Alzheimer's Disease and Other Dementias
Dementia refers to a gradual loss of cognitive (brain) function, generally memory or thought processing, but language skills can be lost as well. There are numerous causes of dementia, but Alzheimer's disease is the most common.
What is Alzheimer's disease?
Alzheimer's disease is a neurodegenerative disorder that affects memory, especially the ability to remember things in the short term. People with Alzheimer's often repeat questions or stories or are confused as to what date it is. They may lose interest in hobbies or socializing.
As the disease grows, it affects other areas like decision making, direction sense, operating devices or driving a car, to name a few. Behavioral changes like paranoia can occur. People with Alzheimer's may have some awareness of their memory problems but generally do not have full awareness.
The stages of Alzheimer's disease:
- Mild cognitive impairment (called prodromal Alzheimer's disease when tests show Alzheimer features): A person is functioning independently but with mild forgetfulness.
- Early Alzheimer's: Memory issues and other cognitive symptoms happen on a daily basis and affect functioning.
- Middle stage: A person cannot manage on their own and require very frequent supervision.
- Late stage: A person requires constant supervision and help with activities like eating, walking and using the restroom.
It varies how long someone will progress through the stages of Alzheimer's disease but the average is 10 years.
Alzheimer's FAQs
What is the difference between dementia and Alzheimer's disease?
Dementia is a term that refers to the decline of cognitive functions, of which there are many causes. Fortunately, some causes, such as neurosyphilis and AIDS, are on the decline. Alzheimer's disease is the most common of the age-related dementias, making up 50-75% of all dementias.
Is Alzheimer's genetic?
Genetics can play a part in getting Alzheimer's, but it's not as frequent and is usually seen in early cases (before age 60).
Can someone who is developing Alzheimer's disease tell when they start to lose their memory?
Yes, they may be aware changes in memory. If so, they should visit their provider. However, there are so many causes of memory loss, so a provider will sort through all of the possibilities including sleep disorders, stress, anxiety, depression, substance abuse, nutritional factors, and more.
Is there a treatment for Alzheimer's?
There is no treatment that slows down the progression of the disease. There are medications that can help with memory function and behavior for a few years.
Can I do anything to prevent Alzheimer's
While the main risk factor is age, there are a few other factors you can help monitor. For example, hypertension, high cholesterol, diabetes, obesity and smoking. Recent research suggests that establishing good habits early in life (regular exercise, getting good sleep, eating healthy foods, trying new skills or socializing), can help lower risk or delay the onset. Traumatic brain injury is another risk factor so fall prevention and use of helmets during certain sports is also important.
How is the diagnosis made?
It all starts with a visit to a neurologist or geriatrician. They will ask for your medical history, perform an exam and a standardized memory test. A brain scan and labs may be ordered. Certain patients will be referred for a more in-depth tests.
Other Types of Dementia
Lewy Body Dementia (LBD)
This form of dementia is the second most common behind Alzheimer disease and is more common in men. It can be difficult to diagnose due to similarities with Parkinson's disease, but in LBD the cognitive problems and Parkinson's features start within a year of each other, while in Parkinson's disease, dementia is normally a late stage symptom. Unique features of LBD include visual hallucinations early on and vividly acting out dreams which the person does not recall doing. Only 10% of cases are inherited.
Frontotemporal Dementia
This form of dementia generally occurs in the late 40's to 60's and has a faster course than Alzheimer's disease. It is known for affecting behavior, personality, executive functioning (reasoning, logic) and language more so than memory. Diagnosis can be delayed due to the fact that it can appear in a number of symptoms. Only 10-20% of cases are inherited.
Vascular Dementia
Persons with a large stroke or a series of small strokes can have stepwise or progressive cognitive decline. Treatment focuses on managing vascular risk factors and use of blood thinners. Elderly individuals may have evidence of both vascular and Alzheimer's dementia.
Resources
Help for caregivers: