2017, Dementia

10.15.17 Dora and the Explorers – Some Things I Learned About Dementia reposted from November 2014 with updated information

October 15, 2017 – This one is very basic information about Alzheimer’s. I do not have Alzheimer’s, I have Vascular Dementia and Frontotemperal Dementia. Since I want ya’ll to know as much as you can about what you might see happening here’s what I found on the progression of both.

From the Alzheimer’s website about Vascular Dementia this is what they say about its progression:

Vascular dementia develops when brain cells are deprived of oxygen and die. This happens either because of diseases of the very small blood vessels deep in the brain (known as subcortical vascular dementia), or after a major stroke or a series of smaller strokes (both known as stroke-related dementia). The series of smaller strokes is what I’ve had.

It is sometimes difficult to tell whether a person has Alzheimer’s disease or vascular dementia. It is also not unusual to have a mixed form of dementia, meaning the person has both vascular dementia and Alzheimer’s disease together.

Subcortical and stroke-related vascular dementia share some symptoms but have others that differ. They also tend to progress in different ways. Subcortical vascular dementia usually develops gradually and progresses slowly, like Alzheimer’s disease. In contrast, when vascular dementia follows a large stroke, symptoms usually develop suddenly. Stroke-related dementia often then follows a ‘stepped’ progression, with long periods when symptoms remain the same and short periods when they suddenly worsen (this pattern is seen because each stroke further damages the brain).

The symptoms of vascular dementia are overall broadly similar to those of Alzheimer’s disease – and become more similar as the dementia progresses – but with some important differences. The main early symptoms of vascular dementia are often not forgetfulness but rather:

  • difficulties with planning or organizing, following steps (eg cooking a meal) or making decisions
  • slower speed of thought
  • problems concentrating, including short periods of confusion.

You can help someone with vascular dementia by breaking tasks down into smaller steps and giving them plenty of time to think and speak.

A person with early stage vascular dementia is prone to apathy, mood swings and being unusually emotional. They are also particularly likely to have anxiety and depression, partly because they are more aware of the problems their dementia is causing.

Vascular dementia after a major stroke is often accompanied by physical symptoms, such as weakness of a limb, or problems with vision or speech. These early symptoms arise when the stroke has damaged a particular part of the brain. With rehabilitation the symptoms might get a little better or stabilise for a time.

As vascular dementia progresses, the symptoms become closer to those of middle and eventually later stage Alzheimer’s disease. Problems with memory loss, confusion, disorientation, reasoning and communication all become worse. The behavioral changes seen as vascular dementia progresses, such as irritability and agitation, are also similar to those of Alzheimer’s disease. Delusions, and less often hallucinations, are also seen. The late stage of vascular dementia is largely as described above for Alzheimer’s disease.

Each person will experience dementia differently. On average, people with vascular dementia live for around five years after symptoms begin, less than the average for Alzheimer’s disease. In many cases, the person’s death will be caused by a stroke or heart attack. For more information about Vascular Dementia, see our page on vascular dementia.

Symptoms of Frontotemporal Dementia

Each case of FTD is different, but the illness generally becomes more distinguishable from other brain conditions as it progresses. Symptoms may occur in clusters, and some may be more prevalent in early or later stages. Here is a list of ten signs of FTD:

  1. Poor judgment
  2. Loss of empathy
  3. Socially inappropriate behavior
  4. Lack of inhibition
  5. Repetitive compulsive behavior
  6. Inability to concentrate or plan
  7. Frequent, abrupt mood changes
  8. Speech difficulties
  9. Problems with balance or movement
  10. Memory loss

From the Alzheimer’s website about progression of Frontotemporal Dementia (including Pick’s disease)

This type of dementia is caused by damage to the frontal and/or temporal lobes at the front and sides of the brain by the ears. My frontal and temporal lobes have significantly shrunk (they call it atrophy). These are the areas responsible for our behavior, our emotional responses and our language skills. There are three different types of frontotemporal dementia – one type that affects behaviour first, and two that affect language first.

During the early stages of frontotemporal dementia, memory of recent events may be unaffected. However, there will be other changes.

