Caregiver guide
Types of dementia: what each one looks like and what to ask
The main types of dementia are Alzheimer's disease, vascular dementia, Lewy body dementia and frontotemporal dementia, and many older adults have a mix of more than one. Each type damages the brain in a different way, so early signs, care needs and even safe medicines can differ.
Dementia is the umbrella, not the diagnosis
Dementia isn't one disease. It's an umbrella word for losing memory, thinking or reasoning skills to the point that everyday life gets hard. Many different diseases can cause it.
That's why, when a doctor says "it's dementia," it's fair to ask: which type? If someone told you "it's cancer," you'd want to know what kind. Dementia deserves the same question, because the answer shapes treatment, safety and what to expect.
Below is a plain guide to the types families meet most often, a side-by-side chart, and what to do next.
What are the 4 main types of dementia?
1. Alzheimer's disease. The most common type. Protein clumps (plaques and tangles) build up and brain cells die, starting in the area that makes new memories. Forgetting recent events is usually the first sign, and changes come on slowly. Read What is Alzheimer's disease?
2. Vascular dementia. Caused by damage to the blood vessels that feed the brain, often from strokes, including small ones a person may not notice. It can start suddenly after a stroke and get worse in steps, with a drop and then a steady period. Slowed thinking, trouble planning and mood changes are common. Controlling blood pressure, diabetes and cholesterol can help lower the chance of more damage.
3. Lewy body dementia. Caused by clumps of a protein called alpha-synuclein (Lewy bodies). It includes dementia with Lewy bodies and Parkinson's disease dementia. Signs include seeing things that aren't there, alertness that swings from day to day, acting out dreams in sleep, and stiffness or shuffling like Parkinson's. Read our Lewy body dementia guide.
4. Frontotemporal dementia (FTD). Damage to the front and sides of the brain. It often starts younger than Alzheimer's, sometimes in a person's 50s or earlier. The first changes are usually in personality, behavior or language, not memory. A person may act out of character, lose their filter, or struggle to find or understand words.
Mixed dementia is also very common, especially in people over 80. It usually means Alzheimer's changes plus blood vessel damage, and it can be hard to tell which is causing which symptom.
Types of dementia and symptoms chart
This chart shows the most common patterns. Real people don't always follow the pattern, so use it to start a conversation with the doctor, not to diagnose.
| Type | What's happening in the brain | Early signs families often notice | How it usually changes |
|---|---|---|---|
| Alzheimer's disease | Plaques and tangles; brain cells die, starting in memory areas | Repeating questions, forgetting recent events, misplacing things | Slowly, over years |
| Vascular dementia | Strokes or poor blood flow damage brain tissue | Slowed thinking, trouble planning, mood changes; may follow a stroke | Can start suddenly and decline in steps |
| Lewy body dementia | Lewy body protein clumps affect thinking, movement and sleep | Seeing things that aren't there, good days and bad days, acting out dreams, stiffness | Varies; alertness can swing day to day |
| Frontotemporal dementia | Damage to the front and side areas of the brain | Personality or behavior changes, loss of filter, trouble with words | Often starts younger; pace varies |
| Mixed dementia | More than one cause, often Alzheimer's plus blood vessel damage | A mix of the signs above | Depends on the causes involved |
Which types of dementia cause hallucinations?
Seeing things that aren't there is most common in Lewy body dementia, where it often happens early and can look very real, like people or animals in the room. It can also happen in Parkinson's disease dementia and in the middle and later stages of Alzheimer's.
If hallucinations start suddenly, call the doctor. An infection, a new medicine or dehydration can cause sudden confusion. Don't argue about whether what they see is real. Respond to the feeling instead: "That sounds scary. I'm right here." Our guide to dementia hallucinations and paranoia has more ideas.
Be careful with medicines for hallucinations. People with Lewy body dementia can react badly to some of them. Always ask the doctor first.
Dementia-like symptoms that can be treated
Some causes of memory and thinking problems can improve, or even go away, with treatment. That's why a full check-up matters. Doctors look for things like:
- Side effects from medicines, or a mix of medicines
- Depression
- Low vitamin B12 or thiamine (vitamin B1), sometimes linked to heavy drinking
- Thyroid problems, or blood sugar or salt levels that are off
- Infections, including urinary tract infections in older adults
- Fluid buildup in the brain (normal pressure hydrocephalus), which often first shows up as trouble walking and bladder control
- Bleeding near the brain after a fall (subdural hematoma)
Our memory loss guide covers these causes in more detail.
