Alzheimer's And Dementia
- As dementia progresses, patients show disturbing behavior traits
- As Alzheimer's progresses, patients get delusions and hallucinations
- Some causes of dementia are reversible
- Alzheimer's is caused by damage in brain cells and is irreversible
- Treatment helps reduce the symptoms in dementia and aims at slowing down disease progression in Alzheimer's
Dementia and Alzheimer's disease are often considered to be one and the same, but there are notable differences. While Alzheimer's disease is a form of dementia, the latter is a collection of many syndromes. Symptoms common to both conditions include memory loss, difficulties with concentration and orientation, loss of language control and visuospatial skills, and mood and behavior changes. With time, the severity and number of symptoms increase. There is no cure for either condition and treatment for both involves a combination of medicines, alternative remedies, and therapeutic approaches that can slow down the degenerative process.
Dementia and Alzheimer’s disease are terms often used interchangeably. But it’s important to understand the difference between the two so that you can seek the right treatment methods and coping techniques.
Alzheimer’s Disease Is A Form Of Dementia
Dementia is an umbrella term – it is not a single disease but a diverse collection of symptoms. It refers to a decline in mental ability that is serious enough to impair and interfere with a person’s daily life. Alzheimer’s disease, on the other hand, is one of the causes of dementia and is considered the most common form of dementia.1
30% People Above 85 Have Dementia
Approximately 6–10 percent of those aged 65 years or older in the United States are believed to be suffering from dementia. The percentage increases with age, and in those above the age of 85, almost 30 percent or more are suffering from the disease. Among all the cases of dementia, studies estimate that almost 75 percent have Alzheimer’s disease.2
Early-Stage Symptoms Are Similar
Both diseases progress gradually over long periods of time and are characterized by memory loss, problems with thinking and language control, and changes in behavior and mood. The early signs are mild and may often go unrecognized. The symptoms become progressively severe with time and start affecting daily life activities.
The early stages of both conditions are characterized by:
- Memory Loss: Remembering recent events becomes difficult. Little things such as remembering where the keys are or what a recent conversation was about become big challenges. Memories of older life events often remain unchanged in the early stages, which is why the short-term memory lapses are often considered to just be part of the aging process. In addition, getting lost on familiar roads and forgetting names and appointments are more typical of Alzheimer’s.
- Difficulty In Concentrating: Concentrating and planning or organizing a sequence of actions, as in cooking a meal, becomes very difficult.
- Loss In Language Control: Finding the right word or following a conversation become challenging. Patients sometimes repeat themselves frequently.
- Orientation Problems: Patients forget where they are and have problems remembering the date or day of the week.
- Difficulty Judging Distances And Objects: Patients have problems judging distances and objects in three dimensions; that is, they lose their visuospatial skills. For example, climbing stairs becomes difficult.
- Mood And Behavior Changes: Patients may become irritable, frustrated, easily upset, unusually sad, apathetic, withdrawn, or anxious. They start losing interest in hobbies and other activities that they usually enjoy.3 4
As Dementia Progresses, Patients Show Disturbing Behavior Traits
Other characteristics specific to dementia may include the inability to carry out motor functions despite still possessing adequate motor skills and an inability to recognize and identify common objects. Social functioning skills may also diminish, and disturbing behavior may become a common trait.5
As dementia progresses, the symptoms get worse, though the severity will differ for each individual. A patient may develop behavioral traits that are disturbing for the rest of the family. For example, they may become unusually restless or agitated and ask the same question repeatedly.
Certain physical symptoms may develop too, such as weight loss, muscle weakness, and changes in appetite and sleep patterns.6
As Alzheimer’s Progresses, Patients Get Delusions And Hallucinations
While one of the first signs of Alzheimer’s disease is memory loss, the effects of the disease will become severe enough to affect work, relationships, and, eventually, daily activities.7
In time, Alzheimer’s patients develop the same behavioral traits as dementia patients do. Other symptoms that may show up are delusions and hallucinations, and neurological disorders such as sudden muscle contractions and gait disturbances.8
Gradually, patients lose awareness of events around them; they also become frail and in need of help with daily activities. Alzheimer’s patients develop certain neuropsychiatric symptoms as well, such as depression, aggression, agitation, apathy, sleep disruption, and psychosis. These occur in varying degrees in different people and have different effects during the course of the disease.9
Like dementia, Alzheimer’s disease affects and progresses differently in every patient. The symptoms that occur in every stage of Alzheimer’s is still an area that is being researched. On average, patients may live for more than a decade after they are diagnosed with Alzheimer’s, making it the leading cause of disability in the elderly.10
Causes: Dementia Vs. Alzheimer’s
Some Causes Of Dementia Are Reversible
Dementia is a result of damaged or dying brain cells and is most likely to occur with age. Symptoms vary depending on which part of the brain is damaged by the disease.
