Dealing with Dementia: A Guide to Alzheimer's Disease and Other Dementias

By Brian Draper | Go to book overview

CHAPTER 4
THE SYMPTOMS AND
COURSE OF DEMENTIA

IN MOST CIRCUMSTANCES, DEMENTIA is a progressive condition that results in an evolving pattern of symptoms, behaviours, functional impairments and disabilities. The nature of an individual's presenting symptoms and the pattern of their evolution will provide clues to the underlying type of dementia. For example, Alzheimer's disease tends to develop almost imperceptibly and progress gradually over a course that may run, on average, for six to twelve years. Vascular dementia has a more varied presentation and course, but a common variant is of relatively sudden onset followed by a stepwise decline over a somewhat shorter timespan than seen in Alzheimer dementia. Because for most persons dementia is a chronic disorder, it is useful to view its course in stages according to the severity of the disease process. Note that these stages should be viewed as only a rough guide, since they are mainly based on the course of Alzheimer's disease, not the other types of dementia. Further, some people may have some features from one stage and other features from an earlier or later stage. 1 There are also many different symptoms of dementia, as listed in Table 4.1.


PRE-DEMENTIA: MILD COGNITIVE IMPAIRMENT

As with most illnesses, dementia has no set pattern of early symptoms. Presentations can be quite varied, and often are recognised only retrospectively. Furthermore, early symptoms may be subtle and attributable to many causes, a problem accentuated by dementia's relatively slow progression. Currently we have limited knowledge of these earliest symptoms of dementia, and of how

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Dealing with Dementia: A Guide to Alzheimer's Disease and Other Dementias
Table of contents

Table of contents

  • Title Page *
  • Contents v
  • List of Illustrations x
  • List of Tables xi
  • Preface xiii
  • Chapter 1 - What is Dementia 1
  • Chapter 2 - Prevention of Dementia I 12
  • Chapter 3 - Prevention of Dementia II 26
  • Chapter 4 - The Symptoms and Course of Dementia 45
  • Chapter 5 - Types of Dementia 71
  • Chapter 6 - Dementia Assessment 88
  • Chapter 7 - Drug Treatments 106
  • Chapter 8 - Psychosocial Treatments 123
  • Chapter 9 - Families and Other Carers 138
  • Chapter 10 - Community Care Services 154
  • Chapter 11 - Residential Care 170
  • Chapter 12 - Ethical and Legal Issues 188
  • Chapter 13 - The Future 204
  • Appendix 1 - Australian Telephone Helplines 220
  • Appendix 2 - Websites 222
  • Appendix 3 - Books for Carers 230
  • Glossary 232
  • Notes 238
  • Index 252
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