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What are the symptoms of dementia?

Dementia is an umbrella term for a range of progressive disorders affecting the brain.

There are over 200 types of dementia. Alzheimer’s disease is the most common. Each type of dementia stops a person’s brain cells working in specific areas, affecting their ability to remember, think and speak.

Doctors typically use the word ‘dementia’ to describe a set of common symptoms that get worse over time, particularly:

Common symptoms of dementia

Memory problems

  • increasing forgetfulness
  • difficulty retaining new information
  • getting lost in places that used to be familiar
  • struggling with names
  • misplacing things frequently

Cognitive ability

  • difficulty understanding time and place, eg getting up in the middle of the night to go to work, even if they’re retired
  • difficulty with choosing what to buy and paying when shopping
  • struggling with decision-making and reasoning
  • loss of interest in activities they used to enjoy
  • restlessness, eg pacing, fidgeting and trying to leave the house

Communication

  • struggling to find the right words
  • repeating themselves often
  • difficulty making and following conversation
  • difficulty reading and writing
  • becoming quieter and more withdrawn
  • loss of interest in socialising
  • loss of confidence
  • changes in personality and behaviour
  • mood swings, anxiety and depression

Although dementia has a common set of symptoms, each type presents itself differently, and people may have some or all of the symptoms. They may also have more than one type of dementia (‘mixed dementia’), with symptoms of each.

Here, you can find out about the main symptoms of the most common types of dementia. Be aware that everyone has their own experience of dementia, and the symptoms may vary between people.

  • difficulty remembering recent events while having a good memory for past events
  • poor concentration
  • difficulty recognising people or objects
  • poor organisational skills
  • confusion
  • disorientation
  • slow, muddled or repetitive speech
  • withdrawal from family and friends
  • problems with decision-making, problem-solving, planning, and sequencing tasks

The signs and symptoms of vascular dementia depend on which area of the brain has been affected (usually by a stroke).

The main symptom is difficulty with language, reading, writing and communication.

If the area of the brain that is responsible for memory has not been damaged, memory problems may not be an issue initially, although they may develop later on.

There are two main types of frontotemporal dementia: behavioural variant frontotemporal dementia (Pick’s) and primary progressive aphasia.

Symptoms common to both types of frontotemporal dementia include:

  • changes in behaviour and personality
  • disinhibition and inappropriate social behaviour
  • changes to eating patterns, such as bingeing on food, especially sweet foods

Initial symptoms of behavioral variant frontotemporal dementia include:

  • changes in behaviour and personality
  • apathy
  • obsessive or repetitive behaviours
  • loss of empathy
  • changes in appetite and food preferences
  • difficulties with decision-making, problem-solving and concentration

Initial symptoms of primary progressive aphasia include:

  • language difficulties
  • speech problems
  • reduced comprehension
  • loss of understanding of familiar words
  • difficulty recognising people or objects
  • recurring visual hallucinations (seeing things that are not there – these can be pleasant or upsetting)
  • disturbed sleep, known as Rapid Eye Movement (REM) sleep disorder, with restlessness and intense dreams/nightmares
  • sudden changes and fluctuations in alertness – people may stare blankly into space, seem drowsy and lethargic and spend a lot of time sleeping
  • slow movement, difficulty walking, shuffling, or appearing rigid
  • tremors – usually in the hands while at rest
  • problems with balance, leading to falls
  • bladder and bowel problems
  • difficulties with swallowing
  • mood and behaviour changes such anxiety and depression
  • delusions and paranoia, including Capgras syndrome, where the person believes that a friend or family member has been replaced by an imposter
  • changes in blood pressure
  • changes in body temperature
  • impaired sense of smell

Memory is often less affected than with other types of dementia.

Mixed dementia refers to a person having more than one type of dementia at the same time.

The symptoms vary depending on the part of the brain affected. If the person has two types of dementia, the symptoms can be more noticeable and appear to progress more rapidly.

  • involuntary movements
  • poor reasoning, judgement, planning and decision-making abilities
  • changes in emotional engagement
  • poor control of impulses and temper
  • attention problems
  • difficulty learning new things
  • slowed thinking
  • reduced motivation
  • reduced insight
  • depression or anxiety
  • difficulty swallowing
  • speech difficulties
  • balance problems, leading to falls

There are two main types of alcohol-related dementia: Wernicke’s encephalopathy and Korsakoff’s syndrome.

Symptoms common to both types of alcohol related dementia include:

  • deteriorating ability in planning, decision-making and assessment of risk
  • changes in personality
  • reduced impulse and emotional control, which may lead to conflict and socially inappropriate behaviour
  • problems with attention, concentration and memory

Symptoms of Wernicke’s encephalopathy often come on suddenly and include:

  • movement and balance problems
  • loss of coordination
  • confusion
  • disorientation
  • abnormal eye movements

Korsakoff’s syndrome occurs more gradually. Symptoms include:

  • attention and concentration problems
  • gaps in memory, which are usually filled inaccurately (confabulation)
  • difficulty learning new information
  • tremor, shaking, slowness of movement and rigidity
  • problems with balance, leading to an increased risk of falls
  • difficulty swallowing
  • difficulties with speech

As Parkinson’s progresses, cognitive processes may be affected and get worse over time. These include:

  • forgetfulness
  • slowed thought processes
  • reduced concentration
  • difficulties with reasoning, judgement, planning and decision-making
  • difficulty learning new things
  • reduced motivation
  • reduced temper control
  • hallucinations and delusions
  • depression or anxiety

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