Dementia can be triggered by a variety of conditions. Some causes of dementia are reversible, though this has only been shown in 9 percent of cases. Some of the reversible causes of dementia include:
- Vitamin deficiencies
- A dysfunctioning thyroid
- The accumulation of cerebrospinal fluid, which increases pressure within the brain.
In such cases, if the deficiencies and dysfunctions are identified and treated, the symptoms that cause dementia may be reversed and even cured.11
Alzheimer’s Is An Irreversible Cause Of Dementia
Other more serious and irreversible causes and types of dementia include:
- Alzheimer’s disease: This is the most common cause of dementia and its first recognizable effect is memory loss.
- Vascular dementia: This is the second most common type of dementia. It occurs when there is an interruption in the blood supply to the brain, such as during a stroke. Planning and thinking become difficult with the onset of this disease.
- Dementia with Lewy bodies: Tiny spherical structures called Lewy bodies develop inside nerve cells, leading to this condition. Hallucinations and problems with movement are typical symptoms of the condition.
- Frontotemporal dementia: As the name implies, the front and sides of the brain are the first parts to be damaged in this condition. Personality and behavioral changes are the first symptoms to develop.
- Creutzfeldt-Jakob disease: Infectious agents called prions attack the central nervous system and the brain, leading to dementia. This is quite rare.
- Young-Onset dementia: This condition affects people younger than 65 and their problems are somewhat different from those faced by older dementia patients.
- Mild cognitive impairment (MCI): This is a milder form of dementia that leads to minor problems with thinking and memory.
- Other causes: Infections such as HIV and AIDS, and chronic drug and alcohol use can also lead to symptoms that are typical of dementia.12
Alzheimer’s Is Caused By Damage In Brain Cells
Alzheimer’s is a neurodegenerative type of dementia that starts mildly and gets progressively worse. Our knowledge of the path of progress and history of the disease has increased over the years, yet the root cause remains unclear and a cure has been elusive.13
Like dementia, Alzheimer’s disease is triggered by damaged brain cells. The brain cells in the hippocampus, the brain’s center of learning and memory, are often the first cells to be damaged – this is why memory loss is typically the first sign of the disease. 14
As the disease progresses, protein-rich structures called “plaques” and “tangles” build up in the brain. These structures cause nerve cells to lose connection with each other, leading to their death and, consequently, loss of brain tissue. Certain important chemicals are also in short supply, which affects signal transmission within the brain.15
Both Diseases Can Be Inherited In Some Cases
There is a lot of ongoing research investigating this very question. In a few rare cases, a single inherited gene clearly causes Alzheimer’s disease, leading to dementia. And people with Down’s Syndrome are at a higher risk of developing Alzheimer’s disease. In most people, however, a combination of inherited genes may or may not lead to either condition. Understanding both diseases and leading a physically and mentally active lifestyle can reduce the chances of developing either.16 17
There Is No Definitive Diagnostic Test
Neither dementia nor Alzheimer’s disease is easy to diagnose. Doctors will first rule out any other problems before confirming whether the signs and symptoms are severe enough to be a kind of dementia. Diagnosis is based on patient history, physical examination, neuropsychological testing, and laboratory studies; however, there is no definitive diagnostic test for either condition.18
Treatment Includes Medicines And Therapy
Only The Symptoms Of Dementia Can Be Treated
Most causes of dementia cannot be treated. Recommended medication is targeted at treating the symptoms, not the cause. In fact, most health professionals are likely to recommend non-drug treatment paths before starting on any medication.
