The word “DEMENTIA” can be a scary vision in today’s world. It seems the more we know about it, the more we know there is much more to learn. Seldom does the diagnosis impact just one individual as there is almost always a caregiver affected as well once the diagnosis is made. This person is often a close relative or friend who is both emotionally and physically involved in the care required.
Obtaining an accurate diagnosis can be challenging as there are many types of dementia. The symptoms can seem rather subtle at first. One might feel as though they are simply having normal “effects of aging” when they start to become “forgetful”.
This is a misnomer we must overcome as a society if we are to truly embrace what dementia is and isn’t. Normal aging does not mean it is normal to experience increased forgetfulness that impacts our ability to function normally. I can personally attest to having had the joy of meeting multiple centenarians who are as sharp (or sharper) in their memory as I am, which gives me great hope as I age to be one of the lucky ones.
While increased age is a risk factor associated with the development of dementia it is not normal to become forgetful or have signs of dementia surface just because one is increasing in age. Therefore it is imperative to see a physician as soon as one becomes aware symptoms are present that may indicate the presence of dementia, such as decreased short-term memory, memory loss that disrupts daily life, confusion to place, new problems forming and finding words to name a few. To find more information on warning signs visit ALZ.org and look for the ten warning signs of Alzheimer’s.
As a Dementia Care Practitioner one of the most frequent questions I hear is “What is the difference between Alzheimer’s disease and dementia?” The answer to this question is often followed by a discussion of the various types of dementia.
The difference between Alzheimer’s disease and dementia is that dementia itself is not a disease. It is the general term used to describe a condition associated with memory loss and symptoms of decreased mental capacity that impairs the ability to manage day-to-day life.
There are approximately 50 causes for dementia. Alzheimer’s disease is the most common accounting for 60-80 percent of all dementias, In the case of Alzheimer’s there is irreversible, progressive changes created by the build up of protein deposits within brain cells. These proteins, known as beta-amyloid and tau, create plaques and tangles that eventually destroy the neuron.
Alzheimer’s disease is one of the hardest dementia diagnosis to receive in that it is also a terminal illness. The brain will continue to experience deterioration until eventually a person is no longer able to maintain basic functions such as digestion and normal respirations.
Another common dementia is Vascular dementia. With this type of dementia there is usually some precipitating event where the blood flow to the brain is compromised, such as one or more strokes, heart attacks, clogged carotid arteries, or other issues that decrease the blood supply to the brain. Some are profoundly affected and have progression as there may be a continued issue affecting the blood flow in their brain. Others will reach a plateau and show no further progress once the blood flow is restored. It is common to find individuals who are diagnosed with both Alzheimer’s disease and Vascular dementia.
Binswanger’s disease is a specific type of vascular dementia that is characterized by similar symptoms of Alzheimer’s disease, though the memory impairment is usually not as severe. A distinguishing symptom associated with Binswanger’s disease is psychomotor slowness. There may also be mood changes, irritability issues and gait changes present early on.
Lewy body dementias:
Lewy body and Parkinson’s related dementia are two types of dementias that are similar in nature. Both have a significant impact given the fact there is often an earlier onset of gait disturbances accompanied by visual hallucinations and sleep disturbances. Having a slowed gait and Parkinson’s type symptoms with early memory loss are some of the distinguishing criteria between Lewy body and Alzheimer’s disease.
Both Lewy body and Parkinson’s related dementias are caused by aggregates of a protein called alpha-synuclein in the Cortex of the brain. It is also common to find Lewy body and/or Parkinson’s related dementia co-diagnosed with a secondary dementia such as Alzheimer’s disease. An interesting website that provides support specific to Lewy body related dementias is www.lbda.org.
There are many other types of dementias. Pick’s disease, Huntington’s disease and Frontal-temporal dementia to name a few. It is important when dementia is suspected to ask your clinician what specific type of dementia is believed to be the source of the symptoms. Knowing the specific type of dementia is helpful when planning for future needs.
There are times when after extensive testing the exact cause may not be identifiable. However it is important to seek a full and comprehensive medical evaluation that often involves a neurologist as well as the attending physician to make a definitive diagnosis.
Last but not least, if you are curious if you or a loved one have symptoms of dementia and would like to perform a screening test, you might be interested in the SAGE test developed by the Ohio State University. This module is designed to help bring early detection to memory issues, and can be taken in the comfort of your home. SAGE stands for SELF Administered Gerocognitive Exam. Follow the instructions in the link below and take the completed test to your physician for scoring.