Alzheimer’s Vs. Dementia

Ever wonder where it starts? How it is developed? Do you ever wonder if it is genetic? Most common question is what is the difference between Alzheimer’s and Dementia. Discussed throughout this little article will be: Diagnosis, Causes and Risk factors, Dementia vs. Alzheimer’s, Stages, 10 signs and symptoms, Medication and treatment, Dementia: causes, risk and prevention and treatment and care, why you should get checked, Visiting your doctor, Asking questions, Life after diagnosis, Other treatments and Facts and figures. Let’s begin.

This type of disease has no single diagnostic test that can determine it. Usually physicians use a variety of approaches and tools to help with a diagnosis. Sometimes even having to involve a specialist such as: Neurologists, Neuropsychologists, Geriatricians or Geriatric Psychiatrists. Even though a physician can tell if a patient has Dementia, it may be difficult to identify the exact cause. When getting checked for Dementia or Alzheimer’s your provider will review your medical history including: psychiatric history and history of cognitive and behavioral changes. They will want to know about any current or past illnesses along with any medications you are taking. Physician will also ask about key medical conditions affecting other family members such as; whether they may have or had Alzheimer’s or other Dementia's. Usually a physical exam and diagnostic tests are required for becoming diagnosed with Dementia or Alzheimer’s. During a physical exam you can expect to be asked about your diet, nutrition and use of alcohol, review of your medication, check blood pressure, temperature and pulse, listen to the heart and lungs, perform other procedures to assess overall health and collect blood or urine samples for lab test. The physical and lab tests can help identify health issues that could be causing symptoms of Dementia. Some common causes of Dementia would be depression, untreated sleep apnea, delirium, side effects of medication, thyroid problems, certain vitamin deficiencies and excessive alcohol consumption. However, Alzheimer’s and other Dementias often may be reversed with treatment. Along with a physical exam and some blood work there are about four other test your physician will do such as: Neurological exam, Mental status test, Mood assessment and Brain imaging. Neurological exam consists of close evaluation of the person for problems that may signal brain disorders other than Alzheimer’s. Physician will look for signs of small or large strokes, Parkinson’s disease, brain tumors, fluid accumulation on the brain and other illnesses that may impair memory thinking; during this test physicians will test reflexes, coordination, muscle tone and strength, eye movement, speech and sensation. Your mental status will be tested as well. Used to evaluate memory, ability to solve problems and other thinking skills. Can give an overall sense of whether a person is aware of symptoms, knows the date, time where he/she is and can remember a short list of words, follow instructions and do simple calculations. Examples of mental status test are Mini-mental state exam and the Mini-cog test; commonly used as assessments. During the mini-mental state exam the patient is asked a series of questions designed to test a range of every day mental skills; maximum score is 30 points which a scare of is 20-40 suggesting mild Dementia, 13-20 suggesting moderate and less than 12 is suggesting sever Dementia, on average the MMSE score of a person with Alzheimer’s declines about two to four points each year. Mini-cog is used to complete two tasks; to remember and a few minutes later repeat the names of three common objects and draw a face of a clock showing all 12 numbers in the right places and a time specified by the examiner which results of this brief test can help a physician determine if further evaluation is needed. There is a computerized test cleared by the FDA and is used for a growing area of research that is the development of devices to administer computer-based tests of thinking, learning and memory called cognitive tests which are computerized devices involving cantab mobile, cogngram and automated neuropsychological assessment metric devices which using bother clinical tests and computer-based tests can give physicians a clearer understanding of the cognitive difficulties experienced by patients. Along with memory and thinking test there is also a mood assessment physicians will do to evaluate a person’s sense of well-being to detect depression or other mood disorders that can cause memory problems, loss of interest in life and other symptoms that can overlap with Dementia. If necessary, your physician may even us brain imaging such as an MRI or CT. Which is primarily used to rule out other conditions that may cause symptoms like Alzheimer’s but require different treatment. Structural imaging can reveal tumors, evidence of small or large strokes, damage from severe head trauma or a build up of fluid in the brain. In some circumstances a doctor may use a brain imaging tool to find out if the individual has high levels of beta-amyloid, a hallmark of Alzheimer’s ex: normal levels would suggest Alzheimer’s is not the cause of Dementia and researchers are studying other brain imaging techniques, so they can better diagnose and track the progress of Alzheimer’s. Even without a single diagnosis there are ways to be checked for Dementia and Alzheimer’s and begin to understand the causes and risk factors of this disease.

