When a loved one begins acting in unfamiliar ways—forgetting familiar routines, reacting differently to everyday situations, or showing changes in personality—it can be confusing and worrisome. Many people naturally think of Alzheimer’s disease when they hear the word “dementia,” but dementia is an umbrella term that describes a group of conditions that affect memory, thinking, behavior, and movement. Not all forms of dementia look the same, and not all start with forgetfulness.
Some types of dementia can show up as personality changes, loss of empathy, inappropriate behavior, or movement problems long before memory issues begin. Understanding these differences can help families recognize what’s happening and take the right steps toward getting the appropriate care and support. This article will walk you through three of the most common types of dementia beyond Alzheimer’s—Lewy body dementia, frontotemporal dementia (FTD), and vascular dementia—and describe how each differs in symptoms and progression.
Lewy body dementia: When confusion, movement changes, and vivid dreams appear
One of the earliest and most distinctive signs of Lewy body dementia (LBD) specifically is vivid visual hallucinations—seeing things that aren’t really there—or dreams that feel so real they cause distress or confusion. Some people with LBD act out their dreams by moving, talking, yelling, or even striking during sleep, which can be alarming for partners. These experiences can happen early, sometimes before any memory issues become noticeable.
Changes in movement are also common. A loved one may develop stiffness, tremors, or a shuffling walk that looks similar to Parkinson’s Disease. They may move more slowly or have difficulty with balance. The body may also have trouble regulating automatic functions such as blood pressure, heart rate, and sweating. This can cause dizziness, fainting, or falls.
Finally, you may see sudden shifts in alertness; your loved one may seem fully engaged one day and unusually drowsy or disconnected the next.
LBD develops when abnormal protein deposits, known as Lewy bodies, build up in the brain and affect areas that control movement, thinking, and automatic body functions. This is why these other symptoms present more often than symptoms of other types of dementia like memory loss. Lewy body dementia is most common in people over 60, and it is one of the more complex types of dementia because its symptoms overlap with both Alzheimer’s and Parkinson’s disease. This can often lead to misdiagnosis, like in the case of actor Robin Williams. Originally diagnosed with Parkinson’s Disease, he was later re-diagnosed with LBD. His story has helped to raise awareness of LBD, as well as the similarities it shares with other conditions.
Frontotemporal dementia: When behavior and personality shift
Frontotemporal dementia (FTD) often begins with changes in behavior or communication. A loved one who was once kind and thoughtful may suddenly become blunt, impulsive, or disinterested in others’ feelings. They may say or do things that seem inappropriate, such as making rude comments or ignoring social norms, without realizing the impact of their behavior. Someone with FTD might also appear less empathetic or show signs of being emotionally distantor indifferent to the needs of family members.
They may also develop compulsive or repetitive habits—tapping fingers or feet, smacking lips, clapping, or eating the same foods over and over. In some cases, people may compulsively put objects in their mouth or even try to eat non-food items. FTD can also affect language. A loved one might struggle to find the right words, repeat phrases, or have trouble understanding speech.
These symptoms stem from the fact that FTD is caused by the gradual shrinking, or atrophy, of the brain’s frontal and temporal lobes, areas that control personality, judgment, and language. For family members, these resulting shifts can feel deeply personal and painful. It’s important to remember that FTD changes how the brain processes behavior and emotion. What might look like insensitivity or frustration is often a symptom of the disease, not a reflection of who your loved one truly is.
This condition can appear in adults as young as their 40s or 50s, which can make the symptoms especially confusing for families. Actor Bruce Willis’s diagnosis with frontotemporal dementia has helped many families see that these changes in communication and personality stem from neurological causes, not deliberate behavior.
Vascular dementia: when brain health is tied to circulation
The symptoms of vascular dementia can vary depending on which part of the brain is affected. Some people experience slower thinking, difficulty concentrating, or problems with organization and planning. They might struggle to follow a sequence of steps or lose track of what they’re doing mid-task. Others may show mood changes such as irritability, restlessness, or sudden emotional ups and downs.
