Dementia vs Alzheimer’s: Understanding the Different Types of Dementia

Dementia, Alzheimer’s, Frontotemporal, Lewy Body and Vascular Dementia: What’s the Difference?

Short answer: dementia is an umbrella term describing a collection of symptoms caused by diseases that affect the brain. Alzheimer’s disease is one cause of dementia. Frontotemporal dementia, Lewy body dementia and vascular dementia are others.

While these conditions can eventually share symptoms such as changes in memory, communication, behaviour and independence, the way they begin — and the areas of the brain they affect — can look quite different.

For Dementia Action Week 2026 and World Alzheimer’s Day, we’re looking at what dementia actually means, how some of the most common forms differ, and why exercise can remain important after a dementia diagnosis.

What is dementia?

Dementia is not one specific disease.

It is a term used to describe a collection of symptoms caused by diseases that progressively affect the brain.

Depending on the type of dementia and the areas of the brain affected, a person may experience changes involving:

• memory
• thinking and problem-solving
• communication
• behaviour
• judgement
• attention
• movement
• visual processing
• ability to perform everyday activities.

Alzheimer’s disease is the most common form of dementia, but there are many different causes.

Some of the more common include:

• Alzheimer’s disease
• vascular dementia
• Lewy body dementia
• frontotemporal dementia.

Importantly, dementia is not a normal part of ageing.

What is Alzheimer’s disease?

Alzheimer’s disease is a progressive neurological disease and the most common cause of dementia.

Changes within the brain include the abnormal accumulation of proteins such as amyloid plaques and tau tangles, which interfere with communication between brain cells and eventually contribute to neuronal loss.

Because areas involved in learning and memory are commonly affected relatively early, one of the first noticeable symptoms is often difficulty forming or retaining new memories.

Someone may:

• repeatedly ask the same question
• forget recent conversations
• misplace belongings
• become disoriented
• struggle to learn new information
• gradually experience increasing difficulty with everyday tasks.

As Alzheimer’s progresses, communication, judgement, behaviour and physical function can also become affected.

What is frontotemporal dementia?

Frontotemporal dementia, or FTD, refers to a group of neurodegenerative diseases that predominantly affect the frontal and temporal lobes of the brain.

These areas contribute heavily to:

• behaviour
• personality
• judgement
• planning
• impulse control
• motivation and initiation
• emotional regulation
• language.

Because of this, FTD can look very different from the stereotypical picture of dementia.

Memory may be relatively preserved during the earlier stages.

Instead, family members may notice:

• significant personality changes
• reduced motivation or initiative
• impulsive behaviour
• loss of social inhibition
• reduced empathy
• changes in judgement
• difficulty planning and organising
• repetitive or rigid behaviours
• changes in eating habits
• difficulties speaking or understanding language.

FTD also commonly begins at a younger age than Alzheimer’s disease, often between approximately 40 and 65 years.

Why can frontotemporal dementia look like a personality change?

The frontal lobes play an important role in regulating behaviour.

They help us:

• consider consequences before acting
• recognise social expectations
• regulate impulses
• initiate tasks
• plan and organise
• problem-solve
• monitor our own behaviour
• respond appropriately to other people.

When these areas are progressively affected, a person may behave in ways that are very different from their previous personality.

Someone who was previously organised may suddenly require significant prompting.

Someone who was cautious may begin making impulsive decisions.

Someone who was highly empathetic may appear emotionally disconnected.

These changes are not necessarily deliberate. They may reflect changes in the neurological systems responsible for behaviour, judgement and emotional regulation.

What is Lewy body dementia?

Lewy body dementia is associated with abnormal accumulations of a protein called alpha-synuclein, known as Lewy bodies, within brain cells.

It can affect both cognitive and movement-related systems.

Common features can include:

• fluctuating attention and alertness
• visual hallucinations
• slowed movement
• muscle stiffness
• changes in walking and balance
• sleep disturbances
• changes in thinking and problem-solving.

One of the features that can distinguish Lewy body dementia from Alzheimer’s disease is that cognition may fluctuate noticeably.

A person may appear alert and engaged at one point in the day and considerably more confused or drowsy at another.

Movement changes similar to those seen in Parkinson’s disease may also occur.

What is vascular dementia?

Vascular dementia occurs when reduced or interrupted blood flow causes damage to the brain.

This may occur following:

• a major stroke
• multiple smaller strokes
• damage to the small blood vessels within the brain.

The symptoms depend significantly on which parts of the brain have been affected.

