Blog - ReaDementia

10+ Best Incontinence Products for Dementia Patients

Laura Herman Blog, Prevention, Resources March 6, 2021September 5, 2023dementia, incontinence, incontinence products

There are numerous incontinence products for dementia patients, and each has dozens of variations.

Different combinations of products may be right for different individuals, and a person’s needs may evolve over time.

Incontinence Products for Dementia

	Product	Features
	Prevail Air plus Daily Brief	Soft & breathable Ultimate absorbency Pack of 4 (18 count) Night & day Skin smart Omni-odor guard
	Wellness Superio Series BriefsBrand: Unique Wellness	Fully Absorb up to 2.6L Wide absorbent core Resealable landing zone for easy adjustment White with a nylon based crinkle-free plastic Value for money Stays dry for 8+ hours Award winner/ Featured on Discovery Channel
	One Piece Waterproof Snap-on Diaper Cover BriefBrand: Salk	Lightweight Softness of cloth 100% waterproof Polyester/urethane outer Brushed polyester inner Super-absorbent pad 3-ply inner layer Waterproof outer layer Washable
	SOSecure Containment Swim BriefBrand: Discovery Trekking Outfitters	Discreet Swimming Undergarment Durable Polyurethane Fabric Fleece Lining Hook and Loop Closure (Easy) Elastic Waist & Legs Machine Washable Latex Free
	Prevail Overnight Bladder Control PadsBrand: First Quality	For Women Dri-Fit cotton enhanced QUICK WICK Layer and cotton Odor Guard
	Depend Men GuardsBrand: Kimberly Clark	Adhesive strips to hold guard in place Individually wrapped Discreet- pocket-sized pouch Easy carrying and disposal Contoured design Cup-shaped protection for men One size fits most
	Medline Incontinence Bed Pads	Underpads 50 count 36"X36" Heavy absorbancy Polypropylene backing (protects against leakage & resists melting) Ideal for overnight use
	Inspire Washable and Reusable Incontinence Chair or Bed Pads	Washable/reusable Solves incontinence problems Safely absorbs & lock in liquids Soft & comfortable Non-irritating
	Bariatric 2X-Large UnderwearBrand: Attends	Improved side panels (better comfort & fit) Acquisition layer Super absorbent polymer Tear-away sides (easy removal) Looks & feels like regular underwear Bag of 12
	Depend Mens Maximum Absorbency UnderwearBrand: Kimberly Clark	Outstanding protection Improved underwear-like fit Brief-like leg opening Heavy incontinence Soft, quiet, breathable material Conforms to the body
	AIRCUTE Washable Absorbent Urine Incontinence Underwear for Women	6 layers High waist Absorbent & leakproof Washable Breathable Comfortable
	Prevail Adult WashclothBrand: First Quality	Super strong & soft fabric (12" x 8") Stay-open & easy-close lid Press 'N' Pull lid Super strong soft fabric Aloe & lanolin Lid closes tightly

Don’t call them diapers

Many people refer to incontinent products for dementia as “diapers,” but the term has a strong connotation with infants.

It is generally considered to be disrespectful, infantilizing and tactless.

It should not typically be used when referring to adult absorbent undergarments (unless the person themselves prefers that term).

Words like “pads” or “briefs” would be an appropriate way to refer to these products.

Products designed to be worn inside, or instead, of underpants

Pantiliners – a very thin pad that adheres to underpants for small leaks
Disposable pads – adhere to underpants, but are thicker and more absorbent than pantiliners
Pull up briefs / disposable underpants
Washable pads, liners or absorbent underpants
Reusable vinyl waterproof underpants covers
Wraparound tab briefs – similar to a traditional “diaper” design
Extended wear – Products designed for extended use keep urine away from the skin
Brief liners – designed specifically for use in a brief to boost absorbance or easily remove if damp
Insert – for use with special underpants designed with a pocket to hold a disposable or washable pad insert
Condom catheter or body-worn urinal – Designed to fit over a penis and collect urine in a bag

Products to protect furniture from wetness

Waterproof bed sheets
Washable bed pads
Disposable bed pads
Waterproof mattress pads

Other supportive equipment

Raised toilet seat with handles – this can make it easier to get on or off the toilet
Portable bedside commode
Urinal

When the Person with Dementia won’t Keep a Brief On

If someone with dementia keeps removing their brief, pay attention for clues to determine a likely reason.

Is the problem specific to briefs or are they pulling at other clothing too? Does it happen mainly at night or after bathing? Understanding the reason behind it is essential for finding a solution.

Common reasons for removing clothing or briefs can include:

Feeling too warm
Ill-fitting brief or pants
Wet, damp or soiled brief

Is the person new to wearing briefs (or wearing a new type or brand)?

Briefs can be bulky or uncomfortable, especially when they feel unfamiliar.

Start with the smallest, thinnest or most comfortable product that will meet their needs. This might mean changing them more frequently.

Be sure to minimize incontinence with a toileting plan.

Try a different style

It is worth experimenting with various brands and styles to find something more comfortable or successful.

Look for patterns

1. Do they remove the brief mainly at night? Try going without the brief if possible, using several bed pads for absorbance instead. It may help to tuck an additional bed pad up between the person’s legs.

2. Does it happen mainly when the brief is damp? It may help to use a brief liner, or alternate style of brief that pulls wetness away from the skin. Allow skin to dry fully after a shower or wash-up to ensure there is no lingering feeling of dampness.

3. Are they removing the brief when they need the restroom? It may be a non-verbal sign that the person needs to use the restroom.

4. Do they seem to have bored or restless hands? Giving them something interesting for their hands, such as super soft fuzzy gloves, or a dementia fidget lap blanket with lots of interesting textures and items for their hands to explore.

Is this a sudden change?

A sudden change probably indicates a problem other than the brief itself.

Look for signs that the person might be uncomfortable, especially in the abdomen or perineal area.

Possible conditions that could cause discomfort include:

Urinary tract infection
Constipation
Hemorrhoids
Dehydration
Rash
Pressure ulcer or skin breakdown

Special clothing for special situations

Although there are specialty clothing designed to prevent people from removing their own clothing – such as a jumpsuit with a zipper in the back – there are ethical concerns about restricting normal access to one’s body. They can cause distress in some cases.

In many places, these types of clothing are considered restraints.

What if the Person with Dementia won’t Change their Brief when Needed?

There are many potential complications of wearing a soiled brief too long. It greatly increases one’s risk of urinary tract infections, rashes, skin breakdown, and pressure sores.

Unfortunately, it’s an all-too-frequent problem in dementia care.

There are dozens, if not hundreds, of unique reasons – and as many potential solutions. A few examples include:

Set them up for independence

Keep pads and supplies easily within sight and reach from the toilet.

Catch them when they’re in the restroom

Getting them onto the toilet in the first place is often the biggest challenge. Once they’re there, it can be much easier to access the brief to change it.

Avoid “taking” anything without giving something in return

Hand them a clean pad to hold while you swap out the soiled one for another.

Spare their pride

Present non-rinse soap, wetness barrier cream, or other appropriate skincare products as a medical treatment, for example, to “prevent infection” or to “protect your skin.”

Not only are these statements true, they also take the focus off of their incontinence, which can spare their pride – and their need to fight for it.

Incontinence can be Embarrassing, Inconvenient and Challenging

Successfully managing it can make a big difference in terms of quality of life, physical health and mental well-

At What Stage of Dementia Does Incontinence Occur?

Laura Herman Blog, Signs March 6, 2021August 21, 2026dementia, incontinence

At what stage of dementia does incontinence occur? There is no single stage when everyone with dementia becomes incontinent. Continence problems can occur at any stage, although loss of bladder control becomes increasingly common as dementia progresses and is particularly common in the later stages.

Some people never become fully incontinent. Others may begin having occasional accidents much earlier.

Importantly, new or suddenly worsening incontinence should not automatically be assumed to be caused by dementia. Urinary tract infections, constipation, medications and other medical conditions can also cause continence problems and may be treatable.

At What Stage of Dementia Does Incontinence Occur?

The answer varies considerably from one person to another.

According to the NHS, bladder incontinence is common in the later stages of dementia, and some people also experience bowel incontinence.

However, continence problems are not limited to advanced dementia. The Alzheimer’s Society explains that people with dementia can experience difficulties using the toilet for many different reasons as the condition progresses.

