Vascular dementia is caused by conditions that damage blood vessels in the brain, such as stroke, and is linked to high blood pressure, diabetes and high cholesterol. Lewy body dementia comes from abnormal deposits of a protein called alpha-synuclein and often brings visual hallucinations, swings in alertness and acting out dreams. Frontotemporal dementia damages the frontal and temporal lobes, changing behavior or language, and tends to start earlier in life than other types.
What are the main types of dementia besides Alzheimer’s?
The National Institute on Aging (NIA) lists four common types: Alzheimer’s disease, frontotemporal, Lewy body and vascular dementia, plus mixed dementia, a combination of two or more. The CDC gives the same list and calls vascular dementia the second most common type, at about 5% to 10% of cases.
| Type | What is happening in the brain | Clues families often notice |
|---|---|---|
| Vascular | Blood flow to the brain is interrupted or vessels are damaged | Slowed thinking, trouble planning, sometimes a sudden change after a stroke |
| Lewy body | Alpha-synuclein deposits (Lewy bodies) build up in several brain regions | Realistic visual hallucinations, ups and downs in alertness, acting out dreams, slowness or stiffness |
| Frontotemporal | Frontal and temporal lobes shrink | Personality and behavior change, or trouble with words; memory may hold up at first |
| Mixed | Changes from more than one type at once | Often looks like Alzheimer’s or another single type |
What is vascular dementia?
NIA defines vascular dementia as changes to memory, thinking and behavior resulting from conditions that affect the blood vessels in the brain. Symptoms can begin gradually or suddenly, then progress over time, with possible short periods of improvement.
Brain scans usually show earlier strokes, which are often small and sometimes silent, along with diseased small vessels and changes in the brain’s white matter. NIA adds that not everyone who has had a stroke will develop dementia.
What is the link between stroke, blood pressure and vascular dementia?
The National Institute of Neurological Disorders and Stroke (NINDS) says vascular dementia can be caused or worsened by strokes, irregular heartbeats, high blood pressure, diabetes or high cholesterol. It also notes that a person’s risk is higher if a stroke affected both sides of the brain, and that even strokes with no noticeable symptoms raise the risk. Its Mind Your Risks campaign urges people with high blood pressure to control it to lower stroke risk and possibly dementia risk later in life.
NIA lists trouble following instructions, difficulty paying bills, getting lost on familiar routes, poor judgment and mood changes such as depression or anger. Memory loss may or may not be prominent, according to the Alzheimer’s Association.
NIA says treatment often focuses on preventing further strokes by managing high blood pressure, diabetes, high cholesterol and heart rhythm problems. Which medicines are right is the prescriber’s decision. If the person has also had a stroke, our stroke recovery at home guide covers what rehabilitation at home looks like.
What is Lewy body dementia?
NIA describes Lewy body dementia (LBD) as a disease linked to clumps of alpha-synuclein that affect thinking, movement, behavior and mood. It includes two diagnoses: dementia with Lewy bodies, and Parkinson’s disease dementia, diagnosed when thinking changes appear more than a year after Parkinson’s movement symptoms. If your family member has Parkinson’s, see our Parkinson’s care at home guide.
Core features NIA lists for dementia with Lewy bodies:
- Visual hallucinations early on, typically realistic and detailed, such as children or animals
- Fluctuating attention and alertness, from one day to the next and sometimes within a day
- REM sleep behavior disorder, acting out dreams by yelling, flailing or falling out of bed, sometimes years before other symptoms
- Parkinsonism: slowness, tremor, stiffness or difficulty walking
- More trouble with complex mental tasks, such as multitasking, than with memory at first
Why do some antipsychotic medicines need extra caution in Lewy body dementia?
NIA warns that people with LBD may have severe reactions to antipsychotics, including worse confusion, worse parkinsonism, extreme sleepiness and fainting, and that haloperidol-type drugs generally should not be prescribed. The Alzheimer’s Association says serious side effects can occur in as many as 50% of people with LBD. NIA recommends carrying the LBD Medical Alert Wallet Card and telling hospital staff about the diagnosis. Never change or stop a medicine on your own: NIA says to talk with the doctor first.
Is Lewy body dementia hereditary?
