Dementia: Different Types in Grand Rapids, Michigan

Dementia is a broad term used to describe a group of conditions that affect the brain and cause a progressive decline in memory, thinking, behavior, and the ability to perform everyday activities. In Grand Rapids, Michigan, dementia is a growing concern as our population ages, and local health systems such as Corewell Health (formerly Spectrum Health), Trinity Health Grand Rapids, Metro Health–University of Michigan Health, and Mercy Health frequently diagnose and manage these conditions.

Cold West Michigan winters, limited daylight, and chronic conditions common in Michigan (like high blood pressure, diabetes, and heart disease) can all influence brain health and dementia risk.

Dementia Is Not One Specific Disease

Dementia is a collection of symptoms rather than a single disease. Common dementia symptoms include:

  • Memory loss (especially recent events)
  • Confusion and disorientation
  • Changes in personality and behavior
  • Difficulty with language, problem-solving, or planning
  • Reduced ability to manage work, social life, or daily tasks

These symptoms are severe enough to interfere with a person’s social and working life. Dementia is more common in people over age 65, but it is not a normal or inevitable part of aging.

Many different illnesses can cause dementia. Each type has its own pattern of symptoms and brain changes. In most cases, we do not fully understand why a particular person develops dementia, though genetics, lifestyle, and vascular (blood vessel) health all play a role.

Alzheimer’s Disease

Alzheimer’s disease is the most common form of dementia, accounting for about two-thirds of dementia cases. It is frequently diagnosed in older adults throughout Grand Rapids and the broader West Michigan region.

How Alzheimer’s Disease Affects the Brain

Alzheimer’s is a progressive, degenerative brain disease that leads to a gradual decline in:

  • Memory
  • Thinking and reasoning
  • Ability to perform daily activities

In Alzheimer’s disease, two abnormal proteins build up in the brain:

  • Amyloid plaques – clumps of a protein called beta-amyloid that form fibrous patches between nerve cells
  • Neurofibrillary tangles – twisted strands of a protein called tau that build up inside nerve cells

These changes damage and eventually kill brain cells.

Sporadic vs. Familial Alzheimer’s Disease

Most cases of Alzheimer’s disease are sporadic, meaning:

  • They are not caused by a known change in a specific gene
  • They usually occur in people over age 65

A much rarer form, familial Alzheimer’s disease, is inherited:

  • Symptoms often appear between ages 40 and 60
  • Caused by changes in specific genes that increase production of the amyloid protein

People with Down syndrome are at very high risk of developing Alzheimer’s disease at a younger age. Because they have an extra copy of chromosome 21 (which carries the gene for amyloid protein), they produce more amyloid, increasing plaque formation.

If you have concerns about early or familial Alzheimer’s disease in your family, specialists in neurology and memory clinics at Corewell Health or Trinity Health Grand Rapids can offer evaluation and genetic counseling referrals.

Vascular Dementia

Vascular dementia is the second most common form of dementia. It is caused by diseases of the blood vessels in the brain that reduce or block blood flow, leading to brain damage. This is particularly important in Michigan, where high rates of high blood pressure, high cholesterol, diabetes, and stroke increase vascular dementia risk.

Vascular dementia can look similar to Alzheimer’s disease, and some people in Grand Rapids have mixed dementia, with both Alzheimer’s and vascular changes.

Strategic Infarct Dementia (Single Large Stroke)

A single large stroke can cause strategic infarct dementia, depending on the size and location of the stroke:

  • Symptoms can start suddenly
  • Changes may include problems with thinking, behavior, or movement
  • The specific symptoms depend on which area of the brain was damaged

If no further strokes occur, symptoms may stabilize or even improve with rehabilitation. However, additional strokes or ongoing vascular disease can cause symptoms to worsen.

Multi-Infarct Dementia (Multiple Small Strokes)

Multi-infarct dementia is caused by many small strokes, often called “mini-strokes” or transient ischemic attacks (TIAs). These strokes are often “silent,” meaning the person may not realize they are happening.

Over time, as more small strokes occur:

  • Damage in the brain increases
  • Reasoning, planning, and thinking skills decline
  • Depression and mood swings may develop

Symptoms may follow a step-wise pattern: a sudden worsening after each new stroke, followed by a period of stability.