A useful way to think about it is:

Earlier stages: most people remain independent with toileting, although some may experience urgency, occasional accidents or continence problems caused by another medical condition.
Middle stages: memory, communication, mobility and difficulty finding or using the toilet can begin causing more frequent accidents.
Later stages: urinary incontinence becomes much more common. Some people also lose bowel control and may require substantial assistance with toileting and personal care.

Dementia does not progress in exactly the same way for everyone, so continence should be assessed according to the individual rather than used alone to determine a particular stage of dementia.

Why Does Dementia Cause Incontinence?

People with dementia may become incontinent for several reasons, and more than one factor may be involved at the same time.

Dementia Australia explains that dementia can make it difficult for a person to recognize that they need the toilet, remember what to do, find the toilet or use it correctly.

Difficulty Recognizing the Need to Go

As dementia progresses, communication between the brain and the bladder or bowel may become less effective.

A person may not recognize the sensation of a full bladder until the need to urinate becomes urgent.

In later dementia, they may have difficulty recognizing the signal altogether.

Difficulty Finding the Toilet

Memory and spatial awareness problems can make a familiar bathroom surprisingly difficult to locate.

A person may know they need the toilet but forget where it is.

Clear signs, good lighting and keeping the route to the bathroom free from clutter can make a significant difference.

Mobility Problems

A person may recognize the need to use the bathroom but simply be unable to reach it quickly enough.

Arthritis, weakness, balance difficulties and reduced mobility can all contribute to functional incontinence.

Continence Health Australia describes functional incontinence as urine leakage caused by difficulty reaching or using the toilet rather than a problem with the bladder itself.

Difficulty Managing Clothing

Buttons, zippers, belts and complicated clothing can become difficult to manage as cognitive and physical abilities decline.

By the time the person has worked out how to remove their clothing, an accident may have already occurred.

Elastic waistbands and simple clothing can make toileting easier.

Communication Difficulties

As communication becomes more difficult, a person may be unable to explain that they need the toilet.

Caregivers may need to watch for non-verbal signs such as:

Fidgeting
Pulling at clothing
Pacing
Restlessness
Repeatedly standing and sitting
Looking around for the bathroom

Incontinence May Have a Treatable Cause

One of the most important things to understand when asking at what stage of dementia does incontinence occur is that dementia is not always the cause.

The Dementia Australia continence guidance recommends speaking with a doctor so other possible causes can be investigated.

These can include:

Urinary tract infections
Constipation
Prostate enlargement
Other bladder or bowel conditions
Reduced mobility
Medication side effects
Changes in fluid intake

Continence Health Australia also recommends investigating new or worsening urinary incontinence rather than assuming that it is simply part of dementia.

Watch for a Sudden Change

A gradual increase in toileting difficulties may occur as dementia progresses.

A sudden change deserves particular attention.

For example, if someone who was normally continent suddenly begins having accidents, becomes more confused or appears unwell, contact their healthcare professional.

A urinary tract infection is one possible cause.

Symptoms can include:

Sudden urinary urgency or frequency
Pain or burning when urinating
Fever
New or worsening incontinence
A noticeable change in the person’s usual condition or behavior

Not everyone will experience the same symptoms, so significant unexplained changes should be medically assessed.

Types of Incontinence in Dementia

Different forms of urinary incontinence require different approaches.

Urge Incontinence

Urge incontinence involves a sudden, strong need to urinate that may be difficult to control.

The person may know they need the toilet but not have enough time to reach it.

Stress Incontinence

Stress incontinence occurs when pressure on the bladder causes leakage.

For example, a person may leak urine when coughing, laughing, sneezing or exercising.

This is not specifically caused by dementia and can occur in people who do not have dementia.

Functional Incontinence

Functional incontinence is particularly relevant for people with dementia.

The bladder itself may function normally, but cognitive or physical problems prevent the person from reaching and using the toilet successfully.

They may:

Forget where the toilet is
Fail to recognize the toilet
Forget how to remove clothing
Be unable to walk there quickly enough
Have difficulty communicating their needs

Bowel Incontinence

Bowel or fecal incontinence may also occur, particularly as dementia becomes advanced.

However, constipation can sometimes produce leakage around impacted stool, so new bowel incontinence should also be discussed with a healthcare professional.

Incontinence Products for Dementia

As continence problems increase, the right products can help protect clothing, bedding and skin while allowing the person to retain as much independence and dignity as possible.

	Product	Features
	Prevail Air plus Daily Brief	Soft & breathable Ultimate absorbency Pack of 4 (18 count) Night & day Skin smart Omni-odor guard
	Wellness Superio Series BriefsBrand: Unique Wellness	Fully Absorb up to 2.6L Wide absorbent core Resealable landing zone for easy adjustment White with a nylon based crinkle-free plastic Value for money Stays dry for 8+ hours Award winner/ Featured on Discovery Channel
	One Piece Waterproof Snap-on Diaper Cover BriefBrand: Salk	Lightweight Softness of cloth 100% waterproof Polyester/urethane outer Brushed polyester inner Super-absorbent pad 3-ply inner layer Waterproof outer layer Washable
	SOSecure Containment Swim BriefBrand: Discovery Trekking Outfitters	Discreet Swimming Undergarment Durable Polyurethane Fabric Fleece Lining Hook and Loop Closure (Easy) Elastic Waist & Legs Machine Washable Latex Free
	Prevail Overnight Bladder Control PadsBrand: First Quality	For Women Dri-Fit cotton enhanced QUICK WICK Layer and cotton Odor Guard
	Depend Men GuardsBrand: Kimberly Clark	Adhesive strips to hold guard in place Individually wrapped Discreet- pocket-sized pouch Easy carrying and disposal Contoured design Cup-shaped protection for men One size fits most
	Medline Incontinence Bed Pads	Underpads 50 count 36"X36" Heavy absorbancy Polypropylene backing (protects against leakage & resists melting) Ideal for overnight use
	Inspire Washable and Reusable Incontinence Chair or Bed Pads	Washable/reusable Solves incontinence problems Safely absorbs & lock in liquids Soft & comfortable Non-irritating
	Bariatric 2X-Large UnderwearBrand: Attends	Improved side panels (better comfort & fit) Acquisition layer Super absorbent polymer Tear-away sides (easy removal) Looks & feels like regular underwear Bag of 12
	Depend Mens Maximum Absorbency UnderwearBrand: Kimberly Clark	Outstanding protection Improved underwear-like fit Brief-like leg opening Heavy incontinence Soft, quiet, breathable material Conforms to the body
	AIRCUTE Washable Absorbent Urine Incontinence Underwear for Women	6 layers High waist Absorbent & leakproof Washable Breathable Comfortable
	Prevail Adult WashclothBrand: First Quality	Super strong & soft fabric (12" x 8") Stay-open & easy-close lid Press 'N' Pull lid Super strong soft fabric Aloe & lanolin Lid closes tightly

The most suitable product will depend on the person’s mobility, level of incontinence, ability to use the toilet independently and whether protection is required during the day, night or both.

Where possible, seek professional continence advice rather than simply moving immediately to the most absorbent product.

How to Reduce Incontinence and Toilet Accidents

Even when dementia contributes to incontinence, practical changes can sometimes reduce the number of accidents significantly.

Make the Toilet Easy to Find

A person with dementia may have difficulty remembering where the bathroom is or recognizing the toilet once they get there.

The Alzheimer’s Society recommends making the toilet as easy as possible to find and use.

Helpful changes may include:

Putting a clear sign or picture on the toilet door
Keeping the bathroom door visible
Improving lighting
Using night or sensor lights
Removing clutter from the route
Making the toilet itself easy to recognize

Use Easy-to-Remove Clothing

Replace complicated fastenings with clothing that can be removed quickly.

Elastic waistbands can be especially helpful.

This simple change may prevent accidents when the person understands they need the toilet but has difficulty removing their clothing.

Watch for Non-Verbal Clues

Do not rely entirely on asking, “Do you need the toilet?”

A person with dementia may automatically answer no, forget what the question means or fail to recognize the physical sensation.

Instead, learn the person’s usual signs.

Pacing, pulling at clothing, increased agitation or repeatedly getting up may indicate that they need the toilet.

Create a Dementia Toileting Routine

A regular toileting routine can be helpful, particularly when the person is losing the ability to recognize or communicate the need to go.

Rather than repeatedly asking whether the person needs the toilet, caregivers may gently encourage a bathroom visit at predictable times.

For example:

After waking
Before leaving the house
Before or after meals
At regular intervals during the day
Before going to bed

Keeping a simple continence or toilet diary for several days can also reveal patterns.

If accidents repeatedly occur around the same time, a caregiver may be able to offer assistance shortly beforehand.