Usually not. NIA says having a relative with LBD may increase risk, but LBD is not typically considered a hereditary disease, and no genetic test can accurately predict who will develop it.
How long can you live with Lewy body dementia?
NIA reports an average of five to seven years from diagnosis to death, with a range of two to 20. The Lewy Body Dementia Association says most people live four to seven years but that it is not possible to say how long any one person will live. Overall health and age matter.
How does Lewy body dementia lead to death?
LBD is progressive: over time people need more help, and late in the disease may depend entirely on others. NIA does not publish a list of causes of death for LBD. It does document complications such as swallowing difficulty, falls, fainting from low blood pressure and infections that worsen confusion. For later-stage dementia in general, NIA explains that food entering the lungs can cause pneumonia, which can lead to death, and advises asking the doctor or home health team for a swallowing test. NIA also notes that palliative care can begin at diagnosis; see our guides on palliative and hospice care and when hospice is appropriate.
What is frontotemporal dementia?
NIA describes frontotemporal dementia (FTD) as a family of diseases that damage neurons mainly in the frontal and temporal lobes. FTD is rare and tends to occur younger than other dementias: roughly 60% of people with it are 45 to 64. Initially it leaves areas that control short-term memory unaffected.
| Form | Typical first changes |
|---|---|
| Behavioral variant (most common) | Changes in personality, judgment and behavior; impulsive or inappropriate actions; loss of empathy; compulsive eating |
| Primary progressive aphasia | Trouble speaking, understanding, reading or writing |
| Movement-related forms | Balance problems, stiffness, falls, swallowing difficulty |
NIA stresses that people with FTD cannot control these behaviors and, before diagnosis, lack awareness of their illness, so relatives may think the person is misbehaving. FTD is sometimes misdiagnosed as depression or Alzheimer’s. About one-third of cases are inherited, per NIA and the CDC. The Association for Frontotemporal Degeneration (AFTD) runs a helpline staffed by social workers at 866-507-7222, listed by NIA.
What is mixed dementia?
It means brain changes from more than one type at the same time. The Alzheimer’s Association says the most common combination is Alzheimer’s changes plus blood vessel problems, and that autopsy studies suggest it is more common than recognized in life. Most people are diagnosed with one type. Because vascular changes are the most common coexisting finding, controlling heart and blood vessel risk factors may protect the brain.
Which look-alike conditions should a doctor rule out?
Some conditions mimic dementia and can be treated. NIA says that problems with the thyroid, kidney or liver, vitamin deficiencies, medication side effects and emotional problems such as depression can cause memory problems that resemble dementia, and that normal pressure hydrocephalus often resolves with treatment. MedlinePlus adds low vitamin B12. None of this is for self-diagnosis; it is a reason to ask a doctor to rule these out before assuming dementia, including a review of every prescription and over-the-counter medicine.
How are the types of dementia diagnosed?
- Start with a primary care doctor. Describe what changed, when, and what daily tasks have become hard. Bring a list of all medicines and supplements.
- Rule out treatable causes. NIA says doctors first look for treatable conditions with a physical exam, vital signs and lab tests of blood and other fluids.
- Brain imaging. CT or MRI can show strokes, tumors, bleeding and shrinkage patterns. For vascular dementia, MRI almost always shows abnormalities.
- Thinking and behavior tests. Memory, language and problem-solving tests, plus a psychiatric evaluation if mood or behavior changed.
- See a specialist. Neurologists, geriatric psychiatrists, neuropsychologists and geriatricians can tell types apart. NIA notes that a sleep study can identify sleep disorders in LBD.
NIA says LBD can be diagnosed with certainty only by autopsy, and FTD confirmed only by genetic testing in familial cases or autopsy. The LBDA says specialists familiar with LBD may diagnose it accurately up to 90% of the time. For early signs and risk, see our early detection guide.
How does care at home differ by type?
