Types of Dementia

"Dementia" is an umbrella - the type underneath changes what to expect, how fast things move, and which treatments help. Here are the main types, plainly.

Alzheimer's disease (60-70% of cases)

• Starts with recent-memory failure - new information will not stick
• Gradual, steady progression over years
• Abnormal proteins (amyloid, tau) damage brain cells
• The type the dementia medicines (donepezil and relatives) were designed for

Vascular dementia (second commonest)

• Brain damage from strokes or diseased small vessels
• Often progresses in steps - stable, then a dip after a small stroke
• The most preventable type: blood pressure, diabetes and smoking control genuinely slow it

Lewy body dementia

• Fluctuating alertness (clear one hour, confused the next), vivid visual hallucinations, sleep disturbances, and Parkinson-like movement problems
• Important: severe reactions to certain antipsychotic medicines - needs a specialist's care

Frontotemporal dementia

• Younger onset (often 50s-60s); starts with personality, behaviour or language change - memory spared early
• The "he is just not himself anymore" type - disinhibition, apathy, or loss of language

Mixed and others

• Mixed dementia (Alzheimer's plus vascular) is common in the very old
• Rarer types: Parkinson's disease dementia, Huntington's, alcohol-related, and dementia following brain injury

Why the type matters

Vascular dementia rewards aggressive risk-factor control; Lewy body dementia changes which medicines are safe; frontotemporal dementia reshapes behaviour before memory. A proper diagnosis - history, examination, blood tests, often a brain scan - is the first treatment decision.

One-line summary

The main dementia types are Alzheimer's (memory first, gradual), vascular (stepwise, preventable), Lewy body (fluctuations and hallucinations), and frontotemporal (personality first, younger) - each with its own course and care, which is why a real diagnosis beats the umbrella word.