Dementia signs, symptoms and diagnosis

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What is dementia?

Dementia, and the symptoms you see, is a collective term for changes that are made in the brain. Changes can occur due to different causes and can happen in different areas to produce differing symptoms; which is why everybody who is diagnosed with dementia is individual. ‘Dementia’ refers to the range of symptoms that can be seen when these changes take place; these changes will mainly affect reasoning, memory and behaviour; dependant on which area of the brain is affected' (NHS, 2021).

What are the symptoms of the different types of dementia?

There are as many as 100 different types of dementia, however Alzheimer's is the most prominent and accounts for around 60% of diagnosed cases (Dementia UK, 2021). 

The 2 most common types of dementia experienced in the UK and some of the symptoms you might experience include:

1. Alzheimer's

Common symptoms include:

• memory loss or impairment (commonly forgetting names of people, places and times)
• mood changes
• problems with judging distances
• problems with speech (struggling to follow a conversation or repeating themselves)
• poor concentration
• trouble with organisation or planning (difficulty in carrying out a sequence of tasks)
• problems with orientation to time place or person (Alzheimer's society, 2021).

As this is a progressive condition, symptoms may be mild at first but often worsen with time.

2. Vascular dementia

Vascular dementia is caused by reduced blood supply to the brain due to diseased blood vessels or a stroke, for example.

Common early symptoms of vascular dementia include:

• problems with problem solving, decision making, planning and organisation
• confusion and reduced speed of thought
• problems maintaining a concentration
• speech difficulties
• mood changes, including anger and depression.

Memory loss is not usually a main symptom in the early stages. Many people with vascular dementia are aware that their thinking and processing is impaired, this can often lead to a lot of frustration and distress on the persons part (Alzheimer's society, 2021).

This is by no means an exhaustive list symptoms someone might display when suffering with dementia, so if you are noticing any changes in personality, memory decline, difficulties with problem solving or problems with communication, it's important to speak to your GP, or the GP of those you are concerned about, to look into the potential causes of this.

Around 1 in 10 people is also diagnosed as having more than one type of dementia - or 'mixed dementia' (Dementia UK, 2021).

Getting a diagnosis

Early diagnosis is important to give people the opportunity to make plans for their care and be aware of any support or medications that is available to manage their symptoms.

Knowing what to expect can also help to alleviate anxiety and give you a sense of control over your diagnosis (Dementia UK, 2021).

If you are experiencing any of the common symptoms of dementia your GP will likely want to carry out a thorough assessment to determine the underlying cause of this. Whilst there is no one test that can confirm a diagnosis of dementia, there are a range of tests that your GP can carry out to help rule out other conditions that can have similar presentations, for example the MMSE (Dementia UK, 2021).

• MMSE (Mini-mental state examination): this is the test most often used by GPs to assess people with probable dementia. The MMSE assesses a person’s memory and reasoning powers by asking a series of questions. This test takes about 10 minutes to administer and a poor test score suggests that there may be a problem, although it cannot diagnose dementia on its own (Alzheimer's association, 2021).

This assessment cannot confirm a diagnosis on its own and brain scans, blood tests and a more detailed assessment of the individual’s personal and medical history will help rule out other possibilities. These tests help to differentiate between dementia and other conditions that may cause cognitive impairments with similar symptoms such as depression.

If an initial diagnosis is made of possible dementia it may be necessary to refer the individual on for specialist review such as by a geriatrician, neurologist or a psychiatrist (NHS, 2021).

Self-help and treatments for dementia

These treatments will not revert any of the changes made but can help with symptom management:

