Why do some people progress faster than others?

Agreeing with @terei ... doesn't seem to be rhyme nor reason for that.

Could be genetics, how the PWD took care of themselves prior, or other factors.

The only study I've seen close to your question is about factors that may contribute to developing 'it', but nothing on individual progression.

I think different types of dementia have different progression rates. Early-onset is supposed to progress more quickly, but a co-worker's 80's MIL blew that out the window going from stage 5 to nearly stage 8, now, in about a year and a half, shocking all of us! Nope - no rhyme nor reason

This is a great question.

I think a part of this is related to Dementia being an umbrella term. It's known that certain forms of dementia do tend to progress at different rates-- on average, vascular dementia progresses faster than Alzheimer's. On average, EO/YO Alzheimer's progresses more rapidly than the disease in those over 70. The majority of the time, PWD actually have mixed dementia, so there are two progressively degenerative conditions in play. There's also the notion that without autopsy I'm not how accurate this kind of diagnosis is.

I think another factor is where in the disease progression a PWD is diagnosed. Cognitive reserve may cloud onset of symptoms for some. My own dad could do freakishly well on quick screening tests like MMSE and MoCA. He could do serial subtraction faster than my mom at a time when he wasn't sure what state he was living in and was starting to develop incontinence.

And, of course, the PWD would need to be in a situation where a friend, family member or physician recognized symptoms triggering an evaluation. Not everybody has someone who would recognize early symptoms for what they are nearby. And sometimes, when you see a PWD daily and are providing scaffolding, it's harder to notice the subtle loss of memory and cognitive skills.

My one aunt likely had mild dementia when her DH died in 2003. In retrospect, I can now remember him directly scaffolding her when we saw them and talking about lifestyle changes they'd made which I know recognize as "best practices". But she didn't get diagnosed until her sister visited her sitting alone in her cold, dark house wondering why the cable was out in 2008. She was initially diagnosed with VD and progressed slowly dying in 2018.

Her sister also developed VD. She lived with her daughter as caregiver. While my cousin knew something wasn't right with her mom, she had trouble articulating what she saw in ASL because it can be hard to find interpreters in a PCP's office who are up to that kind of conversation and her written English is somewhat irregular in vocabulary and syntax. Her mom was finally diagnosed about stage 5 but showtimed her doctor into a mild dementia diagnosis. She went into an AL, crash and burned breaking a hip in the process which spiraled into stage 7. She was diagnosed in 2016 and died the next year.

With my dad, I saw personality changes as early as 2005 and frank memory loss by 2008. Mom, on the other hand, bought dad's line about this being a normal part of the aging process. He was officially diagnosed in mid-stages mixed dementia in 2016 and died in 2018. While I would describe dad's disease course as a good 15 years, mom initially described it as "fast-moving". That said, the later stages did seem shorter than averages.

I don't know where these numbers come from, but I found this page interesting.

Alzheimer’s / Dementia Life Expectancy Calculator (dementiacarecentral.com)

There's a link to a calculator for an individual calculator. It was way off for my dad. But I think his speech skills skewed this.

HB

My MIL had an MRI in January that revealed chronic extensive white matter disease of the periventricular area of the brain. The doctor said she could no longer operate a vehicle.

She has rapidly increased in the amount of delusions she is experiencing weekly. We she the neurologist Monday. She has lived with us 20 plus years but our perceived opinion is she is declining rapidly. She is 86 and is on 3 blood pressure meds that barely keep the level in check, as well as cholesterol and diabetes meds.

I have asked our adult children to please come visit by late Spring as I feel at the rate she is declining, she may be vastly different by Summer, if she lasts that long.

Not sure there's an answer. Maybe being alone, not stimulating the brain, poor nutrition. that's just what I've read, but everyone is different. We don't know how their brain works. My mom has progressed fast too. Very sad. Thought we could care for her longer but are headed to assisted living/mem care. Sorry you're going thru it.

Cibione -I think you can trust your instincts in thinking that she needs a walker. However, don’t get your hopes up that she can learn to use it. Once disease has progressed, most PWD cannot learn, or remember to use, a walker.