Subcortical Vascular Dementia (Binswanger’s Disease)

Subcortical vascular dementia (also called Binswanger’s disease) is caused by disease in the small blood vessels deep within the brain:

  • Often related to long-standing, untreated high blood pressure or diabetes
  • Caused by high blood pressure, thickened arteries, and inadequate blood flow

Common symptoms include:

  • Problems with reasoning and thinking
  • Mild memory problems
  • Walking and movement difficulties
  • Behavioral changes
  • Loss of bladder control

Subcortical vascular dementia is usually progressive, with symptoms worsening as more vascular damage occurs, though abilities can fluctuate from day to day.

In Grand Rapids, managing blood pressure, cholesterol, and diabetes through your primary care provider, Spectrum Health or Metro Health clinics, and lifestyle programs at local health centers is critical for preventing or slowing vascular dementia.

Lewy Body Disease (Lewy Body Dementia)

Lewy body disease (LBD) is an umbrella term for conditions caused by abnormal clumps of a protein called alpha-synuclein, known as Lewy bodies, building up in brain cells.

These clumps form in specific brain regions and cause changes in:

  • Movement
  • Thinking
  • Behavior

People with Lewy body disease often experience:

  • Large fluctuations in attention and thinking (from almost normal to very confused within short periods)
  • Visual hallucinations (seeing things that are not there), which are a common symptom
  • Movement symptoms similar to Parkinson’s disease (tremors, stiffness, slowed movement)

Lewy body disease is considered a spectrum, including:

  • Dementia with Lewy bodies (DLB)
  • Parkinson’s disease
  • Parkinson’s disease dementia

All involve Lewy bodies, but the timing of symptoms determines the diagnosis:

  • If thinking and behavior changes (dementia) appear first → often diagnosed as dementia with Lewy bodies
  • If movement symptoms (tremor, stiffness, difficulty initiating movement, speech changes) appear first → diagnosed as Parkinson’s disease
  • If Parkinson’s movement symptoms come first and dementia develops later → diagnosed as Parkinson’s disease dementia

Most people with long-standing Parkinson’s disease will eventually develop some dementia symptoms.

Because symptoms overlap with Alzheimer’s and vascular dementia, diagnosis can be challenging. Neurologists and memory specialists in Grand Rapids (for example, at Corewell Health’s neurology clinics) can perform detailed evaluations to clarify the diagnosis.

Frontotemporal Dementia (FTD)

Frontotemporal dementia (FTD) is a group of dementias that involve degeneration of the frontal and/or temporal lobes of the brain. It may also be called:

  • Frontotemporal lobar degeneration
  • Pick’s disease (for some forms)

These brain regions are responsible for:

  • Mood and social behavior
  • Attention and judgment
  • Planning and self-control
  • Language and understanding

Damage to these areas can cause:

  • Changes in personality, emotion, and behavior
  • Poor judgment and loss of inhibitions
  • Difficulty recognizing objects or understanding language
  • Problems expressing language

Unlike Alzheimer’s disease, memory may be relatively preserved in early FTD.

Symptoms Depend on the Affected Brain Region

  • Frontal lobe involvement → major changes in personality and behavior
  • Temporal lobe involvement → language problems are more prominent

FTD typically affects people younger than those with Alzheimer’s, often with onset between ages 50 and 70, and sometimes even earlier. This can be especially disruptive to work and family life for people in the Grand Rapids area who are still employed and raising families.

Behavioral-Variant FTD

In behavioral-variant FTD, the main changes are in:

  • Personality
  • Habits
  • Emotional responses

Some people become very apathetic and withdrawn, while others lose social inhibitions and may act inappropriately. The exact symptoms depend on which parts of the frontal lobes are damaged.

Language Variants of FTD

When FTD primarily affects the temporal lobes, language problems are most noticeable:

  • Semantic dementia – gradual loss of the ability to understand the meaning of words; reading, spelling, comprehension, and expression are affected.
  • Progressive non-fluent aphasia (PNFA) – the least common form; speech becomes slow and effortful, with distorted words and frequent word-finding difficulty. Over time, the ability to speak fluently is gradually lost.