The routine should be adjusted to the person’s individual needs rather than following a rigid schedule.

Do Not Sacrifice Sleep Unnecessarily

Preventing every overnight accident is not always the most important goal.

Repeatedly waking a person during the night may interfere with valuable sleep and may increase confusion or distress.

For some people, appropriate overnight continence products, waterproof bedding and a clear route to the bathroom may be more practical.

Discuss persistent night-time incontinence with a healthcare professional or continence adviser to determine the most appropriate approach.

Keep the Person Well Hydrated

Reducing fluids dramatically may seem like an obvious way to reduce accidents, but it can create other problems.

People with dementia can already be vulnerable to dehydration because they may forget to drink or no longer recognize thirst.

Dementia Australia recommends maintaining adequate fluid intake.

The person’s healthcare professional can advise on appropriate fluid intake if they have other medical conditions that affect how much they should drink.

Caffeine may increase urinary frequency for some people, but dietary or medication changes should be considered in the context of the person’s overall health.

Can Medication Help Incontinence in Dementia?

Medication may sometimes be appropriate, but it depends on the type and cause of the incontinence.

This is particularly important for people with dementia because some medicines used for overactive bladder can have side effects including confusion, constipation, dizziness and an increased risk of falls.

A 2026 review from Continence Health Australia recommends discussing the potential benefits and harms of continence medication with a doctor or pharmacist.

Some existing medications can also contribute to urinary symptoms.

These can include certain diuretics, sedatives and some other medications.

Do not stop or change prescribed medication without discussing it with the person’s doctor or pharmacist.

When Should You Talk to a Doctor?

Speak with the person’s doctor if continence problems are new, worsening or causing difficulty.

Medical advice is particularly important when there is:

Sudden onset of incontinence
Pain or burning during urination
Fever
Blood in the urine or stool
Severe constipation
A significant change in behavior or confusion
Difficulty emptying the bladder
Repeated falls while trying to reach the toilet
Skin irritation or breakdown

A doctor may investigate medical causes and, when appropriate, refer the person to a continence nurse or other specialist.

At What Stage of Dementia Does Incontinence Occur? Closing Summary

There is no exact answer to at what stage of dementia does incontinence occur because every person’s experience is different.

Continence problems can occur in earlier or middle stages, but bladder incontinence becomes increasingly common in later-stage dementia. Some people may eventually experience bowel incontinence as well.

However, an accident does not necessarily mean dementia has suddenly progressed.

Infections, constipation, medications, mobility problems and other conditions can all contribute to incontinence. New or worsening symptoms should therefore be discussed with a healthcare professional.

For people whose continence problems are related to dementia, simple strategies such as clear toilet signs, easy-to-remove clothing, regular toileting routines, appropriate continence products and careful attention to non-verbal cues can make daily life considerably easier.

Above all, continence care should focus on the individual person’s comfort, dignity and remaining independence.

High Blood Pressure and Alzheimer’s Risk

Petra Boh Blog, Causes March 4, 2021October 16, 2021alzheimer's disease, blood pressure, high blood pressure

New research suggests there may be a link between hypertension or high blood pressure and Alzheimer’s disease (AD).

High blood pressure occurs when the force of blood pushing against blood vessels becomes too high.

This can cause harm because it stresses not only the blood vessels but the heart as well.

The blood vessels cease to function properly because they have to work harder than normal.

Over time, the arteries will become narrower which can result in problems such as stroke, kidney failure, or heart disease.

Damaged small blood vessels can also negatively affect the sections of the brain responsible for memory and thinking.

Blood Pressure and Alzheimer’s Risk

Persons with higher blood pressure are also more likely to have brain lesions. These are the areas of dead tissues that develop because of low blood supply.

AHA statistics report that about 46% of America’s adult population has blood pressure. Not to mention, 16% do not even know they have the condition.

Alzheimer’s disease is the most common cause of dementia.

Dementia is a general term for the progressive loss of memory and other cognitive abilities that can seriously interfere with a person’s day-to-day life.

High blood pressure can affect the brain

Scientists believe that hypertension can also affect a person’s brain to the extent of developing some of the main markers for AD.

A study published in Neurology states that seniors who have higher average blood pressure compared to their age-mates are more likely to develop plaques and tangles in the brain which are both markers for Alzheimer’s.

The study had 1,288 participants who were 65 years and older. The researchers conducted annual cognitive testing and blood pressure checks on the subjects.

Moreover, experts also kept track of the medications the participants took and their medical histories. They also agreed to go through a brain autopsy after death to look for signs of brain aging like plaques and tangles.

Researchers discovered that persons who had higher than average blood pressure had more dead tissues resulting from strokes (blocked blood flow) as well as tangles and plaques.

Dr. Claudia Padilla, a neurologist, explained that plaques and tangles happen when proteins that the body produces break down into toxic forms which significantly affect neurons in the brain.

Director of global science initiatives at Alzheimer’s Association, James Hendrix, Ph.D. notes that damage that the toxic proteins cause is only part of the problem.

He said that lack of sufficient blood flow affects how the brain works around damaged tissue which can worsen symptoms of brain tissue damage.

Hypertension may not be the warning sign of AD

Padilla also stated that because this was an observational study on the relationship between blood pressure and Alzheimer’s disease, the results do not prove that hypertension causes warning signs of AD.

The study did not determine how higher average late-life blood pressure ends up increasing plaques and tangles in the brain.

However, she added that the study found a clear association between higher blood pressure in late life and the presence of protein plaques and tangles which are symptoms of Alzheimer’s disease.

Based on the findings of the study, Padilla considers it important to control blood pressure as a strategy for preventing cognitive decline.

In another interesting study on the relationship between blood pressure and Alzheimer’s, a Johns Hopkins analysis of formerly gathered data revealed that individuals who took prescribed blood pressure medication were half as likely to develop AD than those who did not.

The report established earlier work from researchers at Johns Hopkins who found that using potassium-sparing diuretics reduced the risk of Alzheimer’s by about 75%.

The risk was reduced by a third for persons who used any kind of antihypertensive drugs. Director of Johns Hopkins Memory and Alzheimer’s Treatment Constantine Lyketsos, M.D said that they found that if a person did not have Alzheimer’s and they were taking blood pressure medication, they were less likely to develop dementia.

He continues to say that if a person developed dementia from AD and was taking certain antihypertensive, the illness was less likely to progress.

They were not sure if this connection arises from better management of blood pressure or there are specific drugs that end up interfering with processes that relate to AD. Lyketsos suspected that both play a role.

Controlling your levels of blood pressure is important

An in-depth examination of long-term data from 4 countries by a team of global scientists also supported the idea that controlling high blood pressure can reduce the risk of Alzheimer’s.

The experts cross-referenced data from 6 large longitudinal studies. They observed the heath of more than 31,000 adults who were 55 years and above.

The scientists analyzed data from community-based comprehensive health studies conducted between 1987 and 2008 in France, United States, Netherlands, and Iceland.

They looked into 5 primary types of blood pressure drugs diuretics, ACE inhibitors, calcium channel blockers, beta-blockers, and angiotensin II receptor blockers.

The data was divided into 2 groups; 15, 553 people with normal blood pressure, and 15,537 people with high blood pressure.

In all, there were 1,741 Alzheimer’s disease diagnoses over time.

The results showed that treating hypertension reduced the risk of developing Alzheimer’s by 16% regardless of the type of antihypertensive medication a person was on.

In other words, it is important to take the link between lowering blood pressure and Alzheimer’s risk seriously.

High blood pressure medication can boost blood flow to the brain

A small clinical trial also revealed that using blood pressure medication for treatment can enhance blood flow to key brain regions in persons with Alzheimer’s disease.

The research was part of a larger trial that was looking into whether nilvadipine could improve thinking and memory skills with persons with Alzheimer’s.

It involved a trial of 44 participants who had mild to moderate AD. The average age of the participants was 77 years.

They were randomly assigned to either use blood pressure medication nilvadipine or inactive placebo pills for 6 months. At the end of the trial, specialized MRI scans showed the persons on the drugs recorded a 20% increase in blood flow to the hippocampus.

This is the structure of the brain that is involved in learning and memory.

These are the first areas that Alzheimer’s damages.

Persons on the real drug also indicated that their blood pressure dropped by eleven points when compared to the group that was on the placebo.

Experts, however, acknowledged that the size of the study was too small and short.

Unfortunately, it is impossible to conclusively indicate whether enhanced blood flow could have effects on the symptoms.