Talking therapies like counseling can help a patient deal with the diagnosis. Cognitive behavioral therapy (CBT), cognitive stimulation therapy, and cognitive rehabilitation are some ways to help a patient deal with depression, stay active mentally, and retain skills to live a healthy life. Exercises that encourage a patient to talk about their life experiences and participation in art and music activities can stimulate their mental faculties and improve both mood and self-esteem.19
Treatment For AD Can Slow Down Disease Progression
A cure for Alzheimer’s has still not been found. Several symptoms related to Alzheimer’s can be treated separately and different combinations of medicines and therapy are used to arrest the progression of the disease.
For now, the main goal is to slow down this progression and make life easier for the patient and the patient’s family for as long as possible. In this effort, doctors often prescribe inhibitors that slow down or prevent the breakdown of neurotransmitters to improve cognitive impairment. They may also use vitamin E to slow the progression of the disease. Behavioral disturbances including depression, psychosis, and agitation are treated with antidepressants, antipsychotics, and other psychotropic medications.20
Look Out For The Early Symptoms Of Dementia
Spreading awareness about dementia is very important as the early symptoms are so easy to overlook. Since most dementia occurs in old age, the early symptoms, which are very mild, are often dismissed as just signs of aging. In fact, the early signs of dementia may look like personality quirks. It may often seem like the person is being deliberately cantankerous.
Some of these early signs include21:
- Lack of concentration
- Loss of interest in things
- Social withdrawal
In many cases, old people who display impairments in cognitive functioning are written off as being senile. Many people even dismiss severe symptoms as part of the aging process and put off seeing a doctor. Ignoring these symptoms makes it worse for those patients who are suffering from a chronic brain condition that could potentially be a cause for dementia – and may be treatable.22
Treatment For Both Can Be Challenging
In both dementia and Alzheimer’s disease, almost every patient reacts differently to each medicine. This is why diagnosis and treatment can be so challenging.
Effective treatment requires monitoring of symptoms, functional impairment, and safety, and the use of multiple treatment modes including medication, behavioral management, psychotherapies, psychosocial treatments, and support and education for families.
Early diagnosis is very important in both dementia and Alzheimer’s as it allows the possibility of treating with agents that can slow the cognitive decline at a point where there is still minimal impairment.
Since the natural course of behavioral disturbance changes as the illness progresses, patients require repeated regular reassessment of treatment and changes as appropriate.23
Both dementia and Alzheimer’s disease can be frustrating not just for the patient but for the caregiver and family members. Long-term care provided by family members and caregivers becomes the most important factor for the patient. This is why educating and supporting those who deal with the patient on a daily basis is such an integral part of treatment.
References [ + ]
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|2, 5, 8, 11.||↑||Chapman, Daniel P., Sheree Marshall Williams, Tara W. Strine, Robert F. Anda, and Margaret J. Moore. “Dementia and its implications for public health.” Prev Chronic Dis 3, no. 2 (2006): A34.|
|3, 6.||↑||What is dementia? Alzheimer’s Society.|
|4, 10.||↑||Alzheimer’s disease. Alzheimer’s Society.|
|7, 14.||↑||Galvin, James E., and Carl H. Sadowsky. “Practical guidelines for the recognition and diagnosis of dementia.” The Journal of the American Board of Family Medicine 25, no. 3 (2012): 367-382.|
|9, 13.||↑||Li, Xiao-Ling, Nan Hu, Meng-Shan Tan, Jin-Tai Yu, and Lan Tan. “Behavioral and psychological symptoms in Alzheimer’s disease.” BioMed research international 2014 (2014).|
|12.||↑||Types of dementia. Alzheimer’s Society.|
|15.||↑||Alzheimer’s disease. Alzheimer’s Society.|
|16.||↑||What is dementia?. Alzheimer’s Society.|
|17.||↑||Alzheimer’s disease. Alzheimer’s Society.|
|18, 20, 23.||↑||Richards, Stephanie S., and Hugh C. Hendrie. “Diagnosis, management, and treatment of Alzheimer disease: a guide for the internist.” Archives of Internal Medicine 159, no. 8 (1999): 789-798.|
|19.||↑||What is dementia?. Alzheimer’s Society.|
|21, 22.||↑||Butler, Robert N. “Senile dementia: Reversible and irreversible.” The Counseling Psychologist 12, no. 2 (1984): 75-79.|