From recent studies and research, they have found there is not a single cause for these diseases. This disease likely develops from multiple factor such as genetics, lifestyle and environment. Scientist have identified factors that increase the risk; including: age, family history and heredity can’t be changed, and emerging evidence suggest there may be other factors we can influence. However, right now these are the risk factors which are concerning for this disease. Age is a great known risk factor and it is not a normal part of aging to develop these diseases. There is not a direct cause and most with the disease are 65 years-old or older and after the age of 65 the risk doubles every five years and around 85 years-old the risk reaches nearly one third. Family history is another cause where if your parents or sibling have/had the disease you are more likely to develop it. Your risk will increase if more than one family member has it and when the disease tends to run in the families whether it is heredity or environmental factors it may play a role in being a cause and risk factor. Following the first two causes and risk is genetics. Scientist know genes are involved and two categories of genes influence whether a person develops the disease known as risk genes and deterministic genes. These genes are found in both categories and is estimated that less than 1% of the disease is caused by deterministic genes which are genes that cause a disease rather than increase the risk of developing a disease. Besides the basic genes and genetic causes there are other risk factors to consider which scientist are beginning to reveal clues about other risk factors we may be able to influence through general lifestyle and wellness choices and effective management of other health conditions. We don’t always think that the way we live can affect our mental health but even not doing the smallest things such as avoiding head injuries by wearing a helmet while riding your bike or wearing your seat belt in the car. Not considering these simple instructions could lead us down the road to developing Dementia or Alzheimer’s but it takes just two seconds to put a helmet or seat belt on to avoid developing memory loss. Heart-head connection is a condition that damages the heart and blood vessels which leads to the risk of developing Alzheimer’s or vascular Dementia. Damage to these parts of your body that could lead to Alzheimer’s or Dementia are heart disease, diabetes, stroke, high blood pressure and high cholesterol. Studies of donated brain tissue provide additional evidence for the heart-head connection where these studies suggest that plaques and tangles are more likely to cause Alzheimer’s symptoms if strokes or damage to the brain’s vessel are present. Still isn’t a cure but research is making progress, overall healthy aging plays a huge role in developing theses diseases. Research suggest that strategies for overall healthy aging may help keep the brain healthy and may even reduce the risk of developing Alzheimer’s, however it should include eating a healthy diet, staying socially active, avoiding tobacco and excess alcohol and exercising both the body and mind. Our bodies should be treated like we will never have another one, so keeping your body healthy and your mind healthy increases your risk of developing Alzheimer’s or Dementia. However, let’s not confuse the two because they are different but similar in some ways.

Most people assume that when a person has Dementia they automatically have Alzheimer’s or the other way around. These two are different from each other. They share similar symptoms and are referred to as synonymous even though each word means different things. These terms can be confusing until broken down and explained properly to understand the difference.

Dementia is a general term for a decline in mental ability which is severe enough to interfere with daily life. It isn’t a specific disease and describes a group of symptoms associated with a decline in memory, reasoning and thinking skills. There are many different types of Dementia and many conditions cause it. Overall this disease is not a normal part of aging but caused due to damage to the brain cells that affects their ability to communicate which affects thinking, behavior and feelings. Can be prevented through living a healthy lifestyle.