The lead author Dr. Jurgen Claassen hoped that future research could give a better answer to the query and it should mostly focus on persons with early Alzheimer’s.

He, however, explained that persons with early-stage AD showed benefits.

Closing Remarks

Even though several studies have linked high blood pressure to Alzheimer’s symptoms more research is still required.

The findings of the studies affirm that what’s good for the heart is also good for the brain.

We can reduce hypertension through various lifestyle changes like physical exercise, eating a healthy diet, and reducing sodium. Some medications can also help lower blood pressure.

Do Concussions Cause Alzheimer’s Disease?

Petra Boh Blog, Causes March 4, 2021October 16, 2021alzheimer's, alzheimer's disease, concussion

There has been a lot of concern as to whether concussions cause Alzheimer’s disease (AD) in the medical field.

This is mostly because the immediate effects of a head injury can include symptoms that are seen in the disease. These would be memory loss, confusion, and changes in speech, personality, and vision.

Can Concussions Increase Risk for Alzheimer’s

These symptoms can quickly vanish, last for some time, or become permanent depending on the severity of the injury.

Also, the symptoms that develop after an injury in most cases will not become worse over time something synonymous with AD.

This said some kinds of head injuries increase the risk of a person developing Alzheimer’s later in life.

Concussions can stimulate cognitive decline

Research reveals that concussions can accelerate the development of cognitive decline and brain atrophy.

These relate to Alzheimer’s in people who are at the genetic risk of this progressive illness.

This is especially true for people who carry one form of the APOE (apolipoprotein) gene. This gene has the potential to increase the risk of AD.

These findings are documented in the journal Brain and they show promise of identifying the influence that concussions have on neurodegeneration.

One of the environmental risk factors of developing neurodegenerative illnesses such as late-onset Alzheimer’s is a moderate-to-severe traumatic brain injury.

It is still not yet clear whether concussion or mild traumatic brain injury also contribute to increasing the risk.

Several studies have been conducted to try and establish the link between Alzheimer’s disease and concussions. Check out details of a few of these studies below.

Researchers from BUSM (Boston University School of Medicine), observed 160 war veterans from Afghanistan and Iraq.

The group comprised some people who had never suffered a concussion and others who had suffered one or more concussions.

The researchers measured the thickness of the participant’s cerebral cortex using MRI imaging in 7 regions. These are usually the first to indicate atrophy in AD and 7 control regions.

The experts stated that they found that lower cortical thickness in some of the regions of the brain caused by a concussion was first to be affected in AD.

Assistant professor of psychiatry at BUSM and research psychologist at the National Centre for PTSD Jasmeet Hayes, Ph.D. and corresponding author of the study explained that the results suggested that concussions when combined with genetic factors may be associated with accelerated memory decline and cortical thickness in areas that are relevant to Alzheimer’s.

Concussions have an impact on the young brain, too

The researchers noted that the brain abnormalities appeared in a relatively young group. The average age of the participants was 32 years.

The researchers translated this to imply that the influence of concussions on neurodegeneration can be detected early in a person’s lifetime.

They, therefore, advised that after suffering a concussion, it is important to document as much as possible.

But at least when it happened and the symptoms that a person showcased. This is because when concussions combine with other factors like genetics, they can cause long-term health consequences.

The experts were hopeful that other researchers will build on their findings to give a clear answer when asked if concussions cause Alzheimer’s disease.

Head injuries can cause AD twice as likely

Another study revealed that young adults who suffer from moderate or severe head injury are two times likely to develop AD later in life.

This was after Dr. Brenda Plassman and her colleagues from Duke University Medical Centre in Durham, North Carolina conducted research trying to find the link between Alzheimer’s and head injury in over 7000 US marine and Navy veterans from World War II.

The subjects of the study included 548 veterans who had experienced a head injury and 1228 who did not have any head injuries.

The experts discovered that people with a history of head injury were more than double the risk of developing AD.

Moderate head injury was associated with a 2.3 times increase in risk.

In addition to that, severe head injury was associated with more than 4 times the risk.

Severe head injury, in this case, was one where a person remained unconscious and was admitted to a hospital.

Moderate injury referred to bouts of amnesia or loss of consciousness that lasts for less than 30 minutes after the injury.

Do genes have a role?

The experts also went ahead to test for the presence of the apolipoprotein E gene. Participants who had this gene were 14 times more likely to develop Alzheimer’s.

Because there was no apparent relationship with a head injury and APOE gene, the researchers suggested that more work is necessary.

This will allow us to understand the effects of the gene and a head injury better. Potentially, more research will also give a better understanding of the causes of AD.

Yet another study reported that brain scans of elderly persons with a prior head injury and poor memory have more build-up of plaque associated with AD which supports that concussions may cause Alzheimer’s disease.

In this study associate professor of neurology and epidemiology at Mayo Clinic Rochester and her team evaluated 448 residents of Olmsted County who did not have any signs of memory problems.

They also studied 141 residents who had mild cognitive impairment (thinking and memory problems).

All the participants of this study were 70 years and above.

Before the study, they all reported whether they had experienced a brain injury that caused the loss of memory or consciousness.

The researchers conducted brain scans on all the subjects.

The results revealed that persons who had cognitive impairment and concussion history had amyloid plaques levels that were 18% higher than those who did not have a history of head trauma but had cognitive impairment.

They concluded that the link between concussions and AD is quite complex. This is because the results showed an association but not a cause and effect link.

Risk Factors for Developing Alzheimer’s After a Concussion

Scientific research supports the idea that suffering concussions may increase the chances of a person developing AD.

Some factors also seem to affect the risk of concussions causing Alzheimer’s disease and these include:

Age

The age when a person suffers from a concussion may have an impact on whether they end up developing AD.

Several studies suggest that suffering concussions at a young age increases the risk of developing Alzheimer’s disease. This applies to when a person is older.

The severity of the Injury

The risk of concussions causing Alzheimer’s disease increases with the severity of the injury.

Repeated mild injuries may also increase an individual’s risk for future problems with reasoning and thinking.

Conclusion

Keep in mind, although concussions can increase the risk of developing AD, other factors also play a role.

Not everyone who suffers a severe head injury will end up developing the disease.

More research is still necessary to understand the link between Alzheimer’s disease and concussions.

Average Age for Alzheimer’s Disease: Key Facts

Petra Boh Blog, Signs March 4, 2021August 22, 2026age, alzheimer's, alzheimer's disease

Older woman with text reading “Average Age for Alzheimer's Disease”

What is the average age for Alzheimer’s disease? There is no single age at which Alzheimer’s begins, but the vast majority of people who develop the disease are 65 or older.

Age is the greatest known risk factor for Alzheimer’s disease. The likelihood of developing the condition increases substantially as people get older, although Alzheimer’s is not a normal part of aging.

A smaller number of people develop Alzheimer’s before age 65. This is known as younger-onset or early-onset Alzheimer’s disease.

What Is the Average Age for Alzheimer’s Disease?

Most cases of Alzheimer’s disease occur after age 65.

According to the National Institute on Aging, most people with Alzheimer’s develop the disease at age 65 or older, while fewer than 10% develop symptoms before age 65.

There are two broad age-related categories of Alzheimer’s disease: late-onset Alzheimer’s and younger-onset Alzheimer’s.

Late-Onset Alzheimer’s Disease

Late-onset Alzheimer’s is the most common form of the disease and generally refers to Alzheimer’s that develops at age 65 or older.

The risk increases considerably with age.

The 2026 Alzheimer’s Disease Facts and Figures report estimates that 7.4 million Americans aged 65 and older are living with Alzheimer’s dementia.

The percentage of people living with Alzheimer’s rises sharply across older age groups:

Ages 65–74: approximately 5.2%
Ages 75–84: approximately 13.8%
Age 85 and older: approximately 35.8%

About 74% of Americans aged 65 and older who are living with Alzheimer’s are at least 75 years old.

These figures help explain why there is no precise average age for Alzheimer’s disease. The likelihood of developing it continues to increase as people move through their 70s, 80s and beyond.

Importantly, growing older does not mean that someone will inevitably develop Alzheimer’s.

Many people live into their 80s and 90s without developing the disease.

Younger-Onset Alzheimer’s Disease

Although Alzheimer’s is much more common among older adults, it can also develop before age 65.

This is called younger-onset Alzheimer’s disease, although the term early-onset Alzheimer’s is also widely used.

Many people diagnosed with younger-onset Alzheimer’s are in their 40s or 50s, although rare inherited forms of the disease can cause symptoms even earlier.

