Dementia: Symptoms and treatment
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Symptoms
Dementia symptoms differ from one person to the next and may get worse over time. Symptoms may include memory loss as well as:
- difficulty focusing
- challenges with being understood
- difficulty understanding others
- changes in mood and behaviour
- loss of physical coordination
- confusion about place and time
- difficulty doing everyday tasks
Symptoms can differ:
- day to day
- in different settings
- at different times of the day
Some people have milder symptoms when they're rested and relaxed, while others have milder symptoms in familiar settings. Sometimes it's difficult to understand what's causing or contributing to symptoms.
Memory loss
Memory loss is not always caused by dementia. Other types of memory loss include age-related memory loss and mild cognitive impairment.
Dementia-related memory loss is ongoing and tends to get worse over time. People living with dementia may forget things very quickly and may:
- not know where they are
- repeatedly ask the same question
- forget what happened moments earlier
They may be able to remember:
- some things and not others
- events from long ago but not recent ones
Age-associated memory loss
With memory loss related to aging, difficulties with memory may happen but:
- don't noticeably disrupt your daily life
- don't affect your ability to complete tasks
- it is possible to learn and remember new things
Some examples of age-related memory loss may include:
- taking longer to learn new information
- forgetting the name of an acquaintance
- having difficulty finding the right words in a conversation
- not remembering details of an event that took place a year ago
Mild cognitive impairment
People with mild cognitive impairment have memory loss symptoms that go beyond age-related memory loss; however, these symptoms aren't severe enough to interfere with normal daily activities and routines. While those with mild cognitive impairment are at higher risk of developing dementia, not all of them will develop it.
Talk to a health care provider if you have concerns about memory loss in yourself or someone you care about.
Difficulty staying focused
The ability to focus on a conversation or activity may decline as dementia progresses. People living with dementia might walk away in the middle of a conversation or a task. This may be the result of a:
- reduced ability to filter out distractions like background noise
- lack of interest
Challenges with being understood
Some people living with dementia can speak fluently and at length. Others may have increasing difficulty communicating their thoughts. This is known as expressive aphasia, and symptoms may include:
- leaving words out of a sentence
- difficulty saying some sounds or words
- substituting sounds or words that don't fit
- using basic language (for example, short and simple sentences)
If someone living with dementia can't remember the names of familiar objects or people, they might:
- describe it
- use a synonym
- use a word that sounds similar but isn't accurate
Difficulty understanding others
People living with dementia may have difficulty understanding things they hear or read. They might not realize that their sentences don't make sense. This is known as receptive aphasia and its symptoms may include:
- trouble understanding what people say and write
- misinterpreting words, gestures, pictures or drawings
- disorganized speech (for example, words may not be in the right order)
- responding in a way that doesn't make sense to others (for example, making up words)
Changes in mood and behaviour
People living with dementia may experience changes in their mood and behaviour. These changes are different from person to person and may get worse over time.
Changes in mood may include:
- anxiety
- depression
- loss of interest in activities they used to enjoy
'Responsive behaviours' are actions, words or gestures that are in response to something in the social or physical environment. Some examples of responsive behaviours for people living with dementia may include:
- shouting
- agitation
- irritability
- hallucinations
- sleep disruptions
- hitting or grabbing
- making sudden noises
- searching (sometimes called wandering)
Responsive behaviours can be triggered if someone living with dementia feels:
- sick
- frustrated
- grief or loss
- lonely or bored
- afraid or unsafe
- discomfort or pain
- tired or exhausted
- overwhelmed or rushed
They can also be caused by:
- sensory overload
- uncomfortable lighting
- loud or disruptive noises
- side effects from medication
- losing possessions or independence
- unfamiliar situations or surroundings
- changes or reductions in physical and mental abilities
Loss of coordination
People living with dementia may lose fine motor and coordination skills. Even if they understand and know what they want to do, they might not be able to do it. For instance, they may find it challenging to button their shirt or make certain sounds (saying "rayround" instead of "playground" for example). This is called apraxia.
Apraxia may progress gradually or quickly. Loss of coordination and manual skills can lead to difficulties with activities such as:
- eating
- bathing
- dressing
- using a phone
- pouring a drink
- using buttons or zippers
Confusion about place and time
Dementia can affect the internal clock that keeps us on a regular eating and sleeping schedule. People living with dementia may find it hard to judge the passage of time, especially when symptoms become more severe. They might:
- repeatedly ask what the time is
- want to leave a place as soon as they arrive
- feel they've been alone for hours when it's only been a few minutes
An inability to keep track of time can result in them avoiding social activities. They may worry about:
- being late
- missing the bus
- overstaying their welcome
People living with more severe symptoms of dementia may feel confused about where they are as the condition progresses. This often leads to searching (sometimes called wandering) or getting lost, even in familiar places. They may search due to:
- excess energy
- discomfort or pain
- boredom or irritability
- a change of environment
- looking for a place or person
- confusion between night and day
Difficulty with everyday tasks
People living with dementia may find it increasingly difficult to do activities that require organization, planning, abstract thinking or concentration. Familiar tasks such as grocery shopping, cooking, using the television remote, and keeping track of payments may become more challenging.
Treatment
There is currently no cure for dementia, but there are treatments that may help manage cognitive issues and changes in mood and behaviours. They include non-drug therapies and medication.
Non-drug therapies
While symptoms vary and often get worse over time, there are non-drug therapies that may help manage symptoms such as cognitive issues and changes in mood and behaviour. These therapies are often used before choosing medication.
For some people, cognitive stimulation therapy can maintain or improve thinking ability through activities that stimulate the brain. Health professionals who conduct this type of individual or group therapy may include:
- psychologists
- social workers
- occupational therapists
Other types of non-drug therapies that may help with mood and behaviour changes include:
- massage
- art programs
- music programs
- social programs, like:
- book clubs
- intergenerational clubs
- animal-assisted therapy
Some techniques that might reduce symptoms include:
- reassurance from others
- keeping an active social life
- having a variety of activities to take part in
- meaningful engagement, such as continuing favourite activities and finding new ones
- being in familiar settings (avoid changing the location of objects or furniture in the home)
- identifying and addressing personal triggers that cause distress and impair functioning, such as:
- immediate surroundings
- certain times of the day
- distractions in the environment
For more information on treatments and therapies, talk to a health care provider.
Find out about:
Medication to treat cognitive issues
There are 4 medications approved by Health Canada to treat dementia:
- Aricept™ (brand name) or Donepezil (generic name)
- Exelon™ (brand name) or Rivastigmine (generic name)
- Reminyl ER™ (brand name) or Galantamine (generic name)
- Ebixa®(brand name) or Memantine (generic name)
These drugs do not cure or slow the progression of dementia. Instead, they aim to temporarily improve:
- memory
- communication abilities
- ability to perform daily activities
- awareness of time, place and self
Medication to treat changes in mood and behaviour
Non-drug approaches (e.g., therapies and programs) are often the first approach to addressing changes in behaviours. However, health care providers may prescribe medication to treat dementia-related symptoms or conditions, such as:
- psychosis
- depression
- sleep disturbances
- responsive behaviours (such as hitting, grabbing or repetitive actions)
Always seek a health care provider's advice before trying a new medication.
Related links
- Dementia awareness resources toolkit
- Alzheimer's Society of Canada: The 10 warning signs of dementia
- Alzheimer's Society of Canada: How can I treat dementia?
- Canadian Institute for Health Information: Dementia prevention and treatment
- The Centre for Addiction and Mental Health: Dementia
- Forward with dementia: Managing symptoms and changes
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