Story by: David Steen Martin; Reviewed by Rachel N. Hart, D.O., geriatric medicine specialist with Norton Neuroscience Institute on December 13, 2023
Dementia is known as a disease that robs people of their memories, but it’s possible to have dementia without memory loss.
Dementia refers to any loss of mental functioning that is not part of normal aging. This includes not only losing your memory, but issues with thinking, learning and reasoning.
“There are many facets to dementia. People with dementia could start having issues communicating or paying attention, or having issues with their judgment, or becoming disoriented,” said Rachel N. Hart, D.O., geriatric medicine specialist with Norton Neuroscience Institute.
Together, these changes can affect someone’s ability to function and could mean losing the basic skills necessary for daily living.
Dementia with Lewy bodies is one example of dementia that initially presents without memory loss. It is progressive, like Alzheimer’s disease. Initial symptoms include difficulty paying attention and remaining alert, and recurrent visual hallucinations.
Hallucinations and misinterpreting visual signals are common issues in people with dementia. For example, someone who has dementia with Lewy bodies might see a shadow on the ground and think it’s a hole.
Talk to your primary care provider about age, family history and ways to prevent dementia.
In addition to changes in the ability to process information and think, dementia also can result in changes in mood and behavior.
Frontotemporal dementia, or FTD, is a type of dementia typically occurring in people under the age of 65. Initially it causes changes in behavior, rather than memory loss.
FTD can result in obsessive or socially inappropriate behaviors, swearing, a lack of personal hygiene, and an increased interest in sex. People with FTD also can show a lack of empathy, indifference, decreased self-awareness and a lack of judgment.
Like FTD, frontal variant Alzheimer’s disease, or fvAD, is an atypical dementia and shows early symptoms that are behavioral, rather than related to memory. This includes socially inappropriate behaviors, loss of motivation to do things they used to enjoy, lack of empathy, and repetitive or obsessive behaviors.
People with fvAD, which affects about 1 in 50 people with Alzheimer’s, also may struggle to follow a series of simple steps, become easily distracted and have other symptoms related to “executive function.” They also may become fixated on a single thought or object, or have difficulty holding more than one piece of information at a time.
Vascular dementia, which is also called vascular cognitive impairment, often occurs as a result of strokes, which can block major blood vessels in the brain. Depending on which part of the brain is affected, vascular dementia can cause changes in mental abilities other than memory. This can include difficulty following directions, disorientation, and trouble speaking or understanding speech.
Like other forms of dementia, vascular dementia can begin as a mild condition and worsen over time. It also can occur at the same time as Alzheimer’s and dementia with Lewy bodies.
Vascular dementia is diagnosed with a brain scan along with other medical information, such as a history of uncontrolled diabetes or smoking. FTD and other atypical dementias can be diagnosed using brain imaging, such as MRI or positron emission tomography scan, and more comprehensive cognitive testing called neuropsychology testing.
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