Alzheimer’s and Dementia

Alzheimer’s disease is a progressive disorder that causes brain cells to waste away (degenerate) and die.

Alzheimer’s disease is the most common cause of dementia — a continuous decline in thinking, behavioral, and social skills that disrupts a person’s ability to function independently.

The early signs of the disease may be forgetting recent events or conversations. As the disease progresses, a person with Alzheimer’s disease will develop severe memory impairment and lose the ability to carry out everyday tasks.

Current Alzheimer’s disease medications may temporarily improve symptoms or slow the rate of decline.

These treatments can sometimes help people with Alzheimer’s disease maximize function and maintain independence for a time.

Dementia is a broad category of brain disease that includes any disease that causes a severe loss of cognitive ability (the ability to think and reason clearly) that affects a person’s daily functioning.

It must also be a worsening of functioning compared to how the person was previously.

The most common form of dementia is Alzheimer’s disease.

Other common forms of dementia include:

• Lewy body dementia
• Vascular dementia
• Frontotemporal dementia
• Progressive supranuclear palsy
• Corticobasal degeneration
• Normal-pressure hydrocephalus
• Creutzfeldt–Jakob disease.

Dementia is a disease that becomes more common with age. While only 3% of people between the ages of 65–74 have dementia, 47% of people over the age of 85 have some form of dementia.

Therefore, as more people are living longer, dementia is becoming more common.

Dementia affects the brain’s ability to think, reason, and remember clearly. The most commonly affected areas include memory, visual-spatial, language, attention, and executive function (problem-solving).

Most types of dementia are slow and progressive. By the time the person shows signs of the disease, the process in the brain has been happening for a long time.

A patient can have two types of dementia at the same time.

About 10% of people with dementia have what is known as mixed dementia, which is usually a combination of Alzheimer’s disease and another type of dementia such as frontotemporal dementia or vascular dementia.

Additional psychological and behavioral problems that often affect people who have dementia include:

Disinhibition and impulsivity
Depression and/or anxiety
Agitation
Balance problems
Tremor
Speech and language difficulty
Trouble Eating or Swallowing
Delusions (often believing people are stealing from them) or Hallucinations
Memory Distortions (believing that memory has already happened when it has not, thinking an old memory is a new one, combining two memories, or confusing the people in a memory)
Wandering or Restlessness

When people with dementia are put in circumstances beyond their abilities, there may be a sudden change to tears or anger (a “catastrophic reaction”).

Depression affects 20–30% of people who have dementia, and about 20% have anxiety.

Psychosis (often delusions of persecution) and agitation/aggression also often accompany dementia. Each of these must be assessed and treated independently of underlying dementia.

In the early stage of dementia, the person will begin to show symptoms noticeable to the people around them.

In addition, the symptoms begin to interfere with daily activities. The symptoms are dependent on the type of dementia a person has.

The person may begin to have difficulty with more complicated chores and tasks around the house.

The person can usually still take care of himself or herself, but he or she may forget things like taking pills or doing laundry and may need prompting or reminders.

The symptoms of early dementia usually include memory difficulty.

They can also include some word-finding problems (anomia) and problems with planning and organizational skills (executive function).

One very good way of assessing a person’s impairment is to ask if he or she is still able to handle his or her finances independently. This is often one of the first things to become problematic.

Other signs might be getting lost in new places, repeating things, personality changes, social withdrawal, and difficulties at work.