The Big Picture
Dementia affects a person’s ability to remember, think, learn, behave, and communicate. Secondary dementia happens when another illness, a harmful substance, or an injury causes these changes.
There are different types of secondary dementia. Some develop alongside another disease. Others happen because of harmful substances, a lack of an important vitamin, or fluid building up in the brain.
Different types of secondary dementia have different symptoms and treatment possibilities. When caring for someone with dementia, it is important to understand their condition and treat them with respect.
Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.
Quick tip: Tap, click, or press Enter on any term with a dotted underline and an ⓘ icon to see its plain-English definition.
Start Here If You’re Overwhelmed
Focus on these core ideas:
- Secondary dementia results from a physical disease, damaging substances, or injury.
- Parkinson’s disease mainly affects movement, but some people develop dementia in its later stages.
- Creutzfeldt–Jakob disease (CJD) causes rapidly progressing dementia and has no known cure.
- Normal-pressure hydrocephalus involves fluid building up in the brain. Surgery can sometimes correct it.
- Wernicke–Korsakoff syndrome (WKS) results from a lack of vitamin B₁ and is often associated with long-term heavy alcohol use.
- Clients with substance-related dementia must always receive respectful, professional care.
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Course Notes: Key Ideas You Need to Know
What Is Secondary Dementia?
Dementia is a general term for a progressive loss of brain functions. It can affect memory, thinking, learning, behaviour, communication, and social abilities.
Dementia is not one disease. It describes a group of illnesses that affect how the brain works.
Depending on the symptoms, dementia is classified as either a mild or major neurocognitive disorder.
Secondary dementia develops because of another condition or harmful event. Its causes fall into three main groups:
- Physical disease: An illness affects brain function and leads to dementia.
- Damaging substances: Harmful effects from substances contribute to dementia.
- Injury: Damage caused by an injury leads to dementia.
Another important term is cognitive impairment. This means losing some ability to remember, think, reason, understand, or live independently.
The different forms of secondary dementia can have different causes, symptoms, and treatment possibilities.
Nova Scotia CCA Note
Sorrentino’s Canadian Textbook for the Support Worker, 5th Edition describes the symptoms of different secondary dementias. In Nova Scotia, a CCA uses a point-of-care observational assessment to notice changes in a person’s thinking, emotions, or physical condition before, during, and after providing care.
The CCA follows the care plan and reports changes that require attention to a supervisor. These observations do not replace a nursing assessment. A CCA does not perform the comprehensive evaluation used to make care-planning decisions.
Why this matters in Nova Scotia: Learn the symptoms so you can recognize changes, report them, and stay within the CCA’s role.
Official source: Continuing Care Assistant Occupational Standards of Practice
Last checked: October 10, 2026
Parkinson’s Disease Dementia
Parkinson’s disease is a progressive illness that affects the brain’s ability to control movement. Progressive means the illness becomes worse over time.
Movement Problems in Parkinson’s Disease
People with Parkinson’s disease may experience:
- Tremors
- Muscle stiffness
- Slower movements
- Difficulty walking
- Loss of balance
These movement problems are important features of Parkinson’s disease.
When Dementia Develops
Some people develop dementia during the later stages of Parkinson’s disease.
Common dementia symptoms include:
- Memory loss
- Difficulty concentrating
- Problems with thinking
- Difficulty completing familiar, routine tasks
- Trouble finding their way around their environment
People with Parkinson’s disease may also experience depression, hallucinations, or delusions.
Key fact: Parkinson’s disease does not mean a person will automatically develop dementia. Dementia develops in some people during the later stages.
Creutzfeldt–Jakob Disease (CJD)
Creutzfeldt–Jakob disease, or CJD, is a rare disease that causes dementia.
It is a rapidly progressing neurological disease. This means the disease affects the nervous system and becomes worse quickly.
CJD occurs in people between 50 and 70 years of age. The disease can affect humans and animals.
What Causes CJD?
CJD is believed to be caused by proteinaceous prions.
These prions can remain in the body for years before symptoms become noticeable.
Important facts about CJD include:
- A genetic link or susceptibility appears to exist in 5% to 15% of cases.
- The disease can be passed on through infected brain tissue.
- Symptoms may not appear until years after prions are present in the body.
Once symptoms appear, the disease can progress rapidly.