Someone may experience:

• slowed thinking
• difficulty concentrating
• reduced attention
• problems with planning and organisation
• memory difficulties
• changes in walking and balance
• weakness or other physical changes following stroke.

Unlike Alzheimer’s disease, where memory difficulties are often particularly prominent early, vascular dementia can initially present more strongly through executive dysfunction, slowed processing or physical changes.

In some people, the progression can also appear more stepwise, particularly if additional vascular events occur.

How do the main types of dementia differ?

Although symptoms can overlap considerably, the early pattern of changes can sometimes provide clues about which systems of the brain are being affected.

Alzheimer’s disease

Early changes are more commonly associated with:

• recent memory
• learning new information
• orientation
• word finding
• gradual difficulty with everyday tasks.

Frontotemporal dementia

Early changes are more commonly associated with:

• personality
• behaviour
• judgement
• inhibition
• motivation
• planning
• executive function
• speech and language.

Lewy body dementia

Common features include:

• fluctuating cognition
• changes in attention and alertness
• visual hallucinations
• sleep disturbance
• movement changes
• balance difficulties.

Vascular dementia

Changes may include:

• slower information processing
• executive dysfunction
• concentration difficulties
• walking or balance changes
• stroke-related physical impairments
• memory difficulties.

These patterns are useful for understanding the conditions, but they are not diagnostic rules.

Symptoms can overlap considerably, and some people have mixed dementia, meaning more than one disease process is contributing to their symptoms.

This is another reason why dementia should not be thought of as one single condition.

Why does knowing the type of dementia matter?

Different diseases affect different areas and systems of the brain.

That means the challenges someone experiences — and the strategies that help them — may also differ.

Someone living with Alzheimer’s disease may need increasing support with remembering instructions or learning unfamiliar routines.

Someone with frontotemporal dementia may physically understand an activity but have difficulty initiating it, maintaining appropriate behaviour or recognising why something needs to be done.

Someone with Lewy body dementia may have relatively good physical or cognitive function at one time of day but perform very differently later due to fluctuating attention or movement symptoms.

A person with vascular dementia may experience a combination of cognitive and physical changes following stroke or cerebrovascular disease.

This is why support should ultimately be based on how the individual is functioning, rather than assuming everybody with dementia has the same needs.

Can exercise help someone living with dementia or Alzheimer’s disease?

Yes — although it is important to be clear about what exercise can and cannot do.

Exercise does not reverse dementia or restore brain cells already lost through neurodegenerative disease.

It also cannot currently be said to reliably stop or reverse the underlying progression of Alzheimer’s disease, frontotemporal dementia, Lewy body dementia or vascular dementia.

However, that does not mean exercise has little value.

Research suggests appropriately prescribed exercise can support:

• strength
• balance
• mobility
• cardiovascular fitness
• walking ability
• activities of daily living
• physical independence
• overall cognition in some people with dementia.

Exercise is therefore better understood as one tool that may help maintain physical function, support independence and promote overall brain and cardiovascular health.

What happens to the brain when we exercise?

Exercise affects much more than the muscles.

Physical activity also creates physiological changes that may support brain health.

Research suggests exercise can:

• increase cerebral blood flow
• improve cardiovascular and vascular health
• influence inflammatory processes
• stimulate neurotrophic factors
• support processes involved in synaptic plasticity.

One factor commonly discussed is brain-derived neurotrophic factor, or BDNF.

BDNF contributes to the survival and function of neurons and plays a role in neuroplasticity — the brain’s ability to adapt and modify its connections.

This does not mean exercise can regenerate the brain or reverse dementia.

Rather, exercise may help create physiological conditions that support the function and adaptability of the brain that remains.

Maintaining cardiovascular health is also particularly relevant because the brain depends on an adequate blood supply, and vascular risk factors are closely connected to brain health.

Can exercise slow the progression of dementia?

This is where the wording needs to be careful.

It is tempting to say that exercise slows dementia because research consistently shows that physical activity is good for brain health.

However, current research does not allow us to confidently say that exercise directly slows the underlying neurodegenerative disease process in every person with dementia.

What we can say is that exercise may help:

• maintain physical capacity
• support cognition in some individuals
• preserve everyday function
• reduce secondary decline caused by inactivity
• maintain cardiovascular health
• support continued participation in daily life.

For someone living with a progressive condition, maintaining an ability for longer can itself be a meaningful outcome.

If a person maintains enough strength to continue standing independently, enough balance to keep walking or enough cardiovascular fitness to participate in community activities, that can have a significant impact on quality of life even while the underlying condition continues to progress.