Alzheimer’s is the most common cause of Dementia. Diagnosed as a specific disease unlike Dementia. This disease accounts for 60%-80% of Dementia cases. It’s a degenerative brain disease that is caused by complex brain changes following cell damage. Leads to Dementia symptoms that gradually worsen over time; most common early symptom is trouble remembering new information because the disease typically impacts the part of the brain associated with learning first. As it advances the symptoms get more severe and include disorientation, confusion and behavior changes. Towards the end eventually speaking, swallowing and walking become difficult and there is no way to prevent, cure or even slow down the disease. The greatest known risk factor for this disease is increasing age and is not a normal part of aging; though most people with this disease are 65 or older; approximately 200,000 Americans under 65 or younger have onset Alzheimer’s disease.

When talking about Dementia and Alzheimer’s it is important to know the difference. Can empower individuals with the disease or other Dementia patients, families and caregiver’s necessary knowledge needed to cope and deal with what is ahead.

Alzheimer’s has stages and progresses as time goes on. Life span for this type of disease is about four to eight years after being diagnosed, however, can live as long as 2 years. People are affected differently, and symptoms vary. Changes in the brain related to the disease begin years before any signs appear and the time period can last for years; this is referred to as Preclinical Alzheimer’s and it provides an overall idea of how abilities change once symptoms appear and should only be used as a general guide. Alzheimer’s typically progress slowly in three stages known as mild, moderate and severe, even with these stages it may be difficult to place a person in a specific stage as you will see that the stages may overlap. Mild or easy would be the first stage; you would be functioning independently, drive, work and part of social activities. Leads to memory lapses and common difficulties but still being independent at the end of the day. Moderate or mild as they call it is the longest stage and can last for many years and require a greater level of care. In this stage Dementia symptoms are more pronounced and there is a greater difficulty performing tasks, becoming frustrated or angry or acting in unexpected ways. Symptoms become noticeable to others including: forgetfulness, moody or withdrawn, confusion of where they are or what day it is, help choosing appropriate clothing, trouble controlling bladder and bowels, changes in sleep pattern and a risk of wandering or becoming lost. Moderate is the longest stage but not the worst; severe is the final stage. Within this stage the ability to respond to their environment or carry on a conversation and movement start to go. Communicating pain becomes difficult and significant personality changes and extensive help with daily activities ending with round the clock assistance. These stages can be avoided by looking out for 10 simple signs.

With age comes knowledge and wisdom but with Alzheimer’s and Dementia comes memory loss. Most common sign is memory loss;

1. shows an early stage of forgetting recently learned information, important dates or events and asking the same questions over and over and relying on others.

2. Face challenges in planning or solving problems such as: experience changes in ability to develop and follow a plan or work with numbers, trouble following a familiar recipe or keeping track of monthly bills, difficulty concentrating and take longer to do things like before.

3. Difficulty completing familiar tasks done daily, trouble driving to a familiar location or organizing a grocery list.

4. Confusion with time or place such as losing track of dates, seasons and passage of time. Have trouble understanding something if it is not happening immediately and may forget where they are or how they got there.

5. Trouble understanding visual images and spatial relationships; for some Alzheimer’s vision problems would be a sign, lead to difficulty with balance or reading and have problems judging distance and determining color or contrast causing issues with driving.

6. New problems with words in speaking or writing leading to trouble following or joining a conversation, stopping in the middle of a conversation and have no idea how to continue or begin repeating themselves, struggle with vocabulary and trouble naming familiar objects or use the wrong name.

7. Misplacing things and losing the ability to retrace steps as easily as putting things in unusual places and accusing others of stealing.

8. Decreased or poor judgement in making decisions.

9. Withdrawal from work or social activities: withdraw from hobbies, activities or other engagements.

10. Changes in mood and personality: confused, suspicious, depressed, fearful or anxious and easily up. Noticing these ten signs can help a family member begin the process of checking check for Alzheimer’s or Dementia.

Even without a cure or sometimes a diagnosis or a certain type of Dementia or Alzheimer’s; there is a method to understand about how our brain is affected. Neurons are the chief cells that are destroyed, they connect and communicate at synapses where tiny bursts of chemicals called neurotransmitters carry information from one cell to another. Understanding the communication network of the brain is important because the more we nourish and take care of our brain cells the less we would develop these types of diseases. With Alzheimer’s and Dementia, it disrupts the process for the neurotransmitters to complete their job and eventually destroys the synapses and kills neurons damaging the brains communication network. Being educated on our brain function helps us to understand how to proceed forward with these progressing diseases.

