Among the first questions many people ask healthcare providers after a dementia diagnosis are “Is this going to get worse?” and “Can Alzheimer’s be slowed down?” Understanding dementia progression can help you make informed medical decisions for yourself or your family member.

Dementia and Progression

Dementia is a progressive condition. This means that symptoms start out mild and get worse over time. As dementia progresses and more of the brain becomes affected, a person will gradually need more help with daily life and activities.

However, different people experience dementia differently. Some forms of dementia progress more quickly or more slowly than others. Factors like age at diagnosis, overall health, and available treatments may also affect how quickly dementia progresses.

A healthcare professional can tell you what stage of Alzheimer’s disease or another type of dementia you or your loved one may be in. This can give you a general sense of what changes you can expect over time. Still, these are only guidelines — everyone’s disease progresses differently.

Is Dementia Treatable if Caught Early?

Certain types of dementia can be treated with medications, especially when diagnosed in the early to moderate stages. These medications don’t stop the disease, but they may slow its progression and help maintain quality of life.

For example, medications for Alzheimer’s disease can’t stop the disease from destroying neurons. This means that Alzheimer’s isn’t reversible. However, medications can help the remaining healthy cells work better.

Neurologists may also prescribe medications for other dementias, including vascular dementia, Lewy body dementia, and dementia related to Parkinson’s disease. You and your healthcare provider will need to weigh the possible benefits and risks, including the risk of side effects, to decide on the best treatment plan.

Can Dementia Stop Getting Worse?

Dementia does not stop progressing completely. However, some forms of dementia may stay the same for a while before symptoms get worse again. In other words, the progression isn’t always steady. You may find that you or your loved one stays stable for a while, then seem to worsen again.

This pattern is especially common with vascular dementia. This kind of dementia often seems to progress by steps or jumps. Symptoms can worsen suddenly if someone with vascular dementia has a stroke. A stroke can cause significant brain damage all at once, which can make symptoms worsen quickly.

Does Mild Cognitive Impairment Always Progress?

Mild cognitive impairment (MCI) doesn’t always progress to dementia. People with MCI have some trouble with reasoning or cognition, but not enough to impact their daily lives. While the early stages of Alzheimer’s disease are the most common cause of MCI, it can also be caused by many other medical conditions. Getting the right diagnosis and addressing the underlying conditions may help resolve MCI symptoms.

In adults over age 65, MCI progresses to dementia about 15 percent of the time. Regular exercise, brain-stimulating activities, and healthy lifestyle habits may prevent some forms of MCI from getting worse.

What Does a Sudden Worsening of Dementia Symptoms Mean?

Sometimes, dementia symptoms worsen quickly. This is usually caused by another medical issue, not the dementia itself. For example, in vascular dementia, a sudden decline may be related to a cardiovascular problem, especially if a person has multiple vascular risk factors. Getting medical attention right away is key to helping them get the treatment they need.

In fact, a sudden change in thinking or awareness in anyone — not just someone with dementia — may be a sign of a stroke. Quick medical care can help reduce the long-term effects, so it’s important to seek emergency help right away.

Other times, a sudden drop in cognitive function — happening over a day or two — may point to delirium.

Dementia Versus Delirium

Delirium happens when a person suddenly becomes confused or less aware of their surroundings. These changes can happen very quickly — sometimes within hours or over the course of a few days. Some people experiencing delirium may also show emotional changes or shifts in behavior.

A person can have both dementia and delirium at the same time. In fact, episodes of delirium are fairly common in people with a diagnosis of dementia. Many different issues can trigger delirium, and sometimes the cause isn’t immediately clear. Common causes include:

• Certain infections — especially COVID-19, urinary tract infections, pneumonia, or the flu
• Certain medications
• A heart attack, stroke, or worsening liver or kidney diseases
• Insufficient diet, dehydration, or nutritional imbalances
• Exposure to toxins or withdrawal from a substance, such as alcohol
• Lack of sleep
• Significant emotional pain
• Physical pain

Treating the underlying cause of delirium can help cognitive symptoms improve. However, for people already living with dementia, recovery may be slower, or they may not fully return to their previous level of functioning. Generally, the healthier someone is before they experience delirium, the more likely they are to make a full recovery.

Talk to a Doctor

If you have questions about how dementia is progressing — for yourself or a loved one — talk to your doctor. While they can’t predict exactly how symptoms will change over time, they can help you understand what to expect, recognize signs of delirium versus dementia, recommend appropriate treatments, and connect you with support resources. If you’re a caregiver, they can also help you access services to make caregiving more manageable.

Join the Conversation

On myALZteam, people share their experiences with Alzheimer’s, get advice, and find support from others who understand.

How have dementia symptoms progressed for your loved one? Let others know in the comments below.