What is it?
Dementia is an umbrella term for a decline in memory, thinking, language, or other cognitive abilities severe enough to interfere with daily activities.
- Dementia is not a normal part of aging.
- It is a syndrome rather than a single disease.
- Alzheimer’s disease is the most common cause.
- Symptoms and progression depend on the underlying condition.
How does it work?
Dementia develops when damage or disease affects brain cells and the connections between them.
Different brain areas control memory, language, reasoning, behavior, and movement, so symptoms vary depending on the affected regions.
Common Types
| Type | Common Characteristics |
|---|---|
| Alzheimer’s Disease | Progressive memory impairment, often followed by broader cognitive decline |
| Vascular Dementia | Cognitive difficulties associated with cerebrovascular disease |
| Lewy Body Dementia | Fluctuating cognition, visual hallucinations, and movement symptoms |
| Frontotemporal Dementia | Early changes in behavior, personality, or language |
| Mixed Dementia | More than one disease process contributes to cognitive decline |
Why does it matter?
Dementia can affect:
- Memory and orientation.
- Communication and comprehension.
- Judgment and safety awareness.
- Ability to complete activities of daily living.
- Emotional regulation and behavior.
- Mobility, swallowing, and nutrition as the condition progresses.
What should I look for?
Cognitive Changes
- Forgetting familiar people or routines.
- Confusion about time or place.
- Difficulty following instructions.
- Word-finding or communication difficulties.
- Difficulty recognizing familiar objects.
Behavioral & Emotional Changes
- Anxiety or fear.
- Restlessness or agitation.
- Withdrawal from activities.
- Sleep disturbances.
- Changes in personality or usual behavior.
Functional Changes
- Increased assistance needed for dressing, bathing, or eating.
- Difficulty navigating familiar environments.
- Unsafe mobility or increased fall risk.
- Difficulty expressing pain or discomfort.
Dementia vs. Delirium
| Dementia | Delirium |
|---|---|
| Usually develops gradually | Often develops suddenly |
| Often progressive | May fluctuate substantially over hours |
| Associated with underlying brain disease | Often triggered by acute illness, medication effects, or other medical causes |
| Chronic cognitive impairment | Acute disturbance in attention and awareness |
Important: A resident with dementia can also develop delirium.
Sudden confusion or a major change from baseline must be reported promptly rather than assumed to be dementia.
What should I do?
- Compare the resident’s current behavior and abilities with their usual baseline.
- Speak calmly and use clear, simple instructions.
- Allow adequate time for responses.
- Maintain predictable routines when helpful.
- Offer choices and encourage independence.
- Check for possible unmet needs such as pain, hunger, toileting, fatigue, or discomfort.
- Follow the individualized care plan.
- Respect dignity, preferences, and resident rights.
- Report new or worsening cognitive, behavioral, or functional changes.
CNA Scope: Observe changes, provide appropriate support, and report concerns. Diagnosis and treatment planning are responsibilities of qualified clinicians.
Related
- Dementia Care
- Neurological Observations
- Communication Accommodations
- Therapeutic Communication
- Fall Risk
- Patient Rights
- Pain Assessment
- Emotional & Family Support
Sources
- CDC — About Dementia
- CDC — Signs and Symptoms of Dementia
- National Institute on Aging — Caring for Older Patients With Cognitive Impairment
Flashcards
Is dementia a normal part of aging?01-foundations / diseases-conditions
Answer
No.
How does delirium typically differ from dementia?02-mechanisms / diseases-conditions
Answer
Delirium is usually acute and fluctuating; dementia often develops gradually.
What should a CNA do about sudden confusion in a person with dementia?03-application / diseases-conditions
Answer
Report promptly; do not assume it is usual dementia.