Alzheimer’s affects people differently. People experience different symptoms and are faced with different challenges. One of the challenges most Alzheimer’s patients face though is sleep changes. This appears in the later stages such as the moderate or severe. Sleep changes cause difficulty sleeping when you are meant to be awake during the day you are taking naps and instead of sleeping at night you experience being awake. Your mind is playing tricks on you letting you think that during the day it is night time and at night it is day. There are changes that can be made however, understanding the available options, benefits and risks of the choices are important. As changes appear the goal is likely to change during the patients journey with Alzheimer’s. Most recommended treatment begins with non-drug coping strategies, should always be referred first before anything. Along with using non-drug coping strategies; it is important to set a schedule just like for your children. This would include: improve sleep routine, environment and reduce of napping, maintain regular times for meals, time of going to bed and getting up, seek morning sunlight, encourage exercise, avoid alcohol and coffee, treat any pain, avoid medicine before bed, comfortable temperature, nightlights, use bed only for sleeping and discourage watching TV during wakefulness. Each of these suggestions help benefit someone with Alzheimer’s, helps to keep them moving and active. As we age we should want to age gracefully. Dealing with Alzheimer’s is difficult on anyone but with support and care it can be overcome and dealt with.

Dementia is not a single disease, it’s an overall term that covers a wide range of specific medical conditions. Disorders grouped under the general term “Dementia” are cause by abnormal brain changes. Types of changes that are triggered are decline in thinking skills, also known as cognitive abilities severe enough to impair daily life and independent functions, affect behavior, feelings and relationships. Other areas that define this disease that get affected are decline in memory, language, problem solving and other thinking skills that affect a person’s ability to perform every day activities. They may be different on so many levels, but Alzheimer’s is the most common cause of Dementia. Dementia is often incorrectly referred to as “senility” or “senile Dementia”, which reflects the formerly widespread but incorrect belief that serous mental decline is a normal part of aging when this type of disease appears but shouldn’t be happening. Just like Alzheimer’s, Dementia patients experience different symptoms such as problems with short-term memory, keeping track of a purse or wallet, paying bills, preparing meals, remembering appointments and traveling out of the neighborhood. Dementia progresses slowly and gradually gets worse. These symptoms or changes shouldn’t be ignored. Many different types of Dementia aren’t usually defined or given a name. One type that is noticed is vascular Dementia. Occurs due to microscopic bleeding and blood vessel blockage in the brain. Known as the second most common cause of Dementia. Overall Dementia can be categories differently and has been shown to reverse some types such as thyroid problems and vitamin deficiencies when addressed.

Just like Alzheimer’s there is no test to determine Dementia. Determining if someone has Dementia a medical history, physical exam, lab test, characteristic changes in thinking, day to day function and behavior are examined. Physicians are able to determine if a person has Dementia with a high level of certainty but it’s harder to determine the type due to the symptoms and brain changes which can overlap. In some cases, a doctor may diagnose and not specify the type, if this occurs it may be necessary to see a specialist. Dementia is caused from damage to the brain cells which interferes with the daily abilities of brain cells to communicate with each other. When cells in a region are damaged it cannot carry out its functions normally. Dementia is categorized differently along with different parts of the brain being affected. Most changes in the brain cause Dementia to become permanent and worsen over time such as: thinking and memory problems cause by depression, medication side effects, excess use of alcohol, thyroid problems and vitamin deficiencies; however, a condition can be improved when it is treated and addressed right away. There is hope in being able to help a patient’s brain cells recover and continue communicating.

