How Dementia Progresses Everyday Health MenuNewslettersSearch Dementia How Dementia Progresses The pace of dementia varies based on the type of dementia and personal factors. By Pamela KaufmanMedically Reviewed by Michael R. Yochelson, MD, MBAReviewed: August 10, 2022Medically ReviewedMany factors affect the pace at which dementia progresses, including social support networks and overall health.ThinkstockThe most common types of dementia — Alzheimer’s disease, vascular dementia, Lewy body dementia, and frontotemporal disorders — are all progressive. People lose their cognitive skills over time, finding it more and more difficult to meet the demands of everyday life. Yet every person with dementia will experience it in a unique way. Some hold steady for longer than expected; others worsen rapidly. Factors such as a person’s physical makeup, overall health, emotional resilience, medication, and network of support make a difference in the rate at which they move through the various stages. Outlining the stages of dementia only provides the broadest framework for understanding its progression because:Some symptoms may appear earlier or later than usual, or not at allSome stages may overlapSome symptoms, such as irritability, may appear and then vanish (1) Mild Cognitive Impairment A Precursor to Dementia Many people experience a certain amount of normal cognitive decline as they age — needing extra time to connect a person’s name with their face, say, or to recall a computer password. Mild cognitive impairment (MCI) is more significant than that, involving lapses in memory, language, thinking, and judgment that are noticeable to the person and perhaps his or her own family and close friends yet not serious enough to interfere with everyday life. About 12 to 18 percent of people age 60 or older are estimated to have mild cognitive impairment. Researchers believe that mild cognitive impairment may be a precursor to dementia. According to the Alzheimer’s Association, about one-third of those with MCI develop dementia due to Alzheimer’s within five years. (2) Yet some people with mild cognitive impairment never get worse, and a few actually get better. Researchers are working to understand why. Signs of mild cognitive impairment may include:Forgetting things or important eventsLosing your train of thought or the thread of a conversation, book, or movieHaving trouble making your way around a familiar placeBecoming more impulsive or showing poor judgmentIrritability and aggressionApathy (3) Related: 10 Early Signs of Dementia Vascular Dementia A Problem With Blood Vessels Vascular dementia occurs when damage to blood vessels blocks blood flow to the brain, depriving brain cells of the oxygen and nutrients they need.About 5 to 10 percent of people with dementia have a pure vascular dementia. However, it is more common for people with dementia to have a “mixed” pathology and changes in the brain due to vascular dementia and Alzheimer’s. (2) The progression of the resulting dementia depends in part on where and how the blockage occurred. Damage to small blood vessels deep in the brain can cause dementia that worsens gradually, like Alzheimer’s disease. When damage is due to a major stroke (potentially due to the blockage of a major blood vessel) or a series of small strokes, symptoms occur suddenly. Instead of becoming worse gradually, symptoms plateau for long periods, followed by short, intense periods of change. A person with early-stage vascular dementia will have difficulty planning and organizing, completing multistep tasks, and making decisions. Their thinking will also slow and they will have problems concentrating, with brief periods of confusion. Mood swings, apathy, and heightened emotions are common. People with vascular dementia are also vulnerable to depression and anxiety. As the disease progresses, symptoms are more likely to resemble those of middle and eventually later-stage Alzheimer’s disease: increasing memory loss, confusion, disorientation, and problems with reasoning and communication. As with Alzheimer’s, irritability and agitation tend to increase, as do delusions and (less frequently) hallucinations. Although each person with vascular disease will have a unique experience, patients live, on average, for five years after the onset of symptoms. Death is often due to a stroke or heart attack. (1) Lewy Body Dementia As with Alzheimer’s disease, Lewy body dementia tends to develops slowly and progress gradually. But unlike Alzheimer’s, early symptoms include fluctuating levels of attention and alertness that might vary significantly from day to day or even hour to hour. In further contrast to Alzheimer’s, recurrent visual hallucinations are common for people with Lewy body dementia and movement is often affected. Difficulty sleeping is also a common symptom of Lewy body dementia. At least half of those diagnosed with this form of dementia will have symptoms similar to those of Parkinson’s disease — stiffness, slowness of movement, sometimes tremor — and that proportion increases over time. These Parkinsonian symptoms may precede symptoms of memory or cognitive decline. Gradually, symptoms of Lewy body dementia become more like those of middle- and late-stage Alzheimer’s: memory loss, agitation, restlessness, or shouting out. After the onset of symptoms, people with Lewy body dementia tend to live for about six years. (1) Frontotemporal Dementia Early Symptoms Vary In contrast to Alzheimer’s, people at the early stages of frontotemporal disorders (also called frontotemporal dementia) generally don’t have trouble with short-term memory. But depending on the type of frontotemporal issue, early symptoms may vary. For the type of frontotemporal disorder that initially affects the part of the brain that controls behavior, people may behave rudely or appear oblivious to social norms, seem easily distracted, or appear uncharacteristically selfish or unfeeling. For the less-common type of frontotemporal disorder that initially affects the part of the brain that controls language skills, the early stage includes trouble attaching names to things, comprehending words, or speaking fluently. But as dementia becomes progressively worse, people who are experiencing behavior changes will begin having language difficulty, and vice versa. As frontotemporal disorders progress, symptoms will begin to resemble those of Alzheimer’s, though agitation and aggression generally develop before short-term memory loss and other symptoms of later-stage Alzheimer’s, such as trouble judging distance and difficulty seeing objects in three dimensions. On average people with frontotemporal disorders live for six to eight years after the onset of symptoms. (1) NEWSLETTERS Sign up for our Healthy Living Newsletter SubscribeBy subscribing you agree to the Terms of Use and Privacy Policy. Editorial Sources and Fact-Checking The Progression of Alzheimer’s Disease and Other Dementias [PDF]. Alzheimer’s Society. 2020.2022 Alzheimer’s Disease Facts and Figures [PDF]. Alzheimer’s Association. 2022.Mild Cognitive Impairment (MCI). Mayo Clinic. 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