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.
There is currently no cure for dementia. In fact, because dementia is caused by different diseases it is unlikely that there will be a single cure for dementia. Research is aimed at finding cures for dementia-causing diseases, such as Alzheimer's disease, frontotemporal dementia and dementia with Lewy bodies.
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.
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.
Signs of late-stage dementia
having a limited understanding of what is being said to them. needing help with most everyday activities. eating less and having difficulties swallowing.
Smoking, low physical activity, and a poor diet are all lifestyle and environmental influences that have been linked to rapid dementia decline. Physical activity promotes cardiovascular health, which in turn improves brain function. Those who lead a sedentary lifestyle may experience faster cognitive decline.
A person with dementia can often live at home for several years, even through mid-stages, with the right support, but this varies greatly; many stay home until the later stages where 24/7 supervision or specialized care becomes necessary, though some may transition earlier due to safety concerns or caregiver burden, with factors like dementia type, age at diagnosis, and available home help influencing the timeline.
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.
Donepezil (also known as Aricept), rivastigmine (Exelon) and galantamine (Reminyl) are used to treat the symptoms of mild to moderate Alzheimer's disease. Donepezil is also used to treat more severe Alzheimer's disease.
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 ...
The person may be safe for short periods of time alone, but not for 24 hours, seven days a week. Sometimes families may arrange for the person to spend nights at a relative's house. Most often a combination of approaches is tried: home care, adult day programs, regularly scheduled time with relatives.
Many people affected by dementia are concerned that they may inherit or pass on dementia. The majority of dementia is not inherited by children and grandchildren. In rarer types of dementia there may be a strong genetic link, but these are only a tiny proportion of overall cases of dementia.
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.
Weird Things Dementia Patients Do: Strange Behaviors, Odd Symptoms, And Tips. Dementia can manifest in unexpected and often unsettling ways. From hoarding and wandering to aggression and hallucinations, these behaviors can be distressing for both the individual and their caregivers.
The person's needs change after a stay in hospital and they now need continuous care, day and night. The person with dementia may also have health issues that can't be managed at home. The person's needs become too challenging for others to manage at home.
Rapidly progressive dementias (RPDs) are dementias that progress quickly, typically over the course of weeks to months, but sometimes up to two to three years. RPDs are rare and often difficult to diagnose. Early and accurate diagnosis is very important because many causes of RPDs can be treated.
Try to limit or avoid drinking alcohol and smoking.
Over time, excessive drinking can lead to high blood pressure or brain injuries, both of which increase the risk of dementia. Current smoking also increases the risk of developing dementia, including Alzheimer's disease. If you drink alcohol, do so in moderation.
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 cause of roughly 70% of all dementia cases is Alzheimer's disease, a progressive brain disorder characterized by the buildup of amyloid plaques and tau tangles, leading to memory loss and impaired thinking that interferes with daily life, making it the most common form of dementia.
Playing music, having objects to touch and interact with, and hand massage can all help people with dementia in the later stages.