Dementia has a risk and prevention method just like any other disease. Like Alzheimer’s; Dementia cannot be changed with age and genetics. If it runs in the family, it isn’t preventable and as we age we change with time. Researchers continue to explore the impact of other risk on the brain, health and prevention. As researchers continue to search for answers we know we can have something positive to look forward to; something to help keep us hopeful. A healthy choice in lifestyle can help decrease the risk. Types of a healthy lifestyle would be a healthy diet, no smoking and regular exercise. Depending on the cause of dementia drugs may temporarily improve symptoms. Some medication used to treat Alzheimer’s are sometimes prescribed to help symptoms of other types of Dementia. Non-drug therapies can also alleviate some symptoms and ultimately the path to effect treatments is through increased research funding and clinical studies. Overall there is no cure or treatment to slow or stop the progression of Dementia; the best thing to do is make the patient comfortable as they can be.

Our health should be a priority and regular check ups should be scheduled as we age. You should get check if you notice any of the ten signs I’ve mentioned previously; if you notice those signs in yourself or someone you know then you should schedule an appointment with your physician. Having an early diagnosis provides a range of benefits for individuals and loved ones dealing with this disease. By getting checked by the doctor it helps to determine if a patient has Alzheimer’s or some other treatable condition. If Alzheimer’s is the cause; an early diagnosis allows access to treatment options such as medication that can help lessen symptoms, benefitting from treatment such as opportunity to participate in clinical trials and a chance to prioritize your health. Finding out a diagnosis early helps with emotional and social benefits. Could help lessen anxieties about why you are experiencing symptoms. Gives opportunity to maximize time together with family and be able to set up a support network to talk about what you want during each stage of the disease. After a diagnosis it can give piece of mind, reduce burden on family members and prevent disagreements. Allows the patient to express their wishes about legal, financial, end of life decisions and still able to review and update legal documents along with finances, property, identify care preferences and discuss potential safety such as driving or wandering ahead of time. Diagnosis someone with a specific disease is hard especially when it comes to our loved ones, no one wants to know someone is losing their mind. With an early diagnosis families and patients can consider cost of medical care and be able to find out about services for long-term care available and what assistance they can receive from the U.S. government. Taking care of our health is important and making healthy choices go a long way for avoiding diseases such as Dementia and Alzheimer’s.

It is important to communicate with your physician. You should ask questions, be prepared to answer questions and be honest as much as possible. Most primary care physicians would be able to diagnosis a patient with either Dementia or Alzheimer’s, but the patient should feel comfortable with that doctor. During the process the physician will evaluate the overall health and identify any conditions that could affect how well the mind is working. If primary care physician can’t make a diagnosis, they may refer the patient to a specialist. When scheduling an appointment keep in mind there is a list of things to take with you to the appointment such as: list of symptoms, when they began and how frequently they occur written in a journal or care logs and try to be as specific as possible, a list of past and current medical problems; mentioning if other family members had illnesses that cause memory problems, bring all medications both over the counter and prescription and be prepared to answer questions honestly and to the best of your ability. Along with the list of items to bring and questions to ask; the patient or family member should also ask about testing memory loss. Questions that should be asked are: What test will be performed? What does each test involve? How long will the test take? How long will it take to learn about results, by asking these questions you are evaluating the options available. After being diagnosed it is helpful to keep a medication log to help stay organized and keep the doctor informed along with help remembering dosages to take, side effects and special instructions to follow. It is appreciated by the physician when patients keep a journal.

In the beginning it is important to ask the physician questions. When being diagnosed it is an adjustment. Typical questions that should be asked are; What treatments are available? Which option do you think best fits our situation? What kind of assessment will you use to determine if the treatment is effective? How much time will pass before you will be able to asses the treatments effectiveness? Will you monitor for possible drug side effects? What side effects should we watch for? When should we call? Is one treatment option more likely than another to interfere with medications for other conditions? What are the concerns with stopping one drug treatment and beginning another? And At what stage of the disease would you consider it appropriate to stop using the drug? By asking these types of questions you are preparing yourself for a life with this diagnosis of Dementia or Alzheimer’s.