Most younger-onset cases are not caused by a single inherited genetic mutation.

However, researchers have identified three rare genes that can directly cause inherited Alzheimer’s disease: APP, PSEN1 and PSEN2.

The National Institute on Aging explains that these genetic variants account for only a small proportion of younger-onset Alzheimer’s cases.

Another gene, APOE, can affect a person’s risk of developing Alzheimer’s, particularly later in life. However, carrying an APOE risk variant does not mean that a person will definitely develop the disease.

How Does Alzheimer’s Risk Change With Age?

When considering the average age for Alzheimer’s disease, it is important to understand that age itself does not directly cause Alzheimer’s.

Instead, aging is associated with biological changes that can make the brain more vulnerable.

Researchers are studying several age-related processes that may contribute to Alzheimer’s disease. These include inflammation, changes to blood vessels, reduced energy production within brain cells, oxidative damage and changes in the way proteins are processed and cleared from the brain.

Over many years, abnormal forms of proteins including beta-amyloid and tau can accumulate in the brain.

These changes may begin long before noticeable memory problems or other symptoms develop.

Other factors can also influence Alzheimer’s risk, including genetics, cardiovascular health, family history and certain lifestyle and environmental factors.

This is why two people of the same age can have very different levels of risk.

At What Age Is Alzheimer’s Usually Diagnosed?

There is no standard age of diagnosis.

Some people are diagnosed soon after symptoms first appear, while others may experience changes in memory and thinking for several years before receiving a diagnosis.

Because late-onset Alzheimer’s occurs after 65 and becomes increasingly common with advancing age, many diagnoses occur during a person’s 70s and 80s.

A diagnosis may involve medical history, physical and neurological examinations, blood tests, brain imaging and assessments of memory and thinking.

You can read more about the types of cognitive tests used when evaluating dementia.

Anyone experiencing persistent changes in memory, thinking, judgment or everyday functioning should discuss them with a qualified healthcare professional rather than assuming they are simply part of getting older.

What Is the Average Age of Death for Alzheimer’s Patients?

There is no single average age of death for people with Alzheimer’s because the disease can be diagnosed at very different ages.

A more useful measure is how long people typically live following a diagnosis.

According to the Alzheimer’s Association, people aged 65 and older live an average of approximately four to eight years after an Alzheimer’s diagnosis, although some people live for as long as 20 years.

Survival varies considerably from one person to another.

Factors such as age at diagnosis, the stage of the disease, general health and other medical conditions can influence life expectancy.

You can read more about average dementia survival and life expectancy.

Average Age for Alzheimer’s Disease: Closing Thoughts

There is no exact average age at which everyone develops Alzheimer’s disease.

The clearest dividing point is age 65. Alzheimer’s developing at or after age 65 is considered late-onset disease, while Alzheimer’s affecting someone younger than 65 is usually described as younger-onset or early-onset Alzheimer’s.

Most people with Alzheimer’s are older adults, and the prevalence rises significantly with age. Current U.S. data shows that approximately 5% of people aged 65–74 have Alzheimer’s dementia compared with more than one-third of those aged 85 and older.

Age is therefore an important risk factor, but Alzheimer’s should never be regarded as an inevitable consequence of growing older.

Understanding the relationship between age and Alzheimer’s can help people recognize when symptoms deserve further investigation and encourage timely medical assessment.

Obesity and Alzheimer’s Disease – Risk?

Petra Boh Blog, Causes March 3, 2021October 16, 2021alzheimer's disease, obesity

When looking into the risk factors of Alzheimer’s disease (AD), researchers have been paying close attention to the relationship between obesity and Alzheimer’s.

Alzheimer’s Association reports that over 5 million people in the US are living with AD. Unfortunately, we expect this number to rise to almost 14 million by 2050.

Does Obesity Increase Alzheimer’s Risk?

Alzheimer’s is a progressive brain disorder that results in loss of memory, cognitive skills, and also causes changes in behavior.

The increasing rate of this progressive illness means that it is important to identify the biomarkers that tell when a person is at high risk of developing AD.

Early diagnosis can lead to the development of treatment and prevention strategies with a positive impact.

What is obesity?

We can describe obesity as a complex condition that involves too much body fat according to Mayo Clinic.

This increases the risk of a person suffering other health problems like diabetes, heart diseases, certain cancers, and high blood pressure.

Experts also state that obesity is one of the risk factors for developing AD.

This is because obesity often leads to insulin resistance. Data suggests that in middle age, insulin resistance can increase the risk of Alzheimer’s disease through numerous pathways.

These include dysfunctional brain insulin and decreased brain glucose metabolism which can result in increased amyloid deposition as well as reduced brain volume.

Results from human and animal studies show that subjects with AD have increased brain insulin resistance.

Worth noting is that excessive insulin in a person’s bloodstream ends up interfering with the energy supply in the brain. This is primarily because it lowers the amount of glucose or fuel that reaches the brain.

Obesity can contribute to Alzheimer’s

Over the years, research has revealed that obesity and related comorbidities as potential contributors to Alzheimer’s disease pathophysiology.

This suggests that conditions like poor-quality diet, diabetes, and a sedentary lifestyle may be part of AD’s modifiable risk factors.

A study published in Obesity Reviews examined possible mechanisms in the relationship between AD and obesity.

This also included recommended treatment strategies that may play a role in the development as well as the progression of Alzheimer’s.

Reports from numerous animal and human studies suggest that there is a link between obesity and Alzheimer’s.

Obesity and higher body mass index (BMI) have been linked to reduced white matter, brain atrophy, cognitive decline, the integrity of the blood-brain barrier, and an increased risk for late-onset Alzheimer’s.

The calculated effect size of obesity for the neurodegenerative disease was 1.54 according to various results from longitudinal epidemiological studies.

Strong evidence points to midlife obesity as a risk factor for Alzheimer’s.

A cross-sectional study that was published in Obesity revealed that there is an inverse relationship between cognitive function and BMI among healthy middle-aged adults.

Several observational studies have also reported that obesity in mid-life increases the risk of dementia later in life.

Weight loss can occur later in life due to the disease

Even though there seems to be a connection between obesity and Alzheimer’s, this association tends to shift later in life.

According to the statistics about 20%-45% of patients with Alzheimer’s tend to experience weight loss as the illness progresses.

There may be a possibility that a decline in BMI that goes before AD diagnosis may be related to the neurodegeneration sections of the brain that are responsible for homeostatic weight regulation.

Several factors can contribute to weight loss including decreased motivation for self-care, https://readementia.com/why-do-dementia-patients-stop-eating/, paying less attention to mealtime, social withdrawal, and altered metabolism amongst others.

At times, genetic factors might also come into play.

For instance, there have been reports on a connection between increased weight loss in AD and the presence of the APOE gene.

Inappropriate diet has a degenerating impact on the body and mind

Another study on the association between obesity and Alzheimer’s suggests that when HFS (high-sugar and high-fat) diet linked to obesity is paired with normal aging, it can lead to the development of AD.

You can find the details of this study in Physiological Reports. The study was conducted by researchers from Brock University in Ontario, Canada.

They chose to look at the effects of an obesity-inducing diet on insulin signaling which is the process that lets the body know how to use sugar as well as markers of cellular stress, and inflammation.

These are some of the factors that play a role in the progression of Alzheimer’s during the aging process in mice.

There were two groups of mice one on a normal diet and the other on HSF.

The researchers measured the animals’ stress and inflammation levels in the prefrontal cortex and hippocampus areas of the brain after 13 weeks of the allocated diets.

The prefrontal cortex oversees complex cognitive, behavioral, and emotional functions. The hippocampus deals with long-term memory.

Obesity affects aging and brain functioning

After comparing the two groups of mice, the experts found that the HFS had higher markers for insulin resistance, inflammation, and cellular stress in the hippocampus region.

This is thought to play a role in the progression of Alzheimer’s disease. Their prefrontal cortex region also showed more signs of insulin resistance.

On the other hand, there were no alterations in cellular stress and inflammation markers.

The researchers concluded that the region-specific differences between the hippocampus and prefrontal cortex in regards to aging with an HFS diet shows that the pathology of the disease is not uniform in all section of the brain.

When compared to baseline readings, the control group also recorded an increase in inflammation levels.

The results according to this study indicate that although age plays a role in the progression of AD, obesity also worsens the effects of aging on the function of the brain.

The research team acknowledged that their study offers fresh details to the mechanistic link between obesity and Alzheimer’s.

This is regarding the pathways that lead to the early progression of AD and the negative effects that the HFS diet has on the hippocampal and prefrontal cortex regions of the brain.