Inherited Forms of FTD

Some forms of FTD are inherited, caused by specific genetic changes:

  • Familial FTD accounts for about 10–15% of all FTD cases
  • Two genes (for tau protein and progranulin protein) account for around half of familial FTD cases
  • Several other rare genetic changes can also cause FTD

One inherited form, frontotemporal dementia with Parkinsonism-17 (FTDP-17), is caused by changes in the tau gene on chromosome 17:

  • Very rare (about 3% of all dementia cases)
  • Symptoms usually appear between ages 40 and 60
  • Causes progressive problems with thinking, behavior, and movement (rigidity, reduced facial expression, balance problems similar to Parkinson’s disease)

For families affected by inherited FTD, genetic testing and genetic counseling are available. In Grand Rapids, referrals can be made through neurology clinics or genetic counseling services associated with major health systems.

Genetic counseling helps individuals and families:

  • Understand the condition and its inheritance
  • Make informed medical and personal decisions
  • Consider options such as prenatal genetic counseling if planning a pregnancy

Excessive alcohol use, especially when combined with poor nutrition and thiamine (vitamin B1) deficiency, can cause irreversible brain damage. Many experts prefer terms such as:

  • Alcohol-related brain injury
  • Alcohol-related brain impairment

rather than “alcohol-related dementia,” because alcohol can affect many different brain functions, including:

  • Memory
  • Planning and judgment
  • Social skills
  • Balance and coordination

This Type of Dementia Is Largely Preventable

Limiting alcohol intake, maintaining a healthy diet, and addressing alcohol use disorders early can significantly reduce the risk of alcohol-related brain damage. In Grand Rapids, help is available through:

  • Primary care providers
  • Addiction services at local hospitals
  • Community mental health and substance use programs

Wernicke–Korsakoff Syndrome

Wernicke–Korsakoff syndrome is sometimes called alcoholic dementia, but it is primarily caused by thiamine deficiency, often related to heavy alcohol use.

Alcohol damages the stomach lining and interferes with vitamin absorption, leading to low thiamine levels and Wernicke’s encephalopathy.

Symptoms of Wernicke’s Encephalopathy Can Include:

  • Confusion
  • Jerky eye movements or paralysis of the eye muscles
  • Double vision
  • Poor balance, staggering, or inability to walk

High-dose thiamine treatment can reverse many of these symptoms if given early. If left untreated, it can lead to permanent brain damage or death.

Untreated or poorly treated Wernicke’s encephalopathy can progress to Korsakoff’s syndrome, which can also develop on its own.

Symptoms of Korsakoff’s Syndrome Include:

  • Short-term (and sometimes long-term) memory loss
  • Inability to form new memories or learn new information
  • Personality changes
  • Making up stories to fill memory gaps (confabulation)
  • Hallucinations (seeing or hearing things that are not there)

The progression of Korsakoff’s syndrome can often be stopped if the person:

  • Completely abstains from alcohol
  • Eats a healthy, balanced diet
  • Takes vitamin supplements (especially thiamine)

Thiamine supplementation may help prevent further brain damage.

HIV-Associated Dementia

Human immunodeficiency virus (HIV)-associated dementia (HAD) is a complication that affects some people with HIV and AIDS. It was previously known as:

  • AIDS-related dementia
  • AIDS dementia complex (ADC)

HAD is associated with:

  • Severe cognitive problems
  • Motor (movement) difficulties
  • Behavioral changes

These problems can significantly impair daily functioning, independence, and quality of life.

HAD is uncommon in the early stages of HIV infection and is more likely as the disease advances, especially in people not taking antiretroviral medication. It is the most severe form of HIV-associated neurocognitive disorder (HAND). Milder forms of HAND affect thinking skills (memory, language, attention, planning) but are not severe enough to be called dementia.

In the United States, including Michigan, where most people with HIV have access to combination antiretroviral therapy, HAD is now relatively uncommon, though milder cognitive problems still affect many people living with HIV.

If you live in Grand Rapids and are concerned about cognitive changes with HIV, infectious disease and neurology specialists at local hospitals can help evaluate and manage these symptoms.

