Understanding Dementia:
Types, Symptoms, and What Families Should Know
What is Dementia?
Dementia is not a single disease. It is an umbrella term used to describe a group of conditions that affect memory, thinking, behavior, and a person’s ability to manage everyday life. Families often begin searching for information after noticing changes such as increasing forgetfulness, confusion, personality or behavior changes, or difficulty completing familiar tasks.
While some changes in memory and thinking can occur with normal aging, dementia goes beyond occasional memory lapses. It can interfere with a person’s ability to function independently, make decisions, manage everyday tasks, and live safely without additional support.
Normal Aging
vs
Possible Signs of Dementia
Comparison of a healthy brain and a brain affected by severe Alzheimer’s disease-source National Institute on Aging.
Normal Aging
Occasionally forgetting names or appointments, but remembering later
Misplacing items from time to time
Slower processing or needing more time to learn new things
Forgetting why you entered a room
Forgetting the password to a website, or a former classmate’s name
Possible Signs of Dementia
Repeatedly forgetting recently learned information
Getting lost in familiar places or on similar driving routes
Difficulty managing finances or medications
Changes in judgment, personality, or behavior
Struggling with familiar tasks (cooking, driving, household chores)
If changes begin to interfere with daily life, it’s time to look deeper.
When Your Loved One Doesn’t Recognize Their Cognitive Changes
One of the most frustrating and confusing experiences for families can occur when a loved one’s perception of their abilities or recent events no longer matches what others are observing.
Early on, this may be subtle. A parent might insist they already paid a bill or took their medication when they haven’t. They may question whether you told them about an appointment when you’ve discussed the schedule already. Or, they believe someone else misplaced an item they moved themselves. They might become frustrated when family members express concerns about driving, finances, or other everyday tasks.
These situations can sometimes feel like dishonesty. However, changes in memory and other cognitive abilities can affect how a person understands or remembers what happened.
Some people also experience anosognosia, a neurological symptom that limits their ability to recognize their own cognitive impairment. To the person experiencing it, their perception may feel completely accurate.
This distinction can be important for caregivers. Repeatedly correcting, confronting, or trying to prove that a loved one is mistaken may increase frustration without creating greater awareness.
When cognitive changes are affecting safety or independence, the focus can instead shift toward identifying what is happening, putting appropriate supports in place, and preserving the person’s dignity and autonomy whenever possible.
Common Misconceptions
About Dementia
Myth: Alzheimer’s Disease and dementia are the same thing.
Fact: Dementia is an umbrella term for a group of conditions that affect thinking, behavior, and everyday function. Alzheimer’s disease is the most common cause of dementia, but it is not the only one.
Myth: If my parent had dementia, I will develop it too.
Fact: Having a family history can increase the risk of some forms of dementia, but it does not mean that a person will inevitably develop dementia. Risk depends on many factors, including the specific disease, genetics, age, health, and other influences.
Myth: Dementia is an inevitable part of getting older.
Fact: Dementia is not a “normal” or inevitable part of aging. Some changes in memory and processing speed can occur with age, but dementia is caused by diseases and conditions that affect the brain.
Myth: Dementia is only about memory and affects very “old people”.
Fact: Dementia can affect memory, judgment, language, behavior, movement, attention, and other abilities depending on the underlying disease. Although dementia becomes more common with age, younger onset dementia can occur before age 65.
Common Types
of Dementia
Different diseases and conditions can cause dementia, and each can affect the brain in different ways. While symptoms often overlap, certain patterns in memory, thinking, movement, behavior, sleep, and attention can provide important clues about the underlying cause.
Alzheimer’s disease is the most common cause of dementia, but it is not the only one. Some people also have changes associated with more than one type of dementia, known as mixed dementia.
Alzheimer’s Disease
The most common cause of dementia, Alzheimer’s disease is a progressive brain disease that gradually affects memory, thinking, and the ability to manage everyday activities. Changes often begin with difficulty learning or remembering new information and gradually affect other areas of thinking and daily life as the disease progresses.
Hallmark Features
Difficulty learning and retaining new information
Repeating questions or conversations
Increasing difficulty with planning, problem-solving, or familiar tasks
Progressive loss of independence as the disease advances
Lewy Body Dementia
Lewy body dementia is a progressive neurodegenerative disease associated with abnormal deposits of the protein called alpha-synuclein, known as Lewy bodies. It can affect thinking, movement, sleep, behavior, and autonomic functions, and symptoms may fluctuate noticeably from one time or day to another.
Hallmark Features
Fluctuations in attention, alertness, and thinking
Recurrent, often detailed visual hallucinations
REM sleep behavior disorder, including acting out dreams
Parkinsonian movement changes, such as slowness, stiffness, tremor, or changes in walking
Vascular Dementia
Vascular dementia results from conditions that damage blood vessels and reduce blood flow to the brain, including strokes and disease affecting smaller blood vessels. Symptoms vary depending on the areas of the brain affected and may develop suddenly after a stroke or more gradually over time.
Hallmark Features
Slowed thinking and information processing
Difficulty with planning, organization, and problem-solving
Problems with attention or concentration
Changes in walking, balance, or movement
Frontotemporal Dementia (FTD)
Frontotemportal dementia is a group of progressive brain disorders that primarily affect the frontal and temporal lobes, areas involved in behavior, personality, language, and decision-making. Unlike Alzheimer’s disease, early symptoms may involve significant changes in behavior or communication while memory remains relatively preserved.
