It's a mixed picture: many people with dementia don't realize they have it, often due to the condition itself affecting insight (anosognosia), denial, or attributing symptoms to normal aging, while others have some awareness but fear the diagnosis or stigma, leading to resistance or anxiety. Awareness varies greatly by the person, type of dementia (like vascular dementia sometimes offering more insight early on), and stage of the disease.
When a person is diagnosed with dementia they may not understand or accept their diagnosis. They may also have limited or no awareness of their symptoms and the difficulties they are having, even when these are obvious to those around them.
You can live with dementia for an average of 4 to 10 years after diagnosis, but this varies significantly, with some people living 20 years or more, depending on age, overall health, and dementia type, with Alzheimer's averaging 8-10 years and vascular dementia closer to 5 years. Factors like diagnosis stage, age, gender, other health conditions (e.g., heart disease, frailty), and dementia subtype greatly influence life expectancy, with people often succumbing to infections or complications rather than the disease itself.
Dementia behaviors stem from brain changes and include personality shifts, memory issues, mood swings (anxiety, depression, irritability), agitation, aggression, delusions, hallucinations, disinhibition (saying/doing inappropriate things), repetitive actions (pacing, fiddling), and sleep disturbances (sundowning). These symptoms are the disease, not the person, and often result from unmet needs, communication breakdowns, environmental triggers, or underlying pain, requiring patient redirection, routine, and focusing on comfort.
In most cases, we'd recommend that you do tell your loved one about their diagnosis. But if they've made it clear that they don't want to know, that's their right.
Most people who have dementia continue to be interested in the same things they were interested in before their diagnosis. The way they express their interests may be different, and they may not be able to remember as much. But they likely think about the same things they did before they were diagnosed.
When someone gets the diagnosis of dementia, a cure is only very rarely possible (see p2 About Reversible Dementias). In the current issue of Neurology, Sacks and Shulman1 report one of these rare cases of a reversal of dementia involving a patient on steroid medication.
The "2-finger test" for dementia involves an examiner showing a hand gesture (like interlocking index and middle fingers) and asking the patient to copy it, testing motor skills, visual memory, and coordination, as difficulties can signal early cognitive decline, but it's a screening tool, not a definitive diagnosis, prompting further medical evaluation. Other related tests include finger-tapping and finger-to-nose, looking for hesitation or misjudgment in movement.
A recent meta-analysis revealed that higher neuroticism and lower conscientiousness are consistent predictors of higher dementia risk, across dementia types, including Alzheimer's disease (AD), dementia assessment methods, follow-up lengths, and countries (Aschwanden et al., 2021).
Classic TV classics that are also on DVD
Alzheimer's disease – around eight to 10 years. Life expectancy is less if the person is diagnosed in their 80s or 90s. A few people with Alzheimer's live for longer, sometimes for 15 or even 20 years. Vascular dementia – around five years.
Even though a person with dementia may end up sleeping more than a typical person of their age – even as much as 14–15 hours a day – it is unlikely to all be good quality sleep. Sleeping a lot can also be influenced by people's sleeping patterns before they had dementia, as some people need more sleep than others.
The best dementia treatment involves a mix of medications (like cholinesterase inhibitors: donepezil, galantamine, rivastigmine; and memantine) to manage cognitive symptoms, alongside non-drug approaches like cognitive stimulation, support groups, exercise, and lifestyle adjustments, with new disease-modifying drugs (like lecanemab/donanemab) emerging for early Alzheimer's, though there's no cure, treatments aim to improve quality of life.
Remaining at home but with extra support can be a good option for some people with dementia. It allows them to stay in a place that feels familiar and safe to them. It is important to make sure that the person can remain safe and well and get the support they need at home.
For most people with Alzheimer's — those who have the late-onset variety — symptoms first appear in their mid-60s or later. When the disease develops before age 65, it's considered early-onset Alzheimer's, which can begin as early as a person's 30s, although this is rare.
Behavior and personality often change with dementia. People with dementia often act in ways that are very different from their “old self,” and these changes can be hard for family and friends to deal with.
Playing music, having objects to touch and interact with, and hand massage can all help people with dementia in the later stages.
There is currently no cure for dementia, but recognising the early signs and symptoms is still very important. We explore why spotting the early signs matters for everyone affected by dementia and why we support research to improve diagnosis.
You Miss Out on Sleep
You do a few things you know you shouldn't -- we all do. But some of those bad habits can take a toll on your brain. For example, lack of sleep may be a cause of dementia, including Alzheimer's disease. It's best to have regular sleeping hours.
The SAGE test is a short, self-administered evaluation that screens for early signs of memory or thinking problems like dementia. You take it on your own, at home or at your provider's office. It's simple and there's no studying needed. It can catch issues early.
Although the early signs vary, common early symptoms of dementia include: memory problems, particularly remembering recent events. increasing confusion.
Life expectancy with dementia varies greatly but averages a few years to over a decade, often 4 to 8 years for Alzheimer's, depending heavily on age at diagnosis (younger means longer), type (Alzheimer's generally longer than Vascular), and other health conditions, with newer research showing averages like 5.1 years for women and 4.3 for men from diagnosis, but with wide ranges from shorter for older adults to longer for some.
While family caregivers often provide the primary daily support for individuals with dementia, legal responsibility for decision-making and financial management can fall to spouses, adult children (depending on filial responsibility laws), or court-appointed guardians or conservators, especially in the absence of a ...
High blood pressure, or hypertension, has harmful effects on the heart, blood vessels, and brain, and increases the risk of stroke and vascular dementia. Treating high blood pressure with medication and healthy lifestyle changes, such as exercising and quitting smoking, may help reduce the risk of dementia.