Younger-Onset Dementia

Younger-onset dementia (also called early-onset dementia) refers to any dementia diagnosed before age 65. It is much less common than dementia in older adults but can occur in people as young as 30–60.

Younger-onset dementia can be difficult to diagnose and may be mistaken for stress, depression, or other conditions, especially in working-age adults. Certain types of dementia are more likely to occur in younger people, including:

  • Familial (inherited) Alzheimer’s disease
  • Frontotemporal dementia (FTD)
  • Huntington’s disease

In Grand Rapids, younger-onset dementia can place significant stress on families, finances, and employment. Memory clinics, neuropsychology services, and social workers at major health systems can help with diagnosis, planning, and support.

Dementia Caused by Huntington’s Disease

Huntington’s disease is an inherited degenerative brain disorder that affects both mind and body:

  • Usually appears between ages 30 and 50
  • Characterized by intellectual decline and irregular, involuntary movements of the limbs or face (called chorea)

Other symptoms include:

  • Personality changes
  • Memory problems
  • Slurred speech
  • Impaired judgment
  • Psychiatric symptoms (such as depression or irritability)

There is currently no cure to stop the progression of Huntington’s disease, but medications can help manage movement disorders and psychiatric symptoms. Dementia occurs in the majority of people with Huntington’s disease.

Families in Grand Rapids affected by Huntington’s disease can seek genetic counseling, neurology care, and support services through local hospital systems and community organizations.

Creutzfeldt–Jakob Disease (CJD)

Creutzfeldt–Jakob disease (CJD) is an extremely rare but fatal brain disorder caused by an abnormal protein particle called a prion. It occurs in about one in every million people.

There are two main types:

  • Classic CJD – includes sporadic and very rare familial forms
  • Variant CJD – related to “mad cow disease” (bovine spongiform encephalopathy)

Symptoms of Variant CJD Can Include:

Early:

  • Dementia and failing memory
  • Changes in behavior and personality
  • Lack of coordination

As the disease progresses (often rapidly):

  • Marked mental deterioration
  • Involuntary movements
  • Vision loss or blindness
  • Weakness in the arms or legs
  • Eventually, coma

CJD is rare in Michigan and worldwide, but when suspected, rapid referral to a neurologist and specialized centers is essential.

Local Dementia Support and Resources in Grand Rapids, MI

If you or a loved one in Grand Rapids is experiencing memory loss or other dementia symptoms, early evaluation is important. Local resources include:

  • Your primary care provider or GP – first point of contact for assessment and referrals
  • Corewell Health (Spectrum Health) Memory and Neurology Clinics – for specialist evaluation
  • Trinity Health Grand Rapids, Metro Health, Mercy Health – neurology, geriatrics, and behavioral health services
  • Kent County Health Department – public health information and community programs
  • Grand Rapids Public Health and community health centers – screenings, education, and support referrals
  • Local chapters and helplines (e.g., Alzheimer’s Association Michigan Chapter) – for caregiver support, education, and 24/7 helplines
  • Area Agency on Aging of Western Michigan – assistance with in-home care, respite, and long-term care planning
  • Community support groups – many hosted by hospitals, churches, and senior centers in and around Grand Rapids

Ask your doctor or local health department for the most current phone numbers and websites, as these may change.

Key Points About Dementia in Grand Rapids, Michigan

  • Dementia is a group of symptoms (memory loss, confusion, personality and behavioral changes) caused by different brain diseases.
  • These symptoms interfere with social, work, and daily life.
  • Dementia is more common after age 65 but is not a normal part of aging.
  • Alzheimer’s disease is the most common form, accounting for about two-thirds of cases.
  • In Alzheimer’s disease, brain damage is caused by amyloid plaques and neurofibrillary tangles.
  • Other common types include vascular dementia, Lewy body dementia, and frontotemporal dementia, as well as dementia related to alcohol use, HIV, Huntington’s disease, and rare conditions like CJD.
  • In West Michigan, controlling high blood pressure, diabetes, and cholesterol; avoiding smoking; limiting alcohol; staying active; and managing winter-related inactivity and mood can all support brain health.
  • Early diagnosis and support through Grand Rapids health systems and community resources can improve quality of life for people living with dementia and their families.