Why combine movement with cognitive tasks?

Our brains rarely perform physical and cognitive tasks separately in everyday life.

Walking through a shopping centre, for example, may require someone to:

• walk and maintain balance
• navigate other people
• remember where they are going
• process visual information
• respond to conversation
• make decisions.

This is known as dual-tasking — completing a movement while simultaneously processing another cognitive task.

In rehabilitation, this may look like:

• walking while answering questions
• stepping to coloured targets in a sequence
• remembering an instruction while completing a movement
• throwing and catching while naming categories
• performing a balance activity while responding to cues.

These activities increase the cognitive demand of movement and may help train abilities that are relevant to everyday life.

However, dual-task activities need to be appropriate for the individual.

For some people with more advanced dementia, additional cognitive demands may simply create frustration or increase falls risk.

Sometimes simplicity, repetition and familiarity are more valuable than complexity.

What can exercise rehabilitation look like with dementia?

There is no single “dementia exercise program”.

The approach depends on the person, their stage of dementia, physical capacity, cognitive presentation, interests and goals.

Exercise may involve:

• walking and cardiovascular exercise
• strength training
• balance exercises
• gait training
• coordination activities
• practising transfers and functional movements
• dual-task activities
• games that combine movement and cognition
• familiar movement routines
• exercises connected to previous hobbies or interests.

For someone with significant memory difficulties, sessions may rely heavily on consistency and repetition.

For someone with frontotemporal dementia, participation may depend more on managing initiation, attention, behaviour or motivation.

For someone with Lewy body dementia, exercise may need to be adapted around fluctuations in cognition and movement.

For someone with vascular dementia following a stroke, the focus may include rebuilding strength, balance, gait and cardiovascular capacity alongside cognitive demands.

The exercise itself matters.

But with dementia, how the exercise is delivered can matter just as much.

Exercise is about much more than memory

It is easy to judge the effectiveness of exercise only by asking whether it improves cognition.

But someone living with dementia still benefits from maintaining the physical abilities that allow them to participate in everyday life.

Strength can support standing, transfers and walking.

Balance can improve safety and confidence with movement.

Cardiovascular fitness can help someone tolerate everyday activities.

Mobility can support continued community participation.

Routine can provide familiarity and structure.

Social interaction can give someone opportunities to remain engaged with others.

Confidence can encourage continued participation in familiar activities.

For progressive conditions, rehabilitation is therefore not always about regaining something that has been lost.

Sometimes the goal is maintaining function, independence, participation and quality of life for as long as reasonably possible.

Dementia Action Week and World Alzheimer’s Day 2026

Dementia Action Week runs from 21–27 September 2026, with World Alzheimer’s Day held on 21 September.

These awareness events provide an opportunity to improve understanding of dementia and challenge the misconception that dementia is simply a normal part of ageing.

One of the simplest places to start is understanding the terminology:

Dementia is the umbrella.

Alzheimer’s disease is one cause of dementia.

Frontotemporal dementia is another.

Lewy body dementia is another.

Vascular dementia is another.

And behind every diagnosis is an individual whose symptoms, abilities and rehabilitation needs may look completely different.

Want to learn more about dementia and exercise?

At Combined Wellness Solutions, we regularly work with people living with neurological conditions, including individuals at different stages of dementia.

Working alongside people with progressive neurological conditions continually reinforces that rehabilitation is not always about recovering what has been lost.

Sometimes it is about maintaining strength, mobility, routine, confidence and participation despite a condition that continues to progress.

If you are living with dementia, supporting a family member or client, or would like more information about Exercise Physiology and neurological rehabilitation for dementia, Alzheimer’s disease, frontotemporal dementia, Lewy body dementia or vascular dementia, you are welcome to contact our team.

This article provides general educational information and does not replace individual medical or allied health advice. Dementia symptoms and progression vary considerably, and exercise should be appropriate for the individual’s health, abilities and circumstances.

Your next step

Questions about exercise and dementia?

If you would like to understand more about Exercise Physiology, physical activity or neurological rehabilitation for someone living with dementia, contact our team for a conversation.

Book an Appointment   ·   Call 1300 018 328

We support clients across the Gold Coast and Ipswich, with clinic, home visit, hydrotherapy and neurological rehabilitation options available depending on individual needs.

ESSA Accredited Exercise Physiologists · Registered NDIS Provider · Specialists in neurological injury and complex disability since 2019