People tend to use “Alzheimer’s” as a catchall term for memory loss in older adults, but Alzheimer’s disease is only one form of dementia affecting people around the world. While Alzheimer’s is the most common form of dementia, it’s important to understand the differences, especially if a loved one is facing a new diagnosis.
In this article, we’ll take a look at what differentiates Alzheimer’s disease from other forms of dementia and explore long-term care options for those diagnosed with the disease.
Dementia is the umbrella term for the category of brain diseases that cause a gradual decline in the ability to think, remember, and function day-to-day. While dementia isn’t a single disease by itself, it refers to a cluster of symptoms such as short-term memory loss, language deficits, poor judgment, and changes in behavior. While a number of conditions can cause dementia, Alzheimer’s disease is the most common form, comprising 50 to 70 percent of all dementia diagnoses.
Dementia occurs when the nerve cells in a person’s brain no longer function. Typically, dementia happens in older adults, but it can happen at any time and isn’t actually a normal part of the aging process. While everyone’s brain naturally deteriorates as they grow older, the deterioration happens much more quickly in people who have some form of dementia.
Dementia is incredibly common around the world. At the last census, 4.7 million people over age 65 in the United States were living with Alzheimer’s disease, and it’s estimated that there are 47.5 million people living with dementia around the world. About 200,000 people in the United States have early-onset dementia, accounting for about 5 percent of all cases.
Symptoms of Dementia
Depending on the type of dementia a person has, the symptoms may present themselves differently from case to case. But there are a handful of early symptoms that are common in most cases such as:
- Memory loss
- Difficulty problem solving
- Trouble with planning
- Difficulty completing regular tasks
- Confusion about time and place
- Trouble writing or speaking
- Misplacing everyday objects
- Poor decision making
- Personality changes
- Severe mood swings
- Becoming withdrawn
If you notice that a loved one is beginning to experience any of these symptoms, encourage them to see a doctor as soon as possible.
Types of Dementia
There are many different types of dementia, all of which are caused by physical changes in the brain. Regardless of what type of dementia a person has, memory loss is typical, often resulting in a severe decline in mental abilities that interferes with daily life. But there are some key differences between various types of dementia.
Let’s take a look at a few of the most common forms of dementia.
Alzheimer’s disease is the most common form of dementia around the world. The disease is progressive, and the symptoms will worsen with the passing of time. Researchers believe that abnormal structures called plaques and tangles are the cause of Alzheimer’s, but microscopic changes in the brain begin long before the symptoms ever present themselves. Memory loss is mild in the early stages, but as the disease progresses, individuals lose the ability to care for themselves and carry on conversations. There’s currently no cure for Alzheimer’s, but various treatments have been shown to slow the disease’s progression significantly.
Vascular dementia, the second most common cause of dementia, results from high blood pressure, high cholesterol, and diabetes. All of these conditions block the arteries and impede blood flow to the brain, creating what is known as vascular dementia. If blood can’t reach the brain easily, parts of the brain die. This is called an infarct and is similar to what happens in a heart attack, or myocardial infarction. When brain tissue dies, the person begins to exhibit signs of cognitive impairment.
Dementia with Lewy Bodies/Parkinson’s Disease
Lewy body dementia is estimated to be the third most common form of dementia. The presence of brain abnormalities called Lewy bodies is believed to be the cause, though scientists have not yet discovered why they form. Lewy bodies are found in other diseases, including Parkinson’s disease. Many patients with Parkinson’s develop memory problems while many people with Lewy body dementia often develop trouble with movement. This overlap in symptoms points to a link between the two diseases.
Mixed dementia is when characteristics of more than one type of dementia occur at the same time. Most commonly, mixed dementia is a combination of Alzheimer’s disease and vascular dementia, but it can be the result of any combination. Because researchers can’t yet measure most dementia-related brain abnormalities in living people, it’s difficult to say exactly how many dementia patients are actually living with mixed dementia.
The Difficulty with Diagnosis
Part of the confusion around dementia and Alzheimer’s arises from the challenge in diagnosing Alzheimer’s disease with complete accuracy while someone is alive. The “markers” for Alzheimer’s — sticky plaques that accumulate in the brain from abnormally folded proteins, causing inflammation and cellular damage — can only be positively identified on autopsy. Thus, doctors generally make an Alzheimer’s diagnosis by testing for and eliminating other possibilities.
In some cases, what looks like dementia may actually be a vitamin or mineral deficiency, since absorption of nutrients declines with age. Because loss and loneliness tend to increase with age as well, depression can be a major factor in dementia. One study found the effect of loneliness is equivalent to smoking fifteen cigarettes a day! Loneliness and the lack of mental stimulation and emotional connection increase the risk of heart disease and other physical and mental health problems. It’s a downward spiral in which dementia is an effect, rather than cause.
