia progress into the middle stage. This is because as dementia progresses, more of the brain is impacted.

The condition that causes dementia spreads to other sections of the brain over time. Because more of the brain is unable to function properly, this causes greater symptoms. Simultaneously, already-damaged parts of the brain become even more damaged, leading the person's existing symptoms to worsen.

The disease eventually causes severe damage to most areas of the brain. This results in significant changes in memory, thinking, language, emotions, and behavior, as well as physical difficulties. Hence, Dementia is progressive over time.

Stages of Dementia

To be diagnosed with dementia, a person must have problems in at least two of the following cognitive areas:

  • Memory
  • Speech and communication
  • Concentration, and focus
  • Reasoning and Decision-making

Perception of the visual world (including trouble detecting movement, differentiating colors, or experiencing hallucinations)

Different indicators and symptoms will become more apparent as the condition advances. While there are various scales for assessing dementia progression, the Global Deterioration Scale (GDS) for Assessment of Primary Degenerative Dementia is the most often used also known as  The Reisberg Scale.

According to the GDS, Alzheimer's disease is divided into seven phases, each of which corresponds to one of four categories: no Alzheimer's, moderate Alzheimer's (early-stage), Moderate Alzheimer's (middle-stage), and extreme Alzheimer's (last-stage). 

The chart mentioned below represents the Global Deterioration Scale (GDS) for Assessment of Primary Degenerative Dementia as follows:

Global Deterioration Scale (GDS) / The Reisberg Scale

Diagnosis Stage Signs and Symptoms Expected Duration of Stage
No Dementia

Stage 1:

No cognitive Decline

– Normal function

– No memory loss

– People who do not have dementia are classified as Stage 1 patients.

No Dementia

Stage 2:

Very Mild Cognitive Decline

– Forgets names

– Misplaces familiar objects

– Symptoms not evident to loved ones or doctors

No Dementia

Stage 3:

Mild Cognitive Decline

– Increased forgetfulness

– Slight difficulty concentrating

– Decreased work performance

– Gets lost more frequently

– Difficulty finding right words

– Loved ones begin to notice

This period lasts an average of 2years to 7 years.

Stage 4:

Moderate Cognitive Decline

– Difficulty concentrating

– Forgets recent events

– Cannot manage finances

– Cannot travel alone to new places

– Difficulty completing tasks

– In denial about symptoms

– Socialization issues: detach from friends or family

– Physicians can detect cognitive problems

This period lasts an average of 2 years.

Stage 5:

Moderately Severe Cognitive Decline

– Major memory deficiencies

– require support with ADLs (dressing, bathing, etc.)

– Forgets important information such as an address or phone number

– Doesn’t know the time or date

– Doesn’t know where they are

This period lasts an average of 1.5 years.

Stage 6:

Severe Cognitive Decline (Middle Dementia)

– Cannot do ADLs without assistance

– Forgets names of family members

– Forgets recent events

– Forgets major events in past

– Difficulty counting down from 10

– Incontinence (loss of bladder control)

– Difficulty speaking

– Personality and emotional changes

– Delusions

– Compulsions

– Anxiety

This period lasts an average of 2.5 years.

Stage 7:

Very Severe Cognitive Decline (Late Dementia)

– Cannot speak or communicate

– Require help with most activities

– Loss of motor skills

– Cannot walk

This period lasts an average of 1.5 to 2.5 years.


Dementia Care

For many families, caring for someone with dementia is a team effort that involves many people sharing tasks and responsibilities. Taking care of another person, no matter what type of caregiver you are can be stressful at times. These suggestions and recommendations may be useful for day-to-day work and care for Dementia caregivers as follows:

Dementia Care: Care of Everyday tasks

Dementia patients will require support with simple daily routines. This includes things like bathing, grooming, and dressing. Helping the individual in keeping track of to-do lists, appointments, and events in a notepad or calendar, giving the person enough time to eat and provide meals in a consistent, familiar location, and being gentle and considerate are the cares that we can provide to the people with dementia. It might be difficult for a person to require assistance with such basic tasks.

Dementia Care: Care of Changes in Communication and Behavior

Communication can be challenging as people with Alzheimer's and similar dementias have problems with remembering things.  You can do the following to make communication easier:

  • Listen to his or her problems and frustrations while speaking softly. Make an effort to demonstrate that you understand his or her situation.
  • Allow the person to maintain as much control as possible over his or her life. Respect the personal space of others.
  • Include quiet times as well as activities throughout your day.
  • To make the person feel safer, keep well-loved artifacts and photographs about the house.
  • Maintain a two-way dialogue for as long as possible.

