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| Image Description: Yellow background with a cartoon image of 5 adults in the bottom left corner. White text on a burgundy bubble reads "MYTH: There is only one type of dementia" in the top left corner. In the bottom right corner, black text on a green bubble reads "FACT: We know about 10 different types of dementia. Each one is a little bit different! |
Myth 1. There is only one type of dementia.
Many people hear dementia and immediately think of Alzheimer's, perhaps even thinking that they are synonyms. Although Alzheimer's is the most common form of dementia, there are many others. Dementia is a term for a specific set of symptoms caused by changes to the brain, rather than one specific disorder. So far, we know of about 10 primary types of dementia. If you include subtypes, over 100 different types of dementia have been identified! Some symptoms are present with each type of dementia, but different mechanisms and presentations are present. Five of the most common types of dementia are described below.
1) Alzheimer's Disease affects around 60% of people living with dementia. It is characterized by protein clusters in the brain known as plaques and tangled proteins known as tangles. In earlier stages, changes to functioning are minimal and these increase as dementia progresses. The exact symptoms that will appear and their speed of progression can vary significantly between individuals.
2) Vascular Dementia affects about 20% of people living with dementia. This type of dementia is caused by problems with blood circulation to the brain. There are different subtypes based on the cause of the damage and the area of the brain that is affected. Typically, early symptoms include changes in one's ability to plan and make decisions and changes in motor function. Symptoms tend to occur slowly.
3) Dementia with Lewy Bodies accounts for about 10% of dementia diagnoses. It is caused by protein deposits in the brain known as Lewy bodies. Unlike most types of dementia, Dementia with Lewy Bodies affects slightly more men than women. This type of dementia has a similar age of onset to Alzheimer's, often between the ages of 60 and 85. Changes to memory are less likely to occur in the early stages, and hallucinations or other changes to visual-spatial perception are common. Motor symptoms are also more likely to occur than other types of dementia.
4) Frontotemporal Dementia (FTD) more commonly affects younger people and is usually diagnosed between the ages of 45 and 65. Although frontotemporal dementia only makes up about 5% of total dementia diagnoses, it encompasses around 20% of cases diagnosed before age 65. As this type of dementia affects the frontal and temporal regions of the brain, it is more likely to cause behavioural and speech changes. In the early stages, it is uncommon to experience changes in time perception and memory; these typically occur later on in the progression.
5) Mixed Dementia it is possible to experience multiple types of dementia at once, this is known as mixed dementia. Most frequently, this presents as Alzheimer's alongside Vascular Dementia. It is difficult to know the true incidence of mixed dementia and it is rarely diagnosed. Typically, mixed dementia is found during an autopsy and the individual where the individual had been diagnosed with one type of dementia.
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| Image Description: Blue background featuring an image of three senior women. White text on a burgundy bubble that reads "MYTH: Everyone who develops dementia will become violent" and black text on a green bubble that reads "FACT: Only about 1/5 of people with dementia experience aggressive behaviour, and there is usually an event that triggers the response" |
Myth 2. People with dementia are prone to violence.
Although it is true that aggression may increase with dementia, this only occurs in about 20% of people diagnosed. This change is most likely to occur in the mid-late stages of dementia and can increase as cognitive function decreases. When aggression does occur, it is typically reactive. Due to this, it can be less stigmatizing to refer to these occurrences as reactive behaviours and reframing them in such a way can help us to respond more appropriately. A reactive reaction is something done in response to something that is negative, frustrating, or confusing in ones environment. Reactive reactions are not always aggressive or violent. They may also involve agitation (e.g. pacing, repetitive movements), withdrawal, or other previously atypical behaviours.
Therefore, we should not assume that any given person with dementia is aggressive. However, we should be aware that if reactive behaviours occur it is one possible response to the changes that have affected memory, judgement, and mood. Addressing the possible causes of the behaviour may help to limit responsive behaviours, including aggression. A physical sensation such as fatigue or pain, an emotional response such as anger, grief, or fear, or too much or too little stimulation may all trigger these behaviours.
When faced with reactive reactions it can be helpful to maintain a sense of calm, reduce noise, simplify tasks, or redirect attention. However, as a carer or community partner, your safety is important as well. Ensure the ability to leave the room remains an option if this is a concern. Reactive behaviours can impact the quality of life for the person with dementia and changes to care plans may help to limit the impact.
For more information on different types of dementia visit:
https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia
For more information on dementia and violence visit:
https://alzheimer.ca/en/help-support/im-caring-person-living-dementia/understanding-symptoms/responsive-reactive-behaviours
Other sources
Dementia Australia https://www.dementia.org.au/information/about-dementia/types-of-dementia
Alzheimer Calgary https://www.alzheimercalgary.ca/learn/types-of-dementia
Muller-Spahn, F. (2003). Behavioral disturbances in dementia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181717/