A person with behavioural variant frontotemporal dementia may appear uncharacteristically selfish and unfeeling. They may behave rudely, or may seem more easily distracted. Other early symptoms may include loss of inhibition, ritualised behaviour (eg tapping or repeatedly walking the same route) or compulsions and a liking for sweet foods. It is much more likely for those around the person to be aware of these changes than the person is themselves.

In a small number of people with frontotemporal dementia, the first symptoms are problems with recalling the names of objects and understanding words (semantic dementia) or with producing fluent speech (progressive non-fluent aphasia).

As frontotemporal dementia progresses, differences between these types lessen: people with the behavioural variant develop language problems and those with language problems develop behaviour changes. In the later stages, the symptoms of frontotemporal dementia become more similar to those of Alzheimer’s disease. There are some differences – for example, day-to-day memory loss and problems judging distance or seeing objects in three dimensions develop later in frontotemporal dementia, whereas changes in behaviour, such as agitation or aggression, develop earlier. Supporting a person with frontotemporal dementia can be a challenge as they may be younger and will have changes in behaviour and communication.

Each person’s experience of frontotemporal dementia will be different, but on average people live for six to eight years after symptoms begin. For more information on Frontotemporal Dementia, see our page on frontotemporal dementia.

This is the original blog from November 2014:

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Two things I’d like to share today are information from the alz.org site.

  • 10 Early Signs of Alzheimer’s
  • 7 Stages of Alzheimer’s.

autum branch with falling leaves divider
know the 10 signs
Could you spot the early signs of Alzheimer’s before the disease became severe? Often, Alzheimer’s symptoms are overlooked or misdiagnosed as other illnesses. Many times it is easily written off as being forgetful, or misdiagnosed as depression. The info graphic below (from dailyinfographic.com) lays out 10 early symptoms found in Alzheimer’s. While the disease will ultimately progress over time, early detection will delay the process. That means early diagnosis and early treatment will keep you or your loved ones with you that much longer.

There is also a comparison shown below between what is “typical” in an elderly person without Alzheimer’s compared to the actual Alzheimer’s warning signs.


autum branch with falling leaves divider

7 stages

It became obvious to my sister and I that Mama had Alzheimer’s when she was around the 4th to 5th stage. We realized soon that she had been going through the first four stages for maybe a couple of years without us realizing it. After that it was a little over a year that she went from stage 4/5 to stage 7. I haven’t started putting empty boxes of food back in the freezer like she did, which is what first alerted us to a problem. I have done smaller things that makes Roy shake his head because he knows they are not normal.

Below are three different ways to learn about the 7 stages of Alzheimer’s. First is a written explanation, second is a link to an Interactive tour of the brain showing the progression, and third is a graceful, poignant dance representation of the stages. I recommend watching all three. This is important information and it will stick with you better if you do.

Not everyone will experience the same symptoms or progress at the same rate. This seven-stage framework is based on a system developed by Barry Reisberg, M.D., clinical director of the New York University School of Medicine’s Silberstein Aging and Dementia Research Center.

curley dividersAlzheimer’s symptoms vary. The stages below provide a general idea of how abilities change during the course of the disease.

Stage 1: No impairment
Stage 2: Very mild decline
Stage 3: Mild decline
Stage 4: Moderate decline The stage I am in is between Stage 4 and Stage 5
Stage 5: Moderately severe decline
Stage 6: Severe decline
Stage 7: Very severe decline

STAGE 1: No impairment (normal function)
The person does not experience any memory problems. An interview with a medical professional does not show any evidence of symptoms of dementia.

STAGE 2: Very mild cognitive decline (may be normal age-related changes or earliest signs of Alzheimer’s disease)
The person may feel as if he or she is having memory lapses — forgetting familiar words or the location of everyday objects. But no symptoms of dementia can be detected during a medical examination or by friends, family or co-workers.