The basics, such as a predictable routine, a safe home and calm communication, apply to every type. The emphasis shifts.
| Type | Safety focus | Routine and communication |
|---|---|---|
| Vascular | Stroke warning signs, falls, taking the doctor’s prescribed plan reliably | Simple instructions, extra time; see medication management |
| Lewy body | Falls, dizziness on standing, sleep injuries, medication sensitivity | Respond to the fear, not the facts, during hallucinations; redirect, for example to music; consistent schedule, avoid crowds |
| Frontotemporal | Impulsive behavior, compulsive eating (NIA suggests supervising meals and locking cabinets) | Accept rather than argue, limit choices, keep a regular schedule; use a photo notebook if speech is lost |
These come from NIA’s LBD and FTD care pages and its home safety tips. Practical examples: room-by-room checks, nightlights, grab bars, and locked storage for medicines and hazardous products. Evenings can be harder; see our sundowning guide and our fall prevention tips for NYC apartments.
What do official sources suggest for communication and daily routines?
On communication, NIA suggests making eye contact, using the person’s name, waiting longer for answers and asking yes/no or two-choice questions, such as “fish or chicken?” instead of “what do you want?” It also advises avoiding “baby talk” and not talking about the person as if they are absent.
For an upsetting symptom, check for a physical cause first: NIA says infection, pain, constipation or a medicine can worsen confusion and behavior, so report sudden changes to the doctor. For deeper background see our dementia care at home guide.
Where can New York families find support?
- Alzheimer’s Association, New York City Chapter serves the five boroughs. Its free 24/7 Helpline is 800-272-3900, and it offers caregiver support groups and free care consultations with a dementia expert.
- CaringKind has a helpline at (646) 744-2900 or helpline@wearecaringkind.org and lists a wandering safety program on its site.
- Disease-specific groups: AFTD at 866-507-7222 and the Lewy Body Dementia Association at 800-539-9767, as listed by NIA.
Caregivers need breaks too. See respite care, adult day care and caregiver burnout signs.
Dementia care at home: advice from our nurse director
Anna Klyauzova, RN, MSN, MPA, Director of Patient Services at ProLife Home Care, on what she sees in practice:
You can’t do all of it by yourself. Alzheimer’s and other dementias change the whole family’s life, not only the patient’s. The sooner support is in place, the easier it is to keep a familiar routine and a safe home. Even a few hours of professional home care a week gives relatives time to rest.
Families rarely hear this: don’t argue with the person and don’t keep correcting mistakes. If your mother asks the same question for the fifth time, she isn’t doing it on purpose. A calm voice, a familiar room and a routine she can predict usually work better than long explanations.
We are a licensed home care agency in Brooklyn and Queens, licence #2572L001, New York State Department of Health. We can talk through what kind of help at home may fit your family, including Alzheimer’s and dementia care. Call (718) 232-2777 or use our contact page.
Medical guidance changes. Everything above was checked on 12 October 2026 against nia.nih.gov, ninds.nih.gov, cdc.gov, alz.org, lbda.org, medlineplus.gov and caringkindnyc.org. This page is general information, not medical advice. Ask the person’s doctor or prescriber about diagnosis and medicines.
Frequently asked questions
What is vascular dementia?
It is dementia caused by conditions that damage blood vessels in the brain and interrupt blood and oxygen flow, such as strokes. It can start suddenly or gradually, and high blood pressure, diabetes and high cholesterol raise the risk.
What is frontotemporal dementia?
A rare group of diseases that damage the frontal and temporal lobes, causing changes in behavior, personality or language. About 60% of people with it are 45 to 64, and memory may be spared early.
Is Lewy body dementia hereditary?
Not typically. NIA says a family history may raise risk, but LBD is not usually considered hereditary, and no genetic test can predict who will get it.
How long can you live with Lewy body dementia?
NIA gives an average of five to seven years from diagnosis, ranging from two to 20. The LBDA says it cannot be predicted for an individual.
How does Lewy body dementia kill you?
NIA does not list one cause. As the disease advances, people need more help, and NIA documents complications such as swallowing trouble, falls and infections. Ask the care team about palliative care early.
Can someone have more than one type of dementia?
Yes, this is mixed dementia. The most common combination is Alzheimer’s changes plus vascular changes. Autopsy studies suggest it is more common than diagnosed in life.
Which conditions can look like dementia but be treatable?
Thyroid problems, vitamin deficiencies including low B12, medicine side effects, depression and normal pressure hydrocephalus can mimic it. Ask a doctor to rule them out.