Obesity and Alzheimer’s Conclusion

After talking about the link between obesity and Alzheimer’s, it is important for people to manage their weight well especially during mid-life or better yet earlier to reap the benefits later in life.

A healthy diet and proper exercise are key to reducing the risk of a myriad of health problems including Alzheimer’s disease.

Multi-Infarct Dementia: What Is It?

Petra Boh Blog, Types March 3, 2021October 16, 2021dementia, multi-infarct dementia, stroke, vascular dementia

A kind of dementia, multi-Infarct dementia (MID) is a type of vascular dementia that is caused by multiple strokes.

It is also considered to be the second-most common cause of dementia after Alzheimer’s disease.

The strokes interrupt blood flow to the brain, which ends up affecting how the organ functions.

A brain infarct or stroke happens due to the block or interruption of blood flow to any part of the brain.

Everything You Need To Know About Multi-Infarct Dementia

Blood transports oxygen and other essential nutrients to the brain. When the brain lacks oxygen, it causes the death of brain tissues.

Multi-Infract imply that multiple areas in the brain have been injured because of lack of blood from a series of small strokes.

There are times when blockages of the brain cause an infarction (stroke) without any stroke symptoms.

These are known as “silent” strokes which are known to increase an individual’s risk of getting vascular dementia.

If someone experiences a series of small strokes over time, they may end up developing infarct dementia.

Symptoms of Multi-Infarct Dementia

The type of symptoms a person gets often depends on the area of the brain that the stroke has damaged.

At times the symptoms appear suddenly after a stroke or they may appear slowly over time.

We can categorize MID warning signs into two major sections as seen below.

Early Dementia Symptoms

Loss of executive function
Getting lost in familiar places or wandering
Short-term memory loss or confusion
Losing bowel or bladder control
Walking with shuffling rapid steps
Crying or laughing inappropriately
Challenges performing routine tasks like paying bills
Personality changes
Losing interest in activities or things that were previously enjoyed

Late-Stage Symptoms

As the disease progresses, a person may also experience other symptoms such as:

Hallucinations/delusions
Problems with simple tasks like meal preparation and dressing
Changes in sleep patterns
Memory loss
Social withdrawal
Poor judgment
Depression

Some individuals may go through periods where they seem to improve and then decline after experiencing small strokes.

MID Risk Factors

Some of the risk factors that increase a person’s risk of getting this disease include:

Medical Conditions

Diabetes, heart failure, previous strokes, atrial fibrillation, high blood pressure, cognitive decline prior to the stroke, and hardening of the arteries are some of the medical conditions that increase the risk of MID.

Age

Increasing age is a common risk factor for all types of dementia including MID.

The disease mostly affects persons who are between the ages of 60-75. In some rare cases, some people get the illness before they celebrate their 60th birthday.

Research also shows that men are slightly more likely to develop the disease than women.

Lifestyle Risk Factors

These include alcohol consumption, smoking, little to no physical activity, poor diet, and low level of education.

Diagnosing Multi-Infarct Dementia

There is no single test that can determine whether a person has MID or not. Worth noting is that each MID case is not the same.

One person may experience severe memory impairment while another individual may only experience mild memory loss.

Diagnosis can also be difficult because it is possible for a person to have both Alzheimer’s disease and MID making it challenging for a doctor to diagnose either of the diseases.

Medics base diagnosis on a number of factors such as:

History of stepwise mental decline
Blood pressure reading
Neurological exam
Blood tests
Physical Exams: this is where the doctor will ask questions pertaining to diet, sleep patterns, medications, past strokes, personal habits, stressful events, recent illness, and other medical issues.
Ruling out other causes of dementia like depression, diabetes, anemia, high cholesterol, brain tumors, carotid stenosis, chronic infections, thyroid disease, drug intoxication, vitamin deficiency, and high blood pressure.
Radiological imaging tests such as X-rays, CT & MRI scans that detail tiny areas of tissue that died from lack of adequate blood supply, electroencephalograms that measure the electrical activity of the brain, and transcranial doppler that is used to measure the velocity of blood flow through the blood vessels in the brain

MID Treatment Options

Currently, there is no treatment for multi-infarct dementia.

Experts have not yet discovered how to reverse brain damage that occurs after a stroke. Treatment options mainly focus on preventing strokes from reoccurring in the future.

This is done by putting in place measures to avoid or control the medical conditions and diseases that put individuals at risk of experiencing strokes.

Stroke risk factors include diabetes, high blood pressure, cardiovascular disease, and high cholesterol.

Treatment is also tailored to a person’s individual and most of them will include:

Medications

Doctors may prescribe certain medications to help improve symptoms such as:

Folic acid
Memantine
Hydergine
Nimodipine
Angiotensin: these help to lower blood pressure by converting enzyme inhibitors
Calcium channel blockers that help with short-term cognitive function
Some serotonin reuptake inhibitors that are antidepressants which may help neurons grow in a bid to re-establish connections in the brain

Healthy Lifestyle Habits

Practicing healthy habits is also key when it comes to MID treatment and some of them include:

Maintaining a healthy weight
Not smoking
Moderately using alcohol
Exercising
Eating a healthy diet

Alternative Therapies

Herbal supplements are also common when it comes to treating MID. However, more studies are still necessary to prove their efficiency.

Some of the herbal supplements that are being studied for use in MID treatment are:

Lemon Balm: A great alternative to restore memory
Wormwood: It enhances cognitive function
Water Hyssop: Used to improve intellectual function and memory

It is important to consult a doctor before taking any supplements to be on the safe side.

Other treatment options include rehabilitation therapy for mobility problems and cognitive training to help regain mental function.

Caregiver Support

Relatives and friends of persons with MID can help them cope with their physical and mental problems.

This can be done by encouraging regular physical and social activities as well as daily routines to help reinforce mental abilities.

Alarm clocks, calendars, and lists are useful when it comes to reminding the affected persons of important events and times.

MID Prognosis

The prognosis for persons with multi-infarct dementia is not clear.

This is mostly because the symptoms of the disease can appear all over sudden after each small stroke mostly in a step-wise pattern.

Some individuals with the disorder can appear to improve after some time and then decline after experiencing silent strokes.

The disease will spiral downwards with intermittent periods of fast deterioration. Some people may die after a MID diagnosis while others will survive many years.

Death may also occur from heart disease, stroke, pneumonia, or other infections.

Normal Pressure Hydrocephalus: Is It Reversible?

Petra Boh Blog, Prevention, Signs March 2, 2021August 23, 2026dementia, normal pressure hydrocephalus, nph

Doctor reviewing a brain scan for normal pressure hydrocephalus

Normal pressure hydrocephalus (NPH) is an important condition to recognise because some of its symptoms can look very similar to dementia, yet they may improve with treatment.

So, is normal pressure hydrocephalus reversible?

The answer is: sometimes, to a significant degree. Treatment can improve walking, thinking and bladder-control problems in some people with NPH. However, improvement varies from person to person, and a complete recovery cannot be guaranteed.

This makes early recognition particularly important. Unlike many progressive causes of dementia, normal pressure hydrocephalus may be treatable when the right patients are identified.

What Is Normal Pressure Hydrocephalus?

The brain contains interconnected spaces called ventricles. These ventricles contain cerebrospinal fluid (CSF), which surrounds and cushions the brain and spinal cord.

Normally, CSF circulates through the brain and is continuously produced and absorbed.

With normal pressure hydrocephalus, too much CSF accumulates within the ventricles. As the ventricles enlarge, they can affect nearby brain tissue and interfere with areas involved in walking, thinking and bladder control.

Despite the name, the pressure of the cerebrospinal fluid may not always be continuously elevated. The condition is called “normal pressure” hydrocephalus because CSF pressure can sometimes appear within a normal range when measured.

NPH occurs most often in adults over the age of 60. Its symptoms can resemble those seen with Alzheimer’s disease, Parkinson’s disease and other neurological conditions, which is one reason diagnosis can be difficult.

The Johns Hopkins Medicine notes that specialised assessment can help distinguish NPH from other disorders with similar symptoms.

What Causes Normal Pressure Hydrocephalus?

In many people, the exact cause of NPH is unknown. This is often referred to as idiopathic normal pressure hydrocephalus.

In other cases, problems with CSF circulation can develop following another condition or event.