Early Signs and Symptoms of CJD
Early symptoms can involve sleep, memory, behaviour, and physical movement.
They include:
- Fatigue: Feeling unusually tired
- Difficulty sleeping or insomnia
- Excessive sleepiness
- Changes in personality
- Anorexia
- Memory that becomes progressively worse
- Behaviour disturbances
- Body spasms
Depression and psychosis, along with delusions and hallucinations, are reported in 10% of cases.
Later Stages of CJD
As CJD progresses, the client’s condition becomes increasingly serious.
Later changes include:
- Poor balance
- Pain
- Increasing difficulty with stability and walking
- More obvious dementia
- Progression to a mute, rigid state
The disease eventually leaves the client unable to speak and physically rigid.
Treatment and Outlook
There is no known cure for CJD.
Treatment focuses on relieving symptoms, reducing pain and distress, and keeping the client as comfortable as possible.
Number to remember: About 90% of people with CJD die within 1 year of their first symptoms.
Normal-Pressure Hydrocephalus
Normal-pressure hydrocephalus is a type of secondary dementia caused by fluid building up in the brain.
The problem develops when cerebrospinal fluid is not reabsorbed properly. The excess fluid then collects in the brain.
Who Is at Increased Risk?
People with a history of either of these conditions have an increased risk:
- Brain hemorrhage
- Meningitis
Three Important Symptoms
Normal-pressure hydrocephalus can cause:
- Difficulty walking: The person has problems with walking.
- Memory loss: The person has difficulty remembering information.
- Loss of bladder control: The person cannot control urination.
These three symptoms are useful to study together.
Can Normal-Pressure Hydrocephalus Be Treated?
Normal-pressure hydrocephalus can sometimes be corrected through surgery.
Surgery can involve placing a shunt in the brain to drain excess fluid.
Key fact: Unlike CJD, which has no known cure, normal-pressure hydrocephalus can sometimes be corrected.
Substance-Induced Persisting Dementias
Substance-induced persisting dementia develops when the lasting effects of certain substances cause problems with brain function.
Possible sources include:
- Abused substances
- Medications
- Exposure to toxic substances
- Alcohol
The resulting cognitive decline may have several causes.
How Substances Can Affect Brain Function
Substance-related dementia may result from three different effects.
1. Direct effects on brain cells
A substance may have toxic effects that damage brain cells.
2. Effects on internal organs
Substances may affect organs such as the:
- Liver
- Heart
- Kidneys
These substance-related effects can contribute to cognitive decline.
3. Acquired brain injuries
A person who is impaired or disoriented may fall and experience an acquired brain injury (ABI).
These injuries can contribute to dementia.
Respectful Care for Clients With Substance-Related Dementia
Clients with substance-induced persisting dementia must receive the same respectful care as other clients.
A person’s history of substance use must not change the respect they receive.
Support workers need to:
- Treat these clients respectfully at all times.
- Provide care without treating them differently from other clients.
- Remember the DIPPS principles.
- Always behave professionally while providing care.
CCA care consideration: Substance-related dementia does not change the client’s right to respectful, professional treatment.
Wernicke–Korsakoff Syndrome (WKS)
Wernicke–Korsakoff syndrome (WKS) is a brain disorder caused by a lack of thiamine, also called vitamin B₁.
Thiamine deficiency affects the nervous system, including the brain.
WKS is usually associated with alcohol use disorder, involving heavy alcohol consumption over a long period. WKS can also occur with other conditions involving severe malnutrition .
Why Heavy Alcohol Use Is Associated With WKS
People who consume excessive amounts of alcohol may develop thiamine deficiency for two important reasons.
1. Poor nutrition
Many people who drink heavily have poor eating habits.
Their diets may lack essential vitamins, including the thiamine their bodies need.
2. Problems absorbing vitamins
Alcohol can inflame the lining of the stomach.
This inflammation can interfere with the body’s ability to absorb important vitamins from food.
Both problems help explain why thiamine deficiency is often associated with long-term heavy alcohol use.
Symptoms of Wernicke–Korsakoff Syndrome
WKS affects memory, thinking, learning, and the nervous system.
Possible problems include:
- Memory impairment
- Difficulty learning
- Problems with intellectual or cognitive skills
- Difficulty solving problems
- Nerve damage, including damage to areas of the brain
One symptom is especially important to recognize.
