Dementia - What Happens
dementia progresses depends on what is causing it and
the area of the brain that is affected. Some types of dementia progress slowly
over several years. Other types may progress more rapidly. If
vascular dementia is caused by a series of small
strokes, the loss of mental skills may be gradual. If
it is caused by a single stroke in a large blood vessel, loss of function may
The course of dementia varies greatly from one
person to another. Early diagnosis and treatment with medicines used for
Alzheimer's (cholinesterase inhibitors such as
donepezil [Aricept]) may help preserve mental functioning for a while in people
who have vascular dementia,
dementia with Lewy bodies, or
Parkinson's disease.2 Even
without these medicines, some people remain stable for months or years, while
others decline rapidly.
Many people with dementia are not aware
of their mental decline. They may deny their condition and blame others for their
problems. Those who are aware may mourn their loss of abilities
and become hopeless and depressed.
Depending on the type of
dementia, the person's behavior may eventually become out of control. The
person may become angry, agitated, and combative or clingy and childlike. He or
she may wander and become lost. These problems can make it difficult for family
members or others to continue providing care at home.
Even with the best care, people with dementia tend to
have a shorter life span than the average person their age. The progression
varies depending on the disease causing the dementia and whether the person has
other illnesses such as diabetes or heart disease. Death usually results from lung or kidney infections
caused by being bedridden.
For more information on
decisions you may face as your loved one's condition progresses, see the topic
Care at the End of Life.
What to think about
Many older people have a
slight loss of mental skills (usually recent memory) that doesn't affect their
daily functioning. This is called
mild cognitive impairment by some. People who have mild impairment may be in
the early stage of dementia, or they may stay at their present level of ability
for a long time.