Possible causes or associated factors include:

Previous bleeding around the brain, including subarachnoid haemorrhage
Head injury
Brain infection such as meningitis
Brain surgery
Brain tumours or other structural abnormalities
Other conditions that interfere with the normal circulation or absorption of cerebrospinal fluid

A history of one of these conditions does not necessarily mean that someone will develop NPH, and many cases occur without an obvious underlying cause.

What Are the Symptoms of Normal Pressure Hydrocephalus?

Normal pressure hydrocephalus is classically associated with three main groups of symptoms:

Difficulty walking or changes in gait
Cognitive or thinking problems
Urinary urgency or loss of bladder control

This combination is sometimes referred to as the classic NPH triad.

However, a person does not need to have all three symptoms at the same time. Symptoms may develop gradually, and one may be much more noticeable than the others.

Walking and Balance Problems

Walking difficulty is often one of the earliest and most prominent signs of NPH.

A person may:

Walk with shorter steps
Have difficulty starting to walk
Feel as though their feet are stuck to the floor
Shuffle their feet
Have difficulty turning
Become unsteady
Fall more frequently

Because these changes commonly occur in older adults for many other reasons, they can initially be attributed to aging, arthritis or another neurological condition.

Memory and Thinking Changes

NPH can also affect cognition.

Possible changes include:

Forgetfulness
Slower thinking
Difficulty concentrating
Trouble planning or organising tasks
Difficulty responding to questions
Apathy or reduced motivation
Confusion
Mood changes

These symptoms can resemble Alzheimer’s disease or another form of dementia.

However, the pattern can differ. NPH often produces slowing of thinking, reduced attention and problems with planning and organisation rather than memory loss alone.

Bladder Problems

Changes in bladder control are another common feature.

A person may initially experience a sudden or frequent need to urinate. As the condition progresses, some people develop urinary incontinence.

Bladder problems in an older adult can have many causes, so they should not be assumed to indicate NPH on their own.

Why Is Normal Pressure Hydrocephalus Sometimes Mistaken for Dementia?

NPH can be difficult to diagnose because the people most commonly affected are older adults — the same population in which Alzheimer’s disease, Parkinson’s disease, vascular disease and other causes of cognitive impairment become more common.

The Hydrocephalus Association explains that NPH symptoms can overlap with Alzheimer’s disease, vascular dementia, Parkinson’s disease and several other conditions.

It is also possible for a person to have NPH and another neurological condition at the same time.

For this reason, doctors do not diagnose normal pressure hydrocephalus from symptoms alone.

How Is Normal Pressure Hydrocephalus Diagnosed?

Diagnosing NPH usually involves several steps rather than one single test.

A neurologist or neurosurgeon may assess:

The person’s symptoms and medical history
Walking and balance
Cognitive function
Bladder symptoms
Brain imaging
The response to temporary removal of cerebrospinal fluid

Brain Imaging

An MRI or CT scan can show whether the brain’s ventricles are enlarged.

Doctors also look at the pattern of enlargement and other features of the brain to determine whether the changes are consistent with NPH or may have another explanation.

Imaging is important, but enlarged ventricles alone are not enough to confirm that NPH is responsible for a person’s symptoms.

Lumbar Puncture or Spinal Tap

A lumbar puncture can be especially useful when assessing whether someone may respond to treatment.

Doctors remove a quantity of cerebrospinal fluid and then reassess symptoms — particularly walking ability.

If walking or another symptom temporarily improves following removal of CSF, this can provide evidence that the person may respond to a permanent shunt.

However, failure to improve after a single lumbar puncture does not always rule out the possibility of benefiting from surgery.

External Lumbar Drainage

In some cases, doctors may use a temporary lumbar drain to remove cerebrospinal fluid over a longer period.

The healthcare team can then repeatedly assess walking, cognition and other symptoms.

Johns Hopkins lists physical assessment, gait evaluation, MRI or CT imaging, spinal tap and temporary CSF drainage among the tests that may be used when diagnosing NPH and assessing possible response to treatment.

Is Normal Pressure Hydrocephalus Reversible?

This is where NPH differs from many other conditions that can cause dementia-like symptoms.

Normal pressure hydrocephalus can be treatable, and some of its symptoms may be partially or substantially reversed.

However, it would be inaccurate to say that every person with NPH will fully recover.

The degree of improvement depends on factors such as:

Whether NPH is actually responsible for the symptoms
How long the symptoms have been present
The severity of the condition
Other neurological or medical conditions
How the person responds to temporary CSF drainage
Whether complications develop following treatment

Johns Hopkins states that complete recovery is possible but is not often seen. Many patients may instead experience meaningful improvement in one or more symptoms following successful treatment.

How Is Normal Pressure Hydrocephalus Treated?

The most commonly used treatment for normal pressure hydrocephalus is surgery to implant a shunt.

A shunt is a thin flexible tube that allows excess cerebrospinal fluid to drain away from the brain.

Most commonly, one end of the shunt is placed in a ventricle within the brain. The tubing runs underneath the skin to another part of the body — usually the abdomen — where the excess fluid can be absorbed.

A valve helps regulate the amount of cerebrospinal fluid that drains.

The shunt generally remains in place long term.

Which NPH Symptoms Improve Most After a Shunt?

Improvement varies, but walking and gait problems are often among the symptoms most likely to respond.

Some people also experience improvements in thinking, memory, bladder control or independence with everyday activities.

Cognitive symptoms may be less likely to fully resolve when they have been present for a long time or when another neurological condition, such as Alzheimer’s disease, is also present.

This is another reason why identifying NPH early can be valuable.

Does Shunt Surgery Work for Everyone?

No.

Although many appropriately selected patients improve after shunt surgery, not everyone benefits.

Doctors therefore try to determine who is most likely to respond before recommending an operation.

Improvement after a lumbar puncture or temporary CSF drainage can help predict a favourable response, although no test can predict the outcome with complete certainty.

Shunt surgery also has potential complications.

These can include:

Shunt blockage or malfunction
Infection
Over-drainage or under-drainage of cerebrospinal fluid
Bleeding or subdural haematoma
The need for adjustment, repair or replacement of the shunt

For this reason, people with a shunt require ongoing medical follow-up.

Why Early Diagnosis Matters

Symptoms of normal pressure hydrocephalus can progress if the condition remains untreated.

Because the disorder can mimic more common causes of cognitive decline, families may initially assume that changes in walking or thinking are simply due to aging or dementia.

A combination of:

New or worsening walking difficulty
Cognitive changes
Urinary urgency or incontinence

should therefore prompt medical assessment, particularly in an older adult.

Recognising NPH is important because it is one of the neurological conditions in which treatment may produce meaningful improvement.

Normal Pressure Hydrocephalus: The Bottom Line

Normal pressure hydrocephalus is potentially treatable, but describing it as completely reversible for everyone would be misleading.

Some people experience substantial improvements following shunt surgery, particularly in walking and mobility. Cognitive and bladder symptoms may also improve, although the response varies considerably.

A complete recovery is possible in some cases but is not guaranteed.

What makes NPH especially important is that its symptoms can resemble dementia, Parkinson’s disease or normal aging. Identifying the condition correctly may therefore give some patients an opportunity for treatment that would otherwise be missed.

If an older person develops a combination of difficulty walking, worsening thinking or memory problems and changes in bladder control, a healthcare professional can assess whether normal pressure hydrocephalus or another condition may be responsible.

Reversible Causes of Dementia

What Is Dementia?

Common Causes of Memory Loss

Cognitive Tests for Dementia

Alzheimer’s Disease

Post-Stroke Dementia and Cognitive Impairment

Trevor Howitt Blog, Types March 2, 2021October 16, 2021dementia, post-stroke dementia, stroke

After suffering a stroke, many people will end up with post-stroke dementia (PSD).

This can be any type of dementia from Alzheimer’s disease, vascular dementia, degenerative dementia, mixed dementia or stroke-related dementia.

Post-Stroke Dementia Review

PSD is a common occurrence after a stroke covering for about 6%-32% of the cases.

However, not everyone who has suffered a stroke will end up with dementia.

Others will experience a degree of cognitive impairment that is not severe enough to be categorized as PSD.

ResearchGate reveals that many people will experience mild cognitive impairment after a stroke which may or may not progress to dementia.

Cognitive Impairments

Cognitive impairments are generally divided into several domains that include:

Attention

This can generally be defined as shifting, focusing, sustaining, or dividing attention on a particular task or stimulus.

Executive Function

This has a lot to do with abstract thinking, planning, conflict monitoring, inhibition, and organization of thoughts.

Memory

This mostly affects a person’s ability to recognize or recall verbal or visual information.