Physical changes often accompany these cognitive symptoms. A person may walk unsteadily, feel weak on one side of the body, or need to use the restroom more frequently. These signs can appear suddenly after a stroke or emerge gradually as small vessel damage builds over time.
Vascular dementia occurs when blood flow to the brain is reduced, depriving brain tissue of oxygen and nutrients. This can result from a major stroke, a series of smaller “silent” strokes, or conditions that damage blood vessels, such as high blood pressure or diabetes. Sometimes, even a fall or head injury can lead to vascular damage if it disrupts circulation to key areas of the brain.
Because vascular dementia is caused by trauma to the brain tissue, it doesn’t necessarily occur within a particular age range. Families should pay attention to changes that follow a cardiovascular event, a fall, or a period of poor circulation. Sharing these observations with a doctor can make a big difference in getting an accurate diagnosis. Early medical attention can also help slow progression by addressing underlying causes like high blood pressure or blood clots.
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How these dementias differ from Alzheimer’s
Alzheimer’s remains the most common form of dementia, accounting for 60-80% of all dementia cases, and usually appears after age 65. Memory loss, confusion about time and place, and trouble finding words are its hallmarks. If you want to learn more about Alzheimer’s symptoms specifically, visit our Top 10 Signs of Memory Loss article for a deeper look at early indicators and next steps.
While all dementias affect thinking and behavior, each type has its own pattern of symptoms. For comparison:
- Alzheimer’s disease: Gradual memory loss, disorientation, and difficulty finding words
- Lewy body dementia: Fluctuating alertness, vivid hallucinations, movement problems, and sleep disturbances
- Frontotemporal dementia: Early personality or language changes without early memory loss
- Vascular dementia: Slower thinking and reasoning tied to circulation issues, stroke, or head trauma
Each condition affects different regions of the brain, which explains why symptoms vary so widely. Receiving the right diagnosis allows families and care providers to build a care plan that fits your loved one’s needs.
What to do if you notice changes
If you’ve begun noticing unusual behaviors, sleep changes, or emotional shifts in your loved one, it’s understandable to feel uncertain about what’s happening. The good news is that identifying symptoms early can help you find the right care and improve your loved one’s quality of life.
Keep a record of the changes you observe. Write down examples of unusual behaviors, movement issues, language difficulties, or sleep disturbances. Showing how patterns have developed over time can help doctors distinguish between different forms of dementia.
You may also want to make an appointment with a neurologist or memory care specialist. Be prepared with your notes and any specific examples of your loved one’s behavior that will help the doctor better understand what’s going on.
Finally, take care of yourself. Supporting a loved one through diagnosis and change can be emotionally draining. Connecting with caregiver support groups or counseling resources can provide comfort, perspective, and practical help.
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How Belmont Village supports families and residents living with dementia
If your loved one is diagnosed with dementia, there may come a time when you can no longer provide the level of care they need to remain safe and secure. Belmont Village Senior Living is here to help families navigate this stage with compassion and expertise.
Every type of dementia requires a tailored approach, and our communities are equipped to meet residents where they are—cognitively, physically, and emotionally. Our staff receive specialized dementia training and use evidence-based programs that focus on engagement, dignity, and emotional well-being.
Through personalized care plans, meaningful activities, and supportive environments, Belmont Village helps residents live with purpose and connection while giving families peace of mind.
Recognizing the signs is the first step toward support
Watching a loved one change in ways that feel unfamiliar or unexplainable can be upsetting, but understanding what might be happening offers a path toward clarity and action. Each type of dementia has its own signs, and learning those differences can help you make informed choices about care and support.
If you’re concerned about changes you’ve seen in someone close to you, know that you’re not alone. Belmont Village’s compassionate family advisors are here to help you understand your options, access professional resources, and ensure your loved one receives the care they deserve.