Finally, Parkinson’s disease, a long-term degenerative disorder of the central nervous system, can cause dementia symptoms. While dementia only becomes widespread in advanced stages of Parkinson’s, depression and anxiety are more common complications, and can also escalate mental decline.
Despite the difficulty with diagnosis, it’s a good idea to schedule an appointment with a physician as soon as symptoms start to present themselves since an early diagnosis has many benefits for patients.
Getting an Official Dementia Diagnosis
Seeing a doctor soon after dementia symptoms arise can help patients obtain an early diagnosis of Alzheimer’s or discover if the symptoms are due to another cause. An early diagnosis can give you access to the best treatment options, allow you to make lifestyle changes, participate in clinical trials, and gives you the best chance at slowing the progression of the disease. You’ll also be able to better plan for the future.
Visiting your primary care physician is the first step in getting diagnosed. A physician will evaluate the patient’s overall health and may refer patients to a specialist such a neurologist for further testing. There isn’t one single test that can determine the cause of dementia, so patients typically need to undergo a series of tests before they are diagnosed. These tests include physical exams, blood tests, neurological exams that test reflexes and speech, and mental status testing to evaluate thinking and memory. Some patients may also undergo brain imaging scans like an MRI or CT to rule out other problems such as strokes or tumors.
Based on the results of the tests, the doctor will make a diagnosis and develop a course of treatment.
Reducing the Risk
Although Alzheimer’s disease is not currently reversible or curable, its progression can be slowed — and other forms of dementia, such as vitamin deficiency or depression, can be treated, halted, and usually reversed.
Some of the best ways to reduce an older adult’s risk of developing non-Alzheimer’s dementia are surprisingly simple, yet many people ignore them. To brighten your brain or that of a senior loved one:
- Exercise regularly
- Quit smoking
- Learn something new
- Challenge your mind with books and puzzles
- Get enough sleep
- Eat a healthy balanced diet
- Stay socially active
- Get a health check-up, especially for blood pressure and cholesterol
- Protect your head. Over half of those 80 and older fall every year. If you’re unsteady on your feet, use a walking stick, and make sure your home has bathroom handrails and non-skid floors throughout.
These lifestyle choices have been shown to reduce the risk of dementia as well as other diseases such as heart disease and diabetes. While it’s not a cure, there are very few drawbacks to these lifestyle changes that can improve the quality of life for anyone at any age.
When Is Memory Care the Right Choice?
Though most people want to age in place and remain in their own home as they grow older, as dementia progresses this may no longer be feasible, even with a caregiver. These seven questions can help you evaluate whether it’s time for Memory Care:
- Do they forget to turn off the stove, oven, or other appliances that could pose a safety hazard?
- How well does your loved one handle activities of daily living such as eating, dressing, and bathing?
- Is your loved one suspicious of others, fearful of taking medications or eating certain foods, or exhibited other large personality changes?
- Is your loved one taking medications on schedule, following correct dosages, and willing to use an organizer/reminder device if necessary?
- Has your loved one gotten lost on a walk, or while running errands? Can he/she remember personal information such as an address, phone number, contacts, that enable them to return home?
- Do you have additional support to care for your loved one at home?
- Is the amount of home care assistance needed likely to become so great that it is no longer affordable for your family?
If your loved one is making decisions that could cause them harm or the burden of care is too great on the family, memory care may be the best option for everyone.
Other Options for Long-Term Care
Dementia care can be expensive because Medicare and Medicaid do not pay for “custodial care”, meaning day-to-day care that does not require skilled nursing. Because of the high cost of eldercare, many people put off long-term care facilities such as assisted living for as long as possible.
However, there are options beyond memory care facilities that can allow patients to live life to the fullest and give loved ones some peace of mind.
Adult Day Care
Adult day care programs provide care during the day for individuals who are unable to live at home alone but don’t need full-time nursing care. If you or another person is available to care for your loved one during evenings and weekends, adult day care may be an excellent resource to delay or avoid memory care placement. At adult day care programs, trained individuals care for those with dementia in a setting that provides interaction and stimulation, which help keep people’s minds sharper, longer.
Residential Care Home
Another possibility is a residential care home, also known as RCFE (residential care facility for the elderly), adult day home, board-and-care home, or personal care home. These small group settings provide basic services (usually meals and light assistance) at a much lower cost than typical assisted living communities or nursing homes. Medicaid may also pay some of the cost for residents who meet eligibility requirements.
For seniors that wish to stay at home, in-home care can help make life safe and comfortable. In-home care aids help seniors complete activities of daily living like eating, bathing, and getting dressed. Caretakers may also handle chores around the house like cleaning and putting the laundry away. They’ll also ensure that seniors are taking their medication at the correct dosage and time and may help seniors stay active and socialize to stay as happy and as healthy as possible.