• Exercise and mobility – the more mobile someone stays, the better it will be for their health and wellbeing. You don't need  to join a gym or start running marathons to feel the benefit. Moving more while doing something you enjoy can work wonders for your mind and body and really boost your feelgood factor. Take a look at our article for some ways you can get active in a way that suits you. You may benefit from speaking with and occupational therapist or physiotherapist to if you need some extra help with staying safe in your environment (Age UK, 2021).
• Getting support - A diagnosis of dementia can come as a shock, even if you have been expecting it. It’s natural to feel worried about the future but, remember, you are not alone (Age UK, 2021). If you are feeling worried you can give us a call on 0800 003 004 to talk things through with one of our nurses or counsellors for some extra support.
  Dementia affects not only the life of the person who has it but also the lives of their loved ones. Advice and support is available for all affected –the NHS, social services and voluntary organisations can all help (see list of useful links).
• Eating well - if you are having difficulties with this then your GP may be able to help by prescribing additional nutritional supplements (Age UK, 2021).
• Sleep – To encourage a healthy sleep pattern try to limit daytime naps, avoid caffeine too late in the day, incorporate exercise during the day and find ways to encourage relaxation (Alzheimer's society, 2021). We have lots of information and tips to help you get a better night's sleep on or sleep hub.
• Stay as independent as possible, tackling daily tasks as you have always done. If some things become more difficult, think of ways to make them easier or ask for help. Your GP will be able to advise you about the services and treatments that are available to you.
• Keep busy and continue with the activities and hobbies you’ve always enjoyed as these can be a great comfort and stress buster.
• Keep a diary and write down the things you want to remember.
• Put labels around the house, such as on cupboards and drawers.
• Medication can help slow down the progression of dementia symptoms in some cases and there are also medications available to help manage associated conditions (NHS, 2021) - if you would like to know more about the medications that may be available to you please get in contact with your GP or call us here at Health at Hand on 0800 003 004 to speak with one of our pharmacists (Available 8am-8pm Monday to Friday, 8am-4pm Saturdays and 8am-12pm on Sundays).
• It is important that you continue to attend any of your medical appointments, and to follow up with your GP to monitor how your needs may have changed. If you are having difficulties with this it may be that a friend or family member, or a community practitioner, could assist you with attending your appointments.
• Admiral nurses are specialist nurses who work to support people with dementia and their families. If you are finding things difficult and need a little extra support you may want to look into getting in contact with an admiral nurse; you can call the admiral nurse helpline on 0800 888 6678; this line is available 9am-9pm Monday to Friday and 9am-5pm on Saturdays (Dementia UK, 2021).

To discuss what medications or treatments might help you, or your loved one, to manage the symptoms of dementia please speak to your GP or specialist.

Useful links

Age UK - www.ageuk.org.uk

Dementia UK - Specialist support to families facing dementia

Alzheimer’s Society – www.alzheimers.org.uk

Carers UK - www.carersuk.org

Citizens Advice Bureau - www.citizensadvice.org.uk

National Dementia Action Alliance – We are the alliance for organisations across England to connect, share best practice and take action on dementia.

NHS Choices - About dementia - NHS (www.nhs.uk)

References

Age UK, 2021. Being active as you get older. Available at: Exercise advice for keeping active as an older adults | Age UK. (Accessed 2 March 2021).

Age UK, 2021. Healthy eating. Available at: Healthy eating advice for the elderly | Age UK. (Accessed 2 March 2021).

Age UK, 2021. Loneliness. Available at: Combating elderly loneliness | Age UK. (Accessed 2 March 2021).

Alzheimer's association, 2021. How is Alzheimer's disease diagnosed? Available at: Tests for Alzheimer's & Dementia | Alzheimer's Association. (Accessed 2 March 2021).

Alzheimer's society, 2021. Sleep and dementia risk. Available at: Sleep and dementia risk | Alzheimer's Society. (Accessed 2 March 2021).

Alzheimer's society, 2021. Symptoms of Alzheimer's disease. Available at: Alzheimer's disease | Alzheimer's Society. (Accessed 2 March 2021).

Alzheimer's society, 2021. Vascular dementia: what is it and what causes it? Available at: Vascular dementia: what is it, and what causes it? | Alzheimer's Society. (Accessed 2 March 2021).

Dementia UK, 2021. Getting a diagnosis of dementia. Available at: Getting a diagnosis of dementia - Dementia UK. (Accessed 2 March 2021).

Dementia UK, 2021. Tests for dementia - including Alzheimer's disease. Available at: Tests for dementia - including Alzheimer's disease - Dementia UK. (Accessed 2 March 2021).

Dementia UK, 2021. Types and symptoms of dementia. Available at: Types and Symptoms - Dementia UK. (Accessed 2 March 2021).

Dementia UK, 2021. What is an admiral nurse and how can they help? Available at: An Admiral Nurse is a Specialist Dementia Nurse | Dementia UK. (Accessed 2 March 2021).

NHS, 2021. About dementia. Available at: About dementia - NHS (www.nhs.uk). (Accessed 2 March 2021).

NHS, 2021. How to get a dementia diagnosis. Available at: How to get a dementia diagnosis - NHS (www.nhs.uk). (Accessed 2 March 2021).

NHS, 2021. What are the treatments for dementia? Available at: What are the treatments for dementia? - NHS (www.nhs.uk). (Accessed 2 March 2021).