Editing Dementia (section)

== Signs and symptoms ==
The [[signs and symptoms]] of dementia may vary depending on the underlying subtype. However, there are some common features that may be grouped into three areas: cognitive, neuropsychiatric (also known as behavioural and psychological), and physical.<ref name=":0">{{Cite journal |last1=Livingston |first1=Gill |last2=Huntley |first2=Jonathan |last3=Liu |first3=Kathy Y |last4=Costafreda |first4=Sergi G |last5=Selbæk |first5=Geir |last6=Alladi |first6=Suvarna |last7=Ames |first7=David |last8=Banerjee |first8=Sube |last9=Burns |first9=Alistair |last10=Brayne |first10=Carol |last11=Fox |first11=Nick C |last12=Ferri |first12=Cleusa P |last13=Gitlin |first13=Laura N |last14=Howard |first14=Robert |last15=Kales |first15=Helen C |date=2024-07-31 |title=Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission |url=https://linkinghub.elsevier.com/retrieve/pii/S0140673624012960 |journal=The Lancet |language=en |volume=404 |issue=10452 |pages=572–628 |doi=10.1016/S0140-6736(24)01296-0|pmid=39096926 }}</ref>

The cognitive symptoms of dementia relate to the area of the brain affected. Typically this includes memory plus one other cognitive region.<ref name=":1">{{Cite journal |last1=Arvanitakis |first1=Zoe |last2=Shah |first2=Raj C. |last3=Bennett |first3=David A. |date=2019-10-22 |title=Diagnosis and Management of Dementia: Review |journal=JAMA |language=en |volume=322 |issue=16 |pages=1589–1599 |doi=10.1001/jama.2019.4782 |issn=0098-7484 |pmc=7462122 |pmid=31638686}}</ref> The most commonly affected areas of brain function include  [[memory]], [[language]], [[attention]], [[problem solving]], and [[visuospatial function]] affecting perception and orientation. Signs of dementia include getting lost in a familiar neighborhood, using unusual words to refer to familiar objects, forgetting the name of a close family member or friend, forgetting old memories, and being unable to complete tasks independently.<ref>{{Cite web |date=December 19, 2019 |title=What Is Dementia? {{!}} CDC |url=https://www.cdc.gov/aging/dementia/index.html |access-date=October 3, 2022 |website=cdc.gov |language=en-us}}</ref> People with developing dementia can often fall behind on bill payments; specifically mortgage and credit cards, and a crashing [[credit score]] can be an early indicator of the disease.<ref>{{cite journal |last1=Gresenz |first1=Carole Roan |last2=Mitchell |first2=Jean M. |last3=Rodriguez |first3=Belicia |last4=Turner |first4=R. Scott |last5=van der Klaauw |first5=Wilbert |date=May 2024 |title=The Financial Consequences of Undiagnosed Memory Disorders |url=https://www.newyorkfed.org/medialibrary/media/research/staff_reports/sr1106.pdf |journal=Federal Reserve Bank of New York Staff Reports |series=Staff Reports (Federal Reserve Bank of New York) |issue=1106 |doi=10.59576/sr.1106 |access-date=July 27, 2024}}</ref><ref>{{cite web |last=Casselman |first=Ben |date=May 31, 2024 |title=Alzheimer's Takes a Financial Toll Long Before Diagnosis, Study Finds |url=https://www.nytimes.com/2024/05/31/business/economy/alzheimers-disease-personal-finance.html |archive-url=https://web.archive.org/web/20240630171647/https://www.nytimes.com/2024/05/31/business/economy/alzheimers-disease-personal-finance.html |archive-date=June 30, 2024 |access-date=July 27, 2024 |website=[[The New York Times]] |quote=Credit scores among people who later develop dementia begin falling sharply long before their disease is formally identified. A year before diagnosis, these people were 17.2 percent more likely to be delinquent on their mortgage payments than before the onset of the disease, and 34.3 percent more likely to be delinquent on their credit card bills. |url-status=live }}</ref> The symptoms progress at a continuous rate over several stages, and they vary across the dementia subtypes.<ref>{{cite web |title=Dementia – Signs and Symptoms |url=http://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935289&section=Signs_and_Symptoms |publisher=American Speech Language D Association}}</ref><ref name="Bathini" /> Most types of dementia are slowly progressive with some deterioration of the brain well established before signs of the disorder become apparent.

