Each person’s experience with dementia is unique.
Not every person will experience all the signs and symptoms of their type of dementia. Other illness or health care issues can occur. As a result, how the disease will progress varies from one person to another.
Dementia may last many years, sometimes progressing faster, sometimes more slowly. This means that it is not possible for anyone to tell you exactly how the condition will progress and how long a person can live with dementia. Many people find it stressful that they do not have answers to these questions and that is normal. Understanding as much as you can about dementia will help. It can be useful to think about the way dementia progresses in stages, however it is important to remember that this is only a guide, some symptoms may appear earlier or later or not at all.
The following provides an outline of the three stages that are associated with Alzheimer’s disease. Following this, there is a note on the progression of Vascular dementia, Lewybody dementia and Fronto-temporal dementia which all have specific characteristics associated with them.
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The progression of Alzheimer’s disease
On average people live eight to ten years from the time first symptoms emerge. However, life expectancy varies considerably depending on how old a person is when symptoms begin. A person diagnosed in their 60’s will live longer than someone diagnosed in their 90’s. Life expectancy is also affected by other illnesses the person experiences.
In the early stages of dementia changes are slight and it is possible to continue to do lots of things. Typically mean a person may:
forget things easily repeat things frequently.
experience problems with language, such as appearing to be stuck for words or losing track of a conversation,
find new situations or places confusing.
show poor judgement or find it hard to make decisions
lose interest in other people or activities
be unwilling to try new things
experience low mood, may become anxious or withdrawn
feel frustrated or angry
Many people in the early stages of dementia engage in activities they enjoy but at times they may find it hard and may need to rest more frequently.
As dementia progresses, changes are greater and a person will need more support to help them to manage day to day living. As a person finds it harder to do things, they may lose confidence and withdraw or be upset. Others may feel frustrated and angry and be argumentative or quick to lose their temper.
During the middle stage a person may:
forget recent events completely
find conversations, television or reading difficult to follow or confusing
get lost easily, even in familiar places
find bathing and dressing difficult or confusing
need reminders to eat drink and take medication
find meal preparation and managing money very difficult
believe things are real even when they are not
feel restless or agitated
confuse time and experience difficulties with sleeping
The symptoms and behaviours that can occur during this stage are difficult for both the person with dementia and their families. There are supports and services to help and strategies for coping. (link to services page and link to fact sheets in carer section)
During the late stage of dementia, a person will need increasing amounts of support and will gradually become dependent on others for nursing care. A person will become increasingly frail and may walk unsteadily, they may need a wheelchair or be confined to bed. During this stage the ability to fight even simple infections is low.
Typically, a person may:
have difficulty recognising people, although there may be flashes of recognition
experience gradual loss of speech
have difficulty eating and sometimes swallowing
appear restless and seem to be looking for someone or something
While a person with late stage dementia may have difficulty communicating, they will often respond positively to affection, a smile, and a soothing voice. Music, scent and hand massage can bring comfort and enjoyment.
The progression of vascular dementia
Vascular dementia is generally caused by stroke or a series of small strokes. As a result this type of dementia may progress in a ‘stepped’ manner, which differs from the more gradual progression of Alzheimer’s disease. Symptoms may appear to suddenly worsen due to a stroke and then remain level for a period of time. It may be months or years until the next stroke occurs and symptoms worsen. Where vascular dementia is caused by a series of small strokes, then symptoms can emerge in a more gradual way.
People with vascular dementia tend to maintain their personality and emotional responsiveness until the later stages of the condition. This can mean that people are more aware of their condition and can be more prone to depression than people with Alzheimer’s disease.
In general people with vascular dementia live for around five years after symptoms begin. In many cases, the person’s death will be caused by a stroke or heart attack.
The progression of Lewybody dementia
Half or more of people with Lewybody dementia will also develop symptoms of Parkinson’s disease. These include slowness of movement, stiffness and tremor. Other symptoms include difficulty judging distances, falls and fainting. Visual hallucinations, paranoia and delusions may also emerge.
In the early stages of this dementia, the abilities of the person may fluctuate drastically, even during the course of a day. This can be very confusing for all concerned.
In the later stages, this dementia progresses in a similar way to Alzheimer’s disease. People usually live for six to twelve years following onset of symptoms.
Each person’s experience with their dementia is unique to them, and there is no way to say exactly how their dementia will progress, which symptoms will emerge and when and how long they may live with their condition. The above is a guide to help to understand how a dementia may progress.
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