What is dementia?Dementia is a term used to describe confusion, memory loss and other changes in cognition. Dementia is defined by the 1997 book by Neal R. Cutler, MD and John J. Sramek, Parm. D., Understanding Alzheimer's Disease "as progressive and global memory loss accompanied by deterioration of other intellectual functions including deficits in at least two of the following areas: language use, perception, motor skills, learning ability, problem-solving, abstract thought, and judgment."
What is Alzheimer's disease?Alzheimer's disease is a progressive neurological disease which results in a type of dementia. Many times, a physician will diagnose an individual with "dementia of Alzheimer's type." Alzheimer's disease was first reported in 1906 by the German neuropathologist, Alois Alzheimer. Upon autopsy of a young woman, he discovered what are called "plaques" and "tangles" in her brain tissue. Over the years, there have been other health conditions identified that may also cause signs and symptoms of dementia.
What causes dementia?Dementia may be caused by a variety of illnesses or result from some type of brain injury. Alzheimer's disease is the number one cause of dementia today. The second most common dementia is multi-infarct dementia. Some causes of dementia are treatable, such as those found with vitamin B-12 and folic acid deficiency. Neurological diseases, such as Parkinson's and Huntington's Chorea, may also cause dementia.
What are some of the signs and symptoms of dementia and Alzheimer's disease?
The Alzheimer's Disease and Related Disorders Association, Inc., in Chicago, IL, lists the following 10 Warning Signs of Alzheimer's type dementia:
- Recent memory loss that affects job performance
- Difficulty performing familiar tasks
- Problems with language
- Disorientation to time and place
- Poor or weaker judgment
- Problems with abstract thinking
- Misplacing things
- Changes in mood or behaviors
- Personality changes
- Loss of initiative
What causes Alzheimer's disease?
Currently, there is much research going on to discover what actually is the cause of Alzheimer's disease. Research has identified structures in the brain of individuals diagnosed with this disease called plaques and tangles. To date, the research continues to determine if these structures are a cause or byproduct of the disease.
How is Alzheimer's disease diagnosed?Currently, there does not exist a blood test or other type of diagnostic test which can prove, with 100 percent accuracy, that a person has Alzheimer's disease. Diagnostic clinicians rule out every other type or cause of the dementia. Blood tests and brain scans, as well as a review of past medical history, and recent development of symptoms allow an experienced clinician to diagnose Alzheimer's disease to almost 96 percent accuracy. The only true confirmation of Alzheimer's type dementia is upon autopsy.
Can dementia or Alzheimer's disease be treated?
Currently, there is a great deal of research to find a medication that may benefit people who have been diagnosed with Alzheimer's disease. Many new medications and combinations of medications are presently in various phases of clinical research trials. Aricept and Exalon are medications that have been shown to benefit some people with Alzheimer's specific type of dementia. It may help to slow down the progression of the disease for 8-12 months for some people.
Other conditions that cause various types of dementia may have treatment specific to the illness. For example, someone who has a vascular dementia caused from damage to the brain from mini-stokes may require medication and stress management to reduce high blood pressure. People who suffer from pernicious anemia (loss of Vit B-12) and decreased folic acid levels may benefit from supplements.
Can or should a person with dementia continue to drive?The issue of driving a car is often a topic of much heated debate among family members after a diagnosis of dementia is made. Driving is a significant symbol of independence that many people are not willing to give up. Safety for self and others needs to be the primary concern when considering continued driving after a diagnosis of dementia. During the early stages of Alzheimer's disease, a person may be able to make the independent decision to discontinue their driving. Later on, as the disease progresses and cognitive abilities decline, the individual should not be driving. A physician may be needed to encourage the individual to stop and may write a "Do Not Drive" prescription. If there are any questions or doubts regarding an individual's driving abilities, a driving assessment test would be a valid recommendation.
What resources are available when someone suspects, or has been diagnosed with dementia or Alzheimer's disease?There are various resources available depending upon the community in which you live. The National Alzheimer's Association has a listing of all local chapters in the United States. In New York State, Alzheimer's Disease Assistance Centers (ADACs) can assist with assessments, diagnoses, referrals, and follow-up.
There are now adult day programs that are specific to meeting the needs of those with dementia, as well as dementia specific adult homes and special dementia units in nursing homes. Services may also be available, depending on location, to provide in-home assistance to families who choose to care for their loved one in their homes. Visiting nurse associations, home health aide organizations, and hospice programs are available to help families depending on their specific needs.
Where can I obtain more information?If you suspect or have concerns about Alzheimer's disease or dementia, it is always best to start with your primary physician who may be able to refer you to a more appropriate physician or clinic to meet your needs and concerns.
Another resource is the National Alzheimer's Association or one of its local chapters which can guide you in the most appropriate direction. You may also contact the Alzheimer's Disease Assistance Center directly for answers to your questions or to discuss your concerns.