Hannah C
Within this assignment I will be writing about the causes and symptoms of three types of dementia;
Alzheimer’s disease, vascular dementia and frontotemporal dementia. Additionally, I will explain the
progressive effects on an individuals mental and physical health as well as their quality of life for each
dementia. Each dementia will have a significant impact on an individual but symptoms and effects may vary
depending on the type of dementia they have. I will be highlighting these and therefore evaluating the
importance of understanding how the types of dementia can have a progressive effect on all aspect of a
person’s health and wellbeing.
P1: Explain the causes of three different types of dementia
Alzheimer’s disease
Even though Alzheimer’s disease is one of the most common forms of dementia, scientists don’t fully
understand what causes it yet. However, there are theories that are thought to explain what can result in
the loss of neurons and their connections, which may lead to this disease. The build-up of proteins, such as
amyloid and tau, are believed to interrupt the nerve cells passing signals to the brain effectively, eventually
causing different areas of the brain to shrink. Research also indicates that factors such as age, family history,
down syndrome, head injuries or cardiovascular disease can increase the risk of Alzheimer’s forming.
According to (NHS, 2019), an individual’s likelihood of developing Alzheimer’s doubles every 5 years after
reaching 65 years old, which implies that age can be significant factor in causing Alzheimer’s. They also state
that if more than one family member has had the disease then the risk is even higher. Subsequently, it could
be argued there is a genetic link between family history and the causes of Alzheimer’s. Vascular dementia
Vascular dementia is also a common form of dementia where there’s an estimated 150,000 people affected
by it in the UK. In order for the brain to function properly, there needs to be a constant supply of blood
which travels up the blood vessels. However, if a blood vessel in the brain becomes narrow, leaks blood or is
blocked, then it can result in reduced blood flow to the brain causing damage or killing brain cells. Issues
with the blood vessels in the brain can be caused by smoking, an unhealthy diet, a stroke, high blood
cholesterol, diabetes, age or family history. Furthermore, small vessels in the brain can lose their flexibility,
consequently becoming thick-walled and twisted. This can reduce the blood flow and damage nerve fibres
that would then be effecting the transmissions of electrical impulses in the brain. These factors and incidents
can all cause vascular dementia. Frontotemporal dementia Frontotemporal dementia is a less common form
of dementia and refers to the frontal and temporal lobes of the brain which is responsible for behaviour,
emotions and language. Like Alzheimer’s, it’s believed to be caused by abnormal forms of protein like tau
that can build-up in nerve cells and kill brain cells. This can prevent that section of the brain from functioning
properly and would therefore lead to symptoms. Research has suggested there’s a strong family link and
have identified genes that are believed to cause frontotemporal dementia. Roughly 4/10 who have this type
of dementia also have a relative who has had it or some other form of dementia (Bhargava, 2020),
supporting the theory that frontotemporal dementia can be caused through genetic links. Further causes
could include; head injury, down syndrome, alcohol abuse, HIV or AIDS.
P2: Explain the symptoms of three different types of dementia (Extended in M1)
Alzheimer’s disease Due to Alzheimer’s being a progressive disease, symptoms can become worse and more
noticeable over time. An early symptom can include forgetting about recent events or conversations. This
may result in an individual becoming confused or embarrassed, potentially leading them to be more
withdrawn and participating less when in conversations or in their usual interests and hobbies. Moreover,
asking questions repetitively or difficultly thinking of words may also be as a result of Alzheimer’s as well as
misplacing items. These are believed to happen due to the damage at the part of the brain called the
hippocampus which is primarily used for day to day memory. Eventually an individual with Alzheimer’s could
start to have difficulty swallowing, have delusions, problems with speech or language and frequent mood
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swings. All of these may be frightening for the person with dementia as well as the family or carers who have
to witness it. Vascular dementia The most frequent symptoms of vascular dementia is difficultly processing
information, staying organised, following instructions and staying concentrated. Additional to these
symptoms, people with vascular dementia may also have problems regarding their speech or language,
potentially making it difficult to communicate. These all link to someone’s cognitive ability which can be
drastically implicated due to dementia. However, individuals with vascular dementia are also known to
experience severe symptoms that involves their emotions. For example, being overly emotional or having
mood swings which can involve inappropriately laughing or crying as well as being irritable for no apparent
reason. Frontotemporal dementia Early symptoms of frontotemporal dementia may be mild or easy to miss
at first but it’s a progressive form of dementia, meaning they would become worse and more prominent
after time. Someone with frontotemporal dementia may start to make irrational decisions as well as losing
sympathy or empathy. Consequently, acting out of character is common due to appearing cold or distant.
Subsequently, relationships may be implicated and the individual with frontotemporal dementia may lack
understanding of others feelings or emotions. These symptoms could be due to the brain cells being
damaged or dying at the lobes controlling behaviour, emotions and language. This can also influence an
individuals speech and ability to find the right words or pronounce them properly.
M1: Analyse how the different types of dementia might be identified by their symptoms
Individuals can display many symptoms that can overlap with or suggest other age related disorders. This
makes the diagnosis of types of dementia very important in order to treat or manage it as soon as possible.
Even though types of dementia can have similar symptoms, they do exhibit their own individual differences
that enables more effective diagnoses. However, obtaining autopsies from dementia patients who are
deceased can provide a more accurate diagnosis which may eventually help find a way to develop diagnosing
in future.