The behavioral symptoms can include [[agitation (dementia)|agitation]], restlessness, inappropriate behavior, sexual disinhibition, and verbal or physical aggression.<ref name="Sahin">{{cite journal |vauthors=Şahin Cankurtaran E |date=December 2014 |title=Management of Behavioral and Psychological Symptoms of Dementia |journal=Noro Psikiyatri Arsivi |volume=51 |issue=4 |pages=303–312 |doi=10.5152/npa.2014.7405 |pmc=5353163 |pmid=28360647}}</ref> Psychological symptoms can include depression, [[hallucination]]s (most often visual),<ref name="medline">{{cite web |title=Hallucinations: MedlinePlus Medical Encyclopedia |url=https://medlineplus.gov/ency/article/003258.htm |access-date=December 9, 2022 |website=medlineplus.gov |language=en}}</ref> delusions, apathy, and anxiety.<ref name="Sahin" /><ref>{{Cite journal |vauthors=Shub D, Kunik ME |date=April 16, 2009 |title=Psychiatric Comorbidity in Persons With Dementia: Assessment and Treatment Strategies |url=http://www.psychiatrictimes.com/alzheimer-dementia/article/10168/1403050 |url-status=live |journal=Psychiatric Times |volume=26 |issue=4 |archive-url=https://web.archive.org/web/20090427144308/http://www.psychiatrictimes.com/alzheimer-dementia/article/10168/1403050 |archive-date=April 27, 2009}}</ref> Behavioural symptoms in dementia are thought to be often due to unmet needs or untreated physical symptoms.<ref>{{Cite journal |last=Ayalon |first=Liat |date=2006-11-13 |title=Effectiveness of Nonpharmacological Interventions for the Management of Neuropsychiatric Symptoms in Patients With Dementia: A Systematic Review |url=http://archinte.jamanetwork.com/article.aspx?doi=10.1001/archinte.166.20.2182 |journal=Archives of Internal Medicine |language=en |volume=166 |issue=20 |pages=2182–2188 |doi=10.1001/archinte.166.20.2182 |pmid=17101935 |issn=0003-9926}}</ref><ref>{{Cite journal |last=Cohen-Mansfield |first=Jiska |date=September 2001 |title=Nonpharmacologic Interventions for Inappropriate Behaviors in Dementia: A Review, Summary, and Critique |url=https://linkinghub.elsevier.com/retrieve/pii/S1064748112614511 |journal=The American Journal of Geriatric Psychiatry |language=en |volume=9 |issue=4 |pages=361–381 |doi=10.1097/00019442-200111000-00005|pmid=11739063 }}</ref> Many of these symptoms may be improved by non-pharmacological measures such as appropriate exercise and empowering carers.<ref>{{Cite journal |last1=Tampi |first1=Rajesh R. |last2=Jeste |first2=Dilip V. |date=2022-08-01 |title=Dementia Is More Than Memory Loss: Neuropsychiatric Symptoms of Dementia and Their Nonpharmacological and Pharmacological Management |url=https://psychiatryonline.org/doi/10.1176/appi.ajp.20220508 |journal=American Journal of Psychiatry |language=en |volume=179 |issue=8 |pages=528–543 |doi=10.1176/appi.ajp.20220508 |pmid=35921394 |issn=0002-953X}}</ref> Underlying physical causes of distress may also need to be targeted.<ref name=":0" /> 

Dementias may also produce a number of physical manifestations. These may include changes in gait, falls, repetitive movements, parkinsonism, or seizures.<ref name=":1" /> People with dementia are more likely to have problems with incontinence than those of a comparable age without dementia; they are three times more likely to have [[urinary incontinence]] and four times more likely to have [[fecal incontinence]].<ref>{{Cite journal |date=June 21, 2022 |title=Continence, dementia, and care that preserves dignity |url=https://evidence.nihr.ac.uk/themedreview/continence-dementia-and-care-that-preserves-dignity/ |journal=NIHR Evidence |doi=10.3310/nihrevidence_51255 |s2cid=251785991}}</ref><ref>{{cite journal |vauthors=Grant RL, Drennan VM, Rait G, Petersen I, Iliffe S |date=August 2013 |title=First diagnosis and management of incontinence in older people with and without dementia in primary care: a cohort study using The Health Improvement Network primary care database |journal=PLOS Medicine |volume=10 |issue=8 |page=e1001505 |doi=10.1371/journal.pmed.1001505 |pmc=3754889 |pmid=24015113 |doi-access=free |veditors=Prince MJ}}</ref> Dementia can also affect the person’s eating and drinking, often causing swallowing issues and weight loss that worsen as the illness progresses to later stages.<ref>{{Cite journal |last1=Cipriani |first1=Gabriele |last2=Carlesi |first2=Cecilia |last3=Lucetti |first3=Claudio |last4=Danti |first4=Sabrina |last5=Nuti |first5=Angelo |date=December 2016 |title=Eating Behaviors and Dietary Changes in Patients With Dementia |journal=American Journal of Alzheimer's Disease & Other Dementias |language=en |volume=31 |issue=8 |pages=706–716 |doi=10.1177/1533317516673155 |issn=1533-3175 |pmc=10852764 |pmid=27756815}}</ref> Pain can also affect people with dementia, potentially as many as 79.6% of people with dementia in nursing homes may experience pain. However pain can be difficult to assess as people with dementia may be unable to communicate this verbally and instead it may manifest as behavioural symptoms.<ref>{{Cite journal |last1=Helvik |first1=Anne-S. |last2=Bergh |first2=Sverre |last3=Tevik |first3=Kjerstin |date=2023-10-10 |title=A systematic review of prevalence of pain in nursing home residents with dementia |journal=BMC Geriatrics |language=en |volume=23 |issue=1 |page=641 |doi=10.1186/s12877-023-04340-z |doi-access=free |issn=1471-2318 |pmc=10566134 |pmid=37817061}}</ref> 

People with dementia may often have other health conditions present, such as [[high blood pressure]] or [[diabetes]], and there can sometimes be as many as four of these [[Comorbidity|comorbidities]].<ref name="GOVUK">{{cite web |title=Dementia: comorbidities in patients – data briefing |url=https://www.gov.uk/government/publications/dementia-comorbidities-in-patients/dementia-comorbidities-in-patients-data-briefing |access-date=November 22, 2020 |website=GOV.UK |language=en}}</ref> There is also increased prevalence of&nbsp;[[sarcopenia]] (muscle loss) and [[Frailty syndrome|frailty]] among people with dementia.<ref>{{Cite journal |last1=Waite |first1=Samantha J. |last2=Maitland |first2=Stuart |last3=Thomas |first3=Alan |last4=Yarnall |first4=Alison J. |date=January 2021 |title=Sarcopenia and frailty in individuals with dementia: A systematic review |url=https://linkinghub.elsevier.com/retrieve/pii/S016749432030265X |journal=Archives of Gerontology and Geriatrics |language=en |volume=92 |pages=104268 |doi=10.1016/j.archger.2020.104268|pmid=33011431 }}</ref>