Dementia Care: Care of a Healthy and Active Lifestyle

Healthy eating and physical activity are beneficial to everyone, but they are especially important for those with dementia. People with dementia may lack motivation in initiating physical activities as the disease progresses, which can be challenging. Here are a few points that might be useful:

  • Consider many hobbies that a person can enjoy to stay active, such as housework, cooking, exercise, and gardening. If music motivates the person, include it in the exercises or activities. If feasible, dance to the music.
  • Consider how much activity you can fit into a single day. It might be advisable to do a few brief "mini-workouts."
  • Every day, go for a walk together. Exercise is beneficial to caretakers as well!
  • Buy a variety of healthy, easy-to-prepare foods. Allow the person to choose what he or she wants to eat.

Dementia Care: Care of Home Safety

As a caregiver or family member of a dementia patient, you can take certain steps to make the home a safer environment. Consider the following suggestions:

  • Safety plugs should be inserted into unused electrical outlets, and cabinet doors should have safety locks.
  • If you have staircases, make sure they are equipped with a handrail.
  • Make sure the person has adequate lighting in all of the rooms and outdoor spaces he or she accesses.
  • Tag your loved ones with GPS enabled device in case they have walked outside in your absence, and end up somewhere they don't recognize the home address.

Dementia Care: Care of Yourself as a Dementia Caregiver

It takes a lot of time and effort to care for someone who has dementia. It can be both lonely and irritating at the same time. You might even become frustrated, which could be a sign that you're pushing yourself to do too much. It is equally important to give time to take care of yourself too. Here are some suggestions that may help:

  • When you need help, ask for it. You can ask your family and friends for help.
  • Eat nutritious foods, get plenty of rest, and exercise. It can assist you in staying healthy and active for a longer amount of time.
  • Seek the advice of a psychiatrist to help you cope with stress and worry.
  • Join an online or in-person caregiver support group. It is great to have chat with someone who can understand what you are going through.


In conclusion, learning about your loved one’s disease will help you know what action to take as dementia progresses and what you can do. People with dementia symptoms may forget where they've walked, and end up somewhere they don't recognize. When your loved ones are continually putting their physical safety at risk, it is time to consider a Nursing care home. If you are searching for a Nursing Care Home that cares for your loved ones, Arogin Care Home can be your first choice.

Arogin Care Home offers a customized treatment plan, a healthy diet, 24-hour support and supervision, and social activities that not only benefit your loved ones physically but also mentally and socially.

FAQs on Dementia Care:

1. Can dementia be cured?

Ans. Patients with Dementia need specialized care and attention. Because dementia is caused by a variety of disorders, there is unlikely to be a single dementia cure. However, specialized care and attention provided by the Nursing care homes not only improve the quality of life for patients but also reduce unnecessary hospitalizations expenses.

2. What is the best care for dementia patients?

Ans. To help the person stay calm and oriented, dressing and grooming, talking to the person, helping them with memory loss, managing behavior and sleep problems, and encouraging activities that are both stimulating and enjoyable are the best practices for care for dementia patients.

3. How can you tell if someone has Dementia or Alzheimer's?

Ans. Doctors diagnose Alzheimer's disease and other varieties of dementia based on a thorough medical history, physical examination, laboratory tests, and the distinct changes in thinking, day-to-day function, and behavior that each type is linked with. Since the symptoms and brain alterations of different dementias often overlap, it's more difficult to pinpoint the exact type of dementia.

4. Do people with Alzheimer's know they have it?

Ans. People with Alzheimer's disease and dementia are cognitively impaired, and they may not realize they have a problem. This is sometimes caused by a condition known as anosognosia (not to know a disease). As a result, if someone has Alzheimer's disease and also has anosognosia, they will be unaware of their condition.

5. When Should an Alzheimer's Patient Go to a Nursing Home?

Ans. Someone with dementia symptoms may forget where they've walked, and end up somewhere they don't recognize. It is said that when your loved ones are continually putting their physical safety at risk, it's time to consider a Nursing care home. Nursing care homes can offer a customized treatment program, a healthy diet, 24-hour support and supervision, and social activities.