Hallmark Features
Significant changes in personality, judgment, or social behavior
Loss of empathy or awareness of how behavior affects others
Impulsive, compulsive, or repetitive behaviors
Changes in language, including difficulty speaking or understanding words
What About Mild Cognitive Impairment (MCI)?
Mild cognitive impairment describes changes in memory or thinking that greater than expected with normal aging but does not significantly interfere with a person’s ability to manage everyday activities independently. MCI is not dementia. Some people with MCI later develop dementia, while others remain stable or may improve, depending on the underlying cause.
Getting a Thorough
Dementia Evaluation
A dementia diagnosis can bring a lot of information at once. Taking notes and bringing a few questions can help families better understand what to expect and how to plan.
Getting a Thorough Evaluation
If possible, look for a clinician with experience evaluating cognitive changes in older adults. Depending on the symptoms and circumstances, this may include a geriatrician, neurologist, geriatric psychiatrist, or neuropsychologist. A memory or cognitive disorders clinic may also provide access to several specialists in one setting.
If the cause of the cognitive changes remain unclear, ask whether additional evaluation may be helpful—including brain imaging, neuropsychological testing, laboratory testing, or referral to a specialist.
Questions You May Want to Ask Your Doctor
1. What type of dementia is suspected, and what findings support that diagnosis?
2. What changes should we expect as the condition progresses?
3. What level of assistance or supervision is appropriate right now?
4. Are there safety concerns we should address now, such as driving, medications, finances, falls, or living alone?
5. What treatments, therapies, or support services should we consider now?
6. Which cognitive abilities appear most affected, and how might those changes affect judgment, safety, and everyday tasks?
When Is a Higher Level of
Care Needed?
Many people with dementia can remain safely at home with the right combination of family support, home modifications, technology, community services, and professional care. As dementia progresses, however, care needs can eventually exceed what can safely or realistically be provided at home.
The decision is not based on one symptom or diagnosis alone. There should be consideration for both the safety and needs of the person with dementia and the ability of caregivers to provide sustainable care.
Before considering a move, ask whether additional support could make home safer.
This might include medication management, home-safety modifications, meal delivery, increased supervision, in-home care, adult day services, or other community-based supports.
Warning signs that may indicate that a higher level of care is appropriate:
Wandering, getting lost, or leaving home unsafely
Repeated medication errors
Falls or increasing mobility problems
Unsafe cooking or driving
Increasing confusion, agitation, or other behaviors that create safety concerns
Needing supervision that cannot consistently be provided
Caregiver Capacity Matters, Too
A home may be physically safe while the caregiving arrangement is no longer sustainable. Dementia caregiving can involve disrupted sleep, chronic stress, physical demands, missed work, social isolation, and emotional exhaustion. A caregiver’s health and ability to continue providing care are part of the safety equation, not separate from it.
How Diagnosing Dementia
Is Evolving
The way dementia is evaluated and understood continues to evolve. Advances in biomarkers and a growing understanding of overlapping brain diseases are helping researchers and clinicians identify the biological changes associated with dementia more precisely.
Blood Biomarkers and Earlier Detection
Blood-based biomarkers can detect biological changes associated with Alzheimer’s disease, including amyloid and tau-related. changes. Some blood tests are now FDA-cleared for specific clinical uses, but they are not simply a yes/no home test for dementia, are ordered for individuals meeting certain criteria, and results need to be interpreted in the context of a clinical evaluation.
When More Than One Disease Is Present
Dementia isn’t always caused by one disease process. Alzheimer’s pathology can occur alongside Lew body disease and other brain changes, what researchers call co-pathology or mixed pathology. In Lewy body dementia specifically, Alzheimer’s co-pathology can influence the clinical picture and, on average, has been associated with faster cognitive decline, although individual progression varies substantially.
These advances do not replace a comprehensive dementia evaluation, but they are changing how clinicians and researchers understand what may be happening in the brain, and may eventually, help guide more individualized treatment and clinical trials.
Learn More & Explore
Research Opportunities
For families who would like to learn more about dementia research, support resources, or opportunities to participate in clinical studies, the following organizations provide reliable, regularly updated information:
Alzheimer’s Association — Education, caregiver support, local resources, and TrialMatch®, a free service that connects people living with cognitive impairment or dementia, caregivers, and healthy volunteers with research studies.
National Institute on Aging (NIA) — Evidence-based information about Alzheimer’s disease and related dementias, along with a searchable clinical-trials resource covering dementia, MCI, cognitive health, and caregiving studies.
Lewy Body Dementia Association (LBDA) — LBD-specific education, support, Research Centers of Excellence, and the Lewy Trial Tracker for current LBD research opportunities.
How
Sunset Senior Concierge
Can Help
How We Can Support Your Family
Care management, coordination, & planning
Transportation, appointment support, and advocacy
Dementia-informed assistance
Health communication between providers and back to families
Ongoing guidance as needs evolve
If you’re noticing changes or feeling unsure where to start, you don’t have to figure this out alone. The earlier you have a plan, the more options you have.
Other Helpful
Resources for Families
Caring for an Aging Parent When the Relationship is Difficult
Practical guidance for navigating caregiving when the parent-child relationship is strained, complicated, or emotionally difficult.
Read the Guide →
How to Know When an Aging Parent Needs Help
Learn more about common signs that an older parent may need additional support and what families can consider when deciding what to do next.
Read the Guide →