Language

It primarily affects an individual’s ability to be receptive or express themselves through language i.e. reading and writing comprehension.

Social Cognition

This defines the recognition of a person’s or other people’s emotional state as well as an understanding of the mind’s theory.

Perception and Praxis

For the most part, it primarily affects visuospatial abilities, apraxia, prosopagnosia, and agnosia.

Post-stroke cognitive impairment (PSCI) can be described as a failure in the cognitive domain that happens after a stroke.

Cognitive impairment is a threat to post-stroke recovery for persons of all ages. It can compromise a person’s ability to continue working hence the need to be dependent on others at an early stage.

Unlike physical disability that is caused by stroke, cognitive function normally becomes worse over time.

While cognitive problems usually become worse during the first months after a stroke, there is a chance they can become better as the brain starts to become more active in trying to repair itself.

It is a complicated process because recovery can start to slow down after six months.

Even when cognitive problems do not go away completely, they normally get easier to live with.

This is especially the case when cognitive issues do not lead to dementia.

What Causes Cognitive Impairment

Cognitive issues occur because of the damages that happen to the brain.

Different brain sections are responsible for controlling different aspects.

If one of the areas that control cognition is damaged by stroke, this can affect the way a person does certain things.

Cognitive challenges are quite common after a person experiences post-stroke dementia.

Risk Factors for Post-Stroke Cognitive Impairment

After a stroke, the risk factors for cognitive impairment are usually associated with an overlap of dementia and frequent cerebrovascular diseases.

Some of them include:

1. Age: this is a risk factor for both cognitive decline and dementia. The prevalence of cognitive decline increases significantly after the age of 65 according to research by the American Stroke Association.

2. Vascular risk factors like diabetes, smoking, hypertension, and atrial fibrillation increase the risk of cognitive impairment.

3. Recurring strokes are also documented as a risk factor for cognitive impairment.

4. Education level: this is a conflicting risk factor with some studies suggesting that higher education is related to better cognitive performance.

Diagnosing Cognitive Impairment after Stroke

A neuropsychological examination is one of the methods that is used to assess cognition after a person suffers from a stroke.

In clinical practices, this is conducted from one week to a month after the stroke.

It is different when it comes to research because the examination is performed three months after a stroke.

In some cases, it may not be possible to conduct a neuropsychological examination for persons who have had a stroke because they may be too fatigued or disabled to go through with it.

Shorter screening tests are done as an alternative in such cases for both research and clinical purposes.

Early detection of cognitive impairment is critical because it may help reduce the chances of progressing to post-stroke dementia.

Treatment and Management Options

When it comes to treating cognitive impairment caused by post-stroke dementia, the main options include strategies that range from preventing white matter changes, new strokes, to treating underlying vascular risk factors hypertension.

Behavioral Variant Frontotemporal Dementia

Petra Boh Blog, Types March 2, 2021October 16, 2021behavioral variant frontotemporal dementia, bvftd, pick’s disease

Behavioral variant frontotemporal dementia (BvFTD) is one of the most common types of dementia that is called FTD (frontotemporal dementia).

It accounts for around half of the cases of this disease.

What is BvFTD

Brain condition called FTLD (frontotemporal lobar degeneration) causes FTD. BvFTD is a kind of frontotemporal dementia because it affects the temporal and frontal lobes of the brain.

Another name for the disease is also Pick’s disease. Some doctors also use terms frontotemporal disorder or frontal lobe disorder.

The brain’s frontal lobe controls essential facets of daily life such as emotional control, judgment, behavior, planning, multitasking, inhibition, and executive function.

The temporal lobe, on the other hand, primarily affects language, behavior, and emotional response.

Symptoms of Behavioral Variant Frontotemporal Dementia

The symptoms of BvFTD start mildly and progressively become worse over time.

The rate of progression, however, varies from one person to another. A person may experience various emotional and behavioral issues like:

Withdrawal from social interaction
Poor personal hygiene
Abrupt mood changes
Difficulty keeping a job
Disinterest in previously enjoyable activities
Inappropriate or compulsive behavior
Apathy
Hoarding
Repetitiveness

An individual with BvFTD may also experience neurological and language changes such as:

Shrinking vocabulary
Reduced reading and writing skills
Accelerated memory loss
Trouble understanding speech or problems with speaking
Physical weakness
Changes in diet or eating habits
Pacing
Delusions
Repeating or echoing what other people say

The symptoms of this type of dementia usually start showing for people who are between 40-60 years.

In some cases, they can be seen in persons who are as young as 20 years.

Most people with frontotemporal dementia are between ages 45-64.

Persons with Pick’s disease rarely recognize when they change their behaviors or the effect this has on others around them.

Causes of BvFTD

Frontotemporal dementia is normally caused by abnormal amounts of tau which is a kind of nerve cell protein.

These proteins exist in all nerve cells.

If a person has Pick’s disease, the proteins will accumulate into clumps in the brain’s temporal and frontal lobe which can result in the death of cells.

After the cells die, the brain tissue will start to shrink which will result in dementia symptoms.

It is not yet clear what causes the formation of these abnormal proteins in the nerve cells.

Some studies indicate that genetics play a role in the development of this kind of dementia.

This is because about 40% of people with behavioral variant frontotemporal dementia usually have a family history of at least one relative who has been diagnosed with a neurodegenerative disease.

For the rest of the people, the development of this type of dementia is known to be sporadic. It does not relate to genetics, as none of their relatives has FTD.

Stages of Behavioral Variant Frontotemporal Dementia

BvFTD usually occurs in three main stages as explained below.

Early Stage BvFTD

The early stages of FTD usually have some unique features. At this stage, memory loss is usually not prevalent.

A person may, however, experience changes in social and personal behavior. Most individuals will start to disregard social boundaries or start engaging in activities that may be deemed inappropriate.

They can end up behaving carelessly, impulsively, and in some cases criminally.

The ability to handle money may deteriorate and the concern for other peoples’ feelings may start to diminish.

Misdiagnosis also occurs often during this initial stage. This is because a specialist can easily misdiagnose or overlook it as a psychiatric condition.

Middle Stage BvFTD

In the middle stage, the symptoms of BvFTD become more similar to those of frontotemporal dementia.

They may even resemble those of other types of dementia such as Alzheimer’s disease.

At this point, people with progressive disease may require some assistance with day to day activities like bathing, dressing, and grooming.

Disturbances of behavior became more consistent.

Most people will also start developing language problems.

Late-Stage BvFTD

The final stage of the illness is usually the most challenging. Language and behavior problems become worse and memory deterioration also happens fast.

For most people, it may be necessary to have round-the-clock care to ensure adequate safety and care.

BvFTD Diagnosis

Diagnosis for Pick’s disease (or BvFTD) is usually not an easy task, especially in the early stages.

Many times, medics can misdiagnose it for other conditions like depression, Alzheimer’s disease, Parkinson’s disease, vascular dementia, drug or alcohol dependence, or other psychiatric disorders.

The symptoms a person showcases and the results of neurological examinations are key to behavioral variant frontotemporal dementia diagnosis.

Glucose positron emission scans and brain scans like MRIs (magnetic resonance imaging) are also helpful in the diagnosis process.

These must, nonetheless, be interpreted in the context of an individual’s neurological exam and medical history.

Treatment Options

Currently, the FDA has not approved any medication that can be used to treat BvFTD.

In a majority of the cases, it may not be possible to slow down the progression of symptoms.

Environmental and behavioral interventions are considered some of the most effective options for managing symptoms.

Experts advocate for the use of distracting and reassuring tactics instead of challenging disruptive behaviors that can lead to more agitation.

Some doctors can also recommend pharmacological measures to help relieve distressing symptoms. The role of medication in frontotemporal dementia intervention is still not clear.

Selective SSRIs (serotonin reuptake inhibitors) are used to treat challenging behaviors.

Antipsychotics like olanzapine have been used on individuals suffering from prominent psychosis and agitation.

Studies are, however, on-going to try and introduce an effective treatment option for BvFTD.

Behavioral Variant Frontotemporal Dementia Prognosis

Years after positive BvFTD diagnosis, affected persons usually start to showcase problems with coordination and muscle weakness.

This can leave a person bedbound or needing a wheelchair.

The problems can result in difficulties with chewing, swallowing – eating in general – controlling bladder/bowels, and moving.

In the long run, persons with frontotemporal degenerations die because of physical changes that cause lung, skin, or urinary tract infections.

From the onset of symptoms, the average life expectancy is approximately 8-9 years. Some people may live up to 20 years or more with this progressive disease.