Confabulation: A Distinguishing Symptom
Confabulation, also called fabrication, is the most distinguishing symptom of WKS.
Confabulation means making up detailed, believable stories about experiences or situations to fill gaps in memory.
A person with WKS may describe an experience or situation in detail, even though the story was created to fill missing memories.
Treatment for Wernicke–Korsakoff Syndrome
Treatment involves replacing the missing thiamine and supporting the person’s nutrition.
Treatment may include:
- Thiamine replacement through intravenous (IV) injections
- Thiamine replacement through intramuscular (IM) injections
- Proper nutrition
- Adequate hydration
- Drug therapy in some cases
Recovery From WKS
Thiamine replacement does not always reverse the damage already caused by WKS.
Memory loss, including amnesia, and brain damage may continue despite treatment.
When treatment is successful, improvement becomes apparent within 2 years.
Recovery is slow and often incomplete.
Key fact: WKS is caused by thiamine deficiency, but correcting the deficiency does not always reverse memory loss or brain damage.
Other Conditions That Can Cause Secondary Dementia
Several other health conditions can also cause secondary dementia.
These include:
- Acquired immune deficiency syndrome (AIDS)
- Huntington’s disease
- Multiple sclerosis (MS)
- Syphilis
Remember these as additional possible causes of secondary dementia.
Exam Clue Words
Pay attention to words that change how a statement about secondary dementia should be understood.
- Some: Some people with Parkinson’s disease develop dementia in the later stages. It does not happen to everyone.
- Rapidly: CJD progresses quickly once symptoms become apparent. The speed of progression is an important part of the condition.
- No known cure: CJD has no known cure. Treatment focuses on reducing symptoms, pain, and distress.
- Sometimes: Normal-pressure hydrocephalus can sometimes be corrected with a surgically placed shunt. Correction is not guaranteed.
- Always: Clients with substance-related persisting dementia must always be treated respectfully and professionally.
Common Mix-Ups
These conditions can be confusing because they all involve dementia, but their causes and patterns differ.
| Wrong Idea | Better Idea |
|---|---|
| Everyone with Parkinson’s disease develops dementia. | Some people develop dementia in the later stages. |
| CJD and normal-pressure hydrocephalus have the same treatment outlook. | CJD has no known cure. Normal-pressure hydrocephalus can sometimes be corrected. |
| WKS is caused directly by alcohol alone. | WKS is caused by thiamine deficiency and is usually associated with long-term heavy alcohol use. |
| Treating thiamine deficiency always reverses WKS symptoms. | Memory loss and brain damage do not always improve with treatment. |
Fast Review
Secondary dementias have different causes and symptoms. Use these points to review the most important differences.
- Secondary dementia: Develops because of physical disease, damaging substances, or injury.
- Parkinson’s disease dementia: Some people develop dementia in the later stages of Parkinson’s disease.
- Parkinson’s symptoms: Movement problems include tremors, stiffness, slowness, difficulty walking, and poor balance.
- CJD: A rare, rapidly progressing disease believed to be caused by proteinaceous prions.
- CJD outlook: About 90% of affected people die within 1 year of their first symptoms.
- CJD treatment: There is no known cure. Treatment aims to relieve symptoms and improve comfort.
- Normal-pressure hydrocephalus: Poor reabsorption of cerebrospinal fluid causes fluid to build up in the brain.
- Normal-pressure hydrocephalus symptoms: Difficulty walking, memory loss, and loss of bladder control.
- Normal-pressure hydrocephalus treatment: Surgery to place a shunt can sometimes correct the condition.
- Substance-induced persisting dementia: Cognitive decline can result from effects on brain cells, internal organs, or acquired brain injuries.
- Wernicke–Korsakoff syndrome: A lack of thiamine, or vitamin B₁, causes the disorder. Confabulation is its most distinguishing symptom.
- Professional care: Clients with substance-related dementia must always receive respectful care. Support workers should remember the DIPPS principles.
Final Pep Talk
There are several types of secondary dementia to remember, and some symptoms overlap. Focus first on what makes each condition different, especially its cause, pattern, and treatment possibilities. Reviewing those differences a few times can help you recognize them more confidently.