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How quickly dementia progresses depends on what is causing it and the area of the brain that is affected. Some types of dementia progress slowly over several years. Other types may progress more rapidly. If vascular dementia is caused by a series of small strokes, the loss of mental skills may be gradual. If it is caused by a single stroke in a large blood vessel, loss of function may occur suddenly.
The course of dementia varies greatly from one person to another. Early diagnosis and treatment with medicines used for Alzheimer's (cholinesterase inhibitors such as donepezil [Aricept]) may help preserve mental functioning for a while in people who have vascular dementia, dementia with Lewy bodies, or Parkinson's disease.2 Even without these medicines, some people remain stable for months or years, while others decline rapidly.
Many people with dementia are not aware of their mental decline. They may deny their condition and blame others for their problems. Those who are aware may mourn their loss of abilities and become hopeless and depressed.
Depending on the type of dementia, the person's behavior may eventually become out of control. The person may become angry, agitated, and combative or clingy and childlike. He or she may wander and become lost. These problems can make it difficult for family members or others to continue providing care at home.
Even with the best care, people with dementia tend to have a shorter life span than the average person their age. The progression varies depending on the disease causing the dementia and whether the person has other illnesses such as diabetes or heart disease. Death usually results from lung or kidney infections caused by being bedridden.
For more information on decisions you may face as your loved one's condition progresses, see the topic Care at the End of Life.
What to think about
Many older people have a slight loss of mental skills (usually recent memory) that doesn't affect their daily functioning. This is called mild cognitive impairment by some. People who have mild impairment may be in the early stage of dementia, or they may stay at their present level of ability for a long time.
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