People with frontotemporal dementia demonstrate a greater degree of behavioural changes compared to
someone with Alzheimer’s. They may show signs of limited personal care or inappropriate behaviour which
will make frontotemporal more distinguishable against diagnosing Alzheimers. However, (Alzheimer’s
Society, 2021) consider the possibility that the symptoms, like risk taking or obsessive behaviour, may imply
to a GP that they’re going through a difficult emotional time rather than displaying symptoms of
frontotemporal dementia as it’s not very common. Like vascular dementia and Alzheimers, there’s believed
to be a genetic link between frontotemporal dementia and the likelihood of developing it. As a result of this,
it could be argued that genetic testing may be beneficial in diagnosing these dementias. (Alzheimer
Research, 2021) support this by stating that there’s several faulty genes that can cause frontotemporal
dementia, such as tau (MAPT), which can be inherited and may require the NHS to have genetic testing to
look for them faulty genes. Additionally, (Alzheimer research, 2021) also suggest individuals with Alzheimer’s
may have a blood test to confirm a mutation in inherited genes such as PSEN1, PSEN2 or APP genes that
have been linked to early-onset inherited Alzheimer’s disease.
Abnormal gait means to be imbalanced, have frequent falls or stagger. This motor impairment is common in
later Alzheimer’s disease but may also raise the possibility of vascular dementia. (Newcastle University,
2019) state that ‘Scientists found that analysing both step length variability and step time asymmetry could
accurately identify 60% of all dementia subtypes’. Consequently, this emphasises the possibility that the
different types of dementia and any abnormal gait symptoms may help to influence more accurate
diagnoses. Furthermore, vascular dementia symptoms are primarily linked towards worse executive
functions rather than memory. Executive functioning refers to the ability to plan or organise effectively,
which is a very frequent symptom in diagnosing vascular dementia. (Heerema, 2020) detail that within a
study of 76 people with Alzheimer’s and 46 people with vascular dementia, they found similar levels of
executive functioning impairments. However, they also mention that individuals with frontotemporal
dementia would also display a greater executive functioning impairment than people with Alzheimer’s. Both
vascular and frontotemporal dementia exhibit these symptoms earlier in the disease process while
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individuals earlier in Alzheimer’s disease typically demonstrate memory impairments rather than executive
functioning. In order to assess executive functioning, they use tests such as the clock drawing test or the
verbal fluency test.
Acute onset means to have unexpected or rapid development in an illness or its symptoms (Pam, 2013). This
is consistent with rapid degeneration associated with vascular dementia. However, this may also be
considered as delirium. According to (Alzheimer’s society, 2017) delirium and dementia have similar
symptoms which may impact the likelihood of being accurately diagnosed with dementia. Delirium is
primarily the changing of an individual’s mental state that may cause them to be confused, sleepy or drowsy,
which correlate to types of symptoms of dementia. Unlike dementia, symptoms of delirium can become
better over a few days or weeks, whereas dementia would get progressively worse or in the case of vascular
become unsteady.
P3: Explain the effects of three different types of dementia on the mental and physical health of
individuals who have the condition (extended in M2)
Alzheimer’s disease Individuals with Alzheimer’s may become irrational in reasoning and fail to perceive any
threats. For example, scam calls can be quite frequent in people’s everyday lives which may become
dangerous for individuals with Alzheimers. If they get a call regarding their card details, they may go along
with it as they might not realise they’re being deceived or coerced into giving out money. Additionally,
dementia may impact their understanding of morals or worth in society. For example, they might start
spending money excessively as they can’t comprehend what they’re giving away. As a result of this, they
could be financially impacted and therefore have little money to pay for bills or basic necessities in life such
as food. Information processing will also eventually be negatively affected by Alzheimers, resulting in them
becoming more aware of their mental change. Changes can make individuals frustrated at not being able to
function the same as they did before, potentially leading to depression. Depression can lead to people
feeling alienated from society as their mental state deteriorates, keeping feelings to themselves or not being
able to express how they feel. (Dementia UK, 2021) refers to sundowning as the term for changes in
behaviour that occur at night or in the evening. They specify that individuals can feel agitated or have
anxiety and might start arguing or be confused about what’s happening. This overwhelming sense of
confusion can result in sleepless nights and restlessness. Subsequently, an individuals mental or physical
health may be impacted due to loss of energy in ability to carry out personal care or become increasingly
irritable. Vascular dementia (Byers and Yaffe, 2011) state major depressive disorder occurs in up to 50% of
patients with vascular dementia. This may be caused by feeling frustrated or angry about changes happening
to their body. For example, people with vascular dementia have complications with their movement,
specifically their motor skills. Not only could this result in physical risks such as falling or their ability to
balance, it can also affect them mentally. Losing confidence in their ability to be able to move may lead to
anxiety or fear about going out socially in case they fall or have an incident. As a consequence, becoming
isolated can be frequent with individuals with dementia due to embarrassment or being injured. Reduced
socialisation may impact an individual’s likelihood to talk about their emotions or feelings, creating a
communication barrier. Individuals who feel alienated from society might not feel like others would
understand as they themselves might not understand the extent of their body’s changes. Frontotemporal
dementia Frontotemporal dementia primarily affects an individual’s mental health until later stages when
issues with memory and processing information become more impacted. Changes in behaviour is a common
symptom due to the front and temporal lobes losing its function. This may result in a lack empathy and
sympathy, therefore they might say inappropriate things. For that reason, communication can be affected
due to some people feeling insulted by rude or insensitive comments that the patient may not be able to
control. Feeling like people avoid them can make them feel lonely or frustrated at themselves for not
understanding. Their mental health may also be affected by this if they feel like they’re not able to express
their feelings or emotions properly. Additionally, if they can’t or won’t mention if they’re in any pain,
physical injuries can go untreated, thus leading to infections or further severe illnesses.