There are also rarer types of dementia, including Huntington's disease, which runs in families, Creutzfeldt-Jakob disease, which moves very fast, and damage from repeated head injuries. A specialist can test for these if the signs fit.
How do doctors tell the types of dementia apart?
There's no single test. Doctors usually combine:
- Your story. How and when symptoms began, whether they came on slowly or suddenly, and whether dementia runs in the family. You may notice things your person can't report, so go along.
- A physical and neurological exam. Checking blood pressure, balance, reflexes, eye movements and how the person walks.
- Memory and thinking tests. Short tests of memory, language, problem-solving and attention.
- Lab tests. Blood and urine tests to rule out treatable causes.
- Brain scans. CT or MRI can show strokes, tumors and shrinkage. Some special scans can help separate one type from another.
Sometimes the type becomes clearer over time as symptoms change. In many cases, the type can only be confirmed for certain after death, which is one reason families choose brain donation.
What to do once you know the type
Ask the doctor three questions
Which type is it? What should we expect next? Which medicines should we be careful with?
Learn about that type
Each type brings its own challenges. Our free education workshops help you understand what you're seeing day to day.
Make a plan
A free Care Navigation session helps you plan for safety, legal and money matters, and the care your person will need.
Find your people
Support groups connect you with caregivers facing the same type of dementia, in person around Orange and Seminole counties or online.
Questions about the types of dementia
What is the most common type of dementia?
Alzheimer's disease is the most common type. Vascular dementia and Lewy body dementia come next. Many older adults have mixed dementia, usually Alzheimer's plus blood vessel damage.
What are the 12 types of dementia? How many types are there?
There's no official list of 12. Different websites group them in different ways, and when you count every rare condition that can cause dementia, the number runs much higher. For most families, the five types in our chart above (Alzheimer's, vascular, Lewy body, frontotemporal and mixed) cover what they'll meet.
Can a person have more than one type of dementia?
Yes. This is called mixed dementia. It's very common in people over 80, and it can make symptoms harder to sort out. Treating things like high blood pressure may still help.
Can vascular dementia cause mood swings?
Yes. Damage from strokes can affect the parts of the brain that control mood and self-control, so depression, irritability, crying or laughing easily and sudden changes in mood are common. Tell the doctor, because depression and some mood changes can be treated.
What are the treatment options for early-onset dementia?
Treatment depends on the type. Some medicines can ease symptoms of Alzheimer's for a while, and there's no medicine yet that stops frontotemporal dementia. Speech, physical and occupational therapy, counseling and planning ahead for work, money and legal matters are important for younger families. If dementia started young or runs in the family, ask about a referral to a specialist and genetic counseling. Our guide Is Alzheimer's genetic? explains more.
Why does it matter which type of dementia my person has?
The type helps you know what to expect and which treatments may help. It also affects safety. For example, people with Lewy body dementia can have serious reactions to some medicines used for hallucinations, so the care team needs to know.
Is it dementia or Alzheimer's?
Alzheimer's is one type of dementia. Our Alzheimer's and dementia FAQ explains the difference and the stages of dementia.
Where can I get help understanding my person's diagnosis in Central Florida?
Call ADRC at (407) 436-7750. We can talk through what the doctor said, point you to local specialists and services, and connect you with education and support, all free to caregivers and care partners.
Download The Dementias: Hope Through Research
A booklet from the National Institutes of Health on the types of dementia, risk factors, diagnosis and treatment. Based in part on guidance from the National Institute of Neurological Disorders and Stroke and the National Institute on Aging.
Alzheimer's & Dementia Resource Center (ADRC)
Alzheimer's & Dementia Resource Center (ADRC)
1470 Gene Street, Winter Park, FL 32789
Serving Orange and Seminole counties and Central Florida since 1984
(407) 436-7750
info@adrccares.org
Monday to Friday, 8:30 AM to 4:30 PM
The Alzheimer's & Dementia Resource Center (ADRC) in Winter Park, Florida, offers free help for caregivers in Orange and Seminole counties; call (407) 436-7750.