STAGE 3: Mild cognitive decline (early-stage Alzheimer’s can be diagnosed in some, but not all, individuals with these symptoms)
Friends, family or co-workers begin to notice difficulties. During a detailed medical interview,doctorsmay be able to detect problems in memory or concentration. Common stage 3 difficulties include:

  • Noticeable problems coming up with the right word or name
  • Trouble remembering names when introduced to new people
  • Having noticeably greater difficulty performing tasks in social or work settings
  • Forgetting material that one has just read
  • Losing or misplacing a valuable object
  • Increasing trouble with planning or organizing

STAGE 4: Moderate cognitive decline (Mild or early-stage Alzheimer’s disease)
At this point,acarefulmedicalinterviewshould be able to detect clear-cut symptoms in several areas:

  • Forgetfulness of recent events
  • Impaired ability to perform challenging mental arithmetic — for example, counting backward from 100 by 7s
  • Greater difficulty performing complex tasks, such as planning dinner for guests, paying bills or managing finances
  • Forgetfulness about one’s own personal history
  • Becoming moody or withdrawn, especially in socially or mentally challenging situations

STAGE 5: Moderately severe cognitive decline (Moderate or mid-stage Alzheimer’s disease)
Gaps in memory and thinking are noticeable,and individuals begin to need help with day-to-day activities. At this stage, those with Alzheimer’s may:

  • Be unable to recall their own address or telephone number or the high school or college from which they graduated
  • Become confused about where they are or what day it is
  • Have trouble with less challenging mental arithmetic; such as counting backward from 40 by subtracting 4s or from 20 by 2s
  • Need help choosing proper clothing for the season or the occasion
  • Still remember significant details about themselves and their family
  • Still require no assistance with eating or using the toilet

STAGE 6: Severe cognitive decline (Moderately severe or mid-stage Alzheimer’s disease)
Memory continues to worsen, personality changes may take place and individuals need extensive help with daily activities. At this stage, individuals may:

  • Lose awareness of recent experiences as well as of their surroundings
  • Remember their own name but have difficulty with their personal history
  • Distinguish familiar and unfamiliar faces but have trouble remembering the name of a spouse or caregiver
  • Need help dressing properly and may, without supervision, make mistakes such as putting pajamas over daytime clothes or shoes on the wrong feet
  • Experience major changes in sleep patterns — sleeping during the day and becoming restless at night
  • Need help handling details of toileting (for example, flushing the toilet, wiping or disposing of tissue properly)
  • Have increasingly frequent trouble controlling their bladder or bowels
  • Experience major personality and behavioral changes, including suspiciousness and delusions (such as believing that their caregiver is an impostor)or compulsive, repetitive behavior like hand-wringing or tissue shredding
  • Tend to wander or become lost

STAGE 7: Very severe cognitive decline (Severe or late-stage Alzheimer’s disease)

In the final stage of this disease, individuals lose the ability to respond to their environment, to carry on a conversation and, eventually, to control movement. They may still say words or phrases.

At this stage, individuals need help with much of their daily personal care, including eating or using the toilet. They may also lose the ability to smile, to sit without support and to hold their heads up. Reflexes become abnormal. Muscles grow rigid. Swallowing impaired.curley dividersTo learn more about the brain and specifically how Alzheimer’s changes it, CLICK HERE to go to Alz.org. If you find the brain steps 1-7 to be uninteresting, skip to step 8 where they start with the Alzheimer’s brain.

curley dividersSome of us learn things in different ways than others. I do better sometimes when I visually learn from seeing in action, rather than reading. I found this video which uses dance as a unique way of explaining the various stages.

As the three girls dance, the narrator explains the different stages of Alzheimer’s. Then, the purple dancer’s movements slowly begins to differ from the others, correlating to the mental and physical changes that mark each stage of the disease. Take a look.


dance you tube 7 stages autum branch with falling leaves divider

Please come back next time when I’ll share how Alzheimer’s drastically changes vision and about making a dementia friendly home. If you want to get an email whenever I post a blog (I write about other things, not just Alzheimer’s) find the “FOLLOW” box which is usually to the right hand side somewhere, enter your email and respond when the confirmation email is sent to you.

If you are in need of prayer for yourself, in your role as a caregiver, or if you have any specific questions please send me a comment with whatever information you want to share or ask about. I’ll say again that I’m not expert but I probably experienced with my mom a lot of things you’re going through and will try my best to help. If I don’t know the answer I will tell you I don’t know. I’ll never judge, I’ve been judged enough to last a life time and would never do that to someone else. My email address is rosalyn@selu.edu if that is an easier way to communicate.

autum branch with falling leaves divider

Philippians 4:6: “Don’t worry about anything; instead, pray about everything. Tell God what you need, and thank him for all he has done”.


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