Living with Dementia or Alzheimer’s is heartbreaking. However, it is manageable after results are reviewed and a shared conclusion from the physician is presented with the type of disease. As the patient you should find out if the physician will manage your care going forward or who would be the primary doctor in charge of your care. From there the diagnosing physician can schedule the next appointment or provide a referral. Most patients won’t believe there is anything wrong, a way to approach someone would be; I’ve noticed (insert what you’ve noticed that is out of the ordinary) and I’m concerned or you could ask; Have you noticed anything that is worrisome? I’ve noticed (insert what you’ve noticed) in you and I’m concerned. Have you noticed it? Are you worried? By asking theses questions you are approaching the person and letting them know you care, and they should visit their physician. From there you open the floor for a discussion about seeing a doctor together and if needed having multiple conversations about what is going on. After being diagnosed common questions to ask would be; Why the diagnosis? Where you or your loved one may be in the cause of the disease? And What to expect as the disease progresses? Living with Dementia or Alzheimer’s is challenging and the most challenging of all is when memory loss appears. Questions to ask when this happen are: What changes in memory, thinking or behavior do you notice? Or What else is going on? Each of this disease can cause short-term or long-term memory loss. Throughout this stage it is important to make sure there aren’t any concerning changes that happen and to know when to ask for help.

A symptom that affects most patients is change in sleeping pattern. During this period the patient will have trouble sleeping, will take day time naps and instead of sleeping at night will be awake. Even though it does appear in later stages it is still good to understand all the available options and benefits or risk of each choice. +When being treated for Dementia or Alzheimer’s the first strategy should be Non-drug coping strategies. These strategies include: improve sleep routine, environment and reduce napping, maintain regular times for meals, going to bed and getting up, seek morning sunlight, encourage exercise, avoid alcohol and coffee, treat any pain, avoid medicine before bed, comfortable temperature, nightlights, use bed for only sleeping and discourage watching tv during wakefulness. By doing these simple steps it helps to keep the person active and less likely to go downhill faster. No one wants to ever see a family member suffer this way, but it is good to be prepared for what could lie ahead.

Developing Dementia or Alzheimer’s could be a person’s worse nightmare. No one wants to lose their mind or be told they are. Which brings me to some facts and figures about these two diseases that people should be aware of. They are:

· Alzheimer’s is the 6th leading cause of death in the U.S.

· More than 16 million Americans provide unpaid care for people with Alzheimer’s and Dementia

· Caregivers provide an estimated 18.5 billion hours of care valued at nearly $234 billion

· Between 2000 and 2017 deaths from Alzheimer’s increased 14%; while deaths from heart disease decreased 9%

· 1 in 3 seniors die from Alzheimer’s or Dementia

· Only 16% receive regular cognitive assessments during routine health check-ups

· 2019 Alzheimer’s and Dementia will cost the nation $290 billion by 2050; cost could rise as high as $1.1 trillion

· 5.8 million Americans are living with Alzheimer’s but by 2050 the number is projected to rise to nearly 14 million

· Every 65 seconds someone develops the disease in the U.S.

There is a lot to learn about Dementia and Alzheimer’s and just not enough time to explain. Research is constantly going on and new treatments are being discovered. As someone who has experienced Alzheimer’s and Dementia with a loved one, I can speak from experience that it isn’t a disease to wish upon someone. Each stage is scary, and you never know what to expect. Everyday is different and being able to warn others about what to look or ask for helps me cope with what has happened in the past year. Throughout this article I discussed types of diagnosis, causes and risk factors, Dementia vs. Alzheimer’s, stages of Alzheimer’s, 10 early signs and symptoms, how Alzheimer’s medication works, treatment for sleep changes, What is Dementia, diagnosis of Dementia, causes of Dementia, Dementia risk and prevention, Dementia treatment and care, why get checked, visiting your doctor, questions for the doctor, life after diagnosis, treatments and alternative treatments and facts and figures. Each of these topics were discussed more thoroughly than planned. However, I wanted others to understand the importance and difference between Dementia and Alzheimer’s and things that can be done to prevent theses diseases.