Does Dementia Come Before Alzheimer

How Is Alzheimers Diagnosed And Treated

Doctors may ask questions about health, conduct cognitive tests, and carry out standard medical tests to determine whether to diagnose a person with Alzheimers disease. If a doctor thinks a person may have Alzheimers, they may refer the person to a specialist, such as a neurologist, for further assessment. Specialists may conduct additional tests, such as brain scans or lab tests of spinal fluid, to help make a diagnosis. These tests measure signs of the disease, such as changes in brain size or levels of certain proteins.

There is currently no cure for Alzheimers, though there are several medicines approved by the U.S. Food and Drug Administration that can help manage some symptoms of the disease along with coping strategies to manage behavioral symptoms. In 2021, FDA provided accelerated approval for a new medication, aducanumab, that targets the protein beta-amyloid, which accumulates abnormally in the brains of people with Alzheimers. The new medication helps to reduce amyloid deposits, but has not yet been shown to affect clinical symptoms or outcomes, such as progression of cognitive decline or dementia.

Most medicines work best for people in the early or middle stages of Alzheimers. Researchers are exploring other drug therapies and nondrug interventions to delay or prevent the disease as well as treat its symptoms.

Difference Between Alzheimers And Dementia

Alzheimers disease and dementia are two terms that are often used interchangeably as many people believe that one means the other. In fact, the distinction between the two diseases often causes confusion on the behalf of caregivers, families and patients. Learn more about how the two diagnoses, while related, are remarkably different.

Can Alzheimer’s Disease Be Prevented

As the exact cause of Alzheimer’s disease is not clear, there’s no known way to prevent the condition.

But there are things you can do that may reduce your risk or delay the onset of dementia, such as:

• staying physically fit and mentally active

These measures have other health benefits, such as lowering your risk of cardiovascular disease and improving your overall mental health.

Read more about preventing Alzheimer’s disease.

Also Check: How To Remember The 7 A’s Of Dementia

What Is The Difference Between Dementia And Alzheimer’s

Most people are able to go well into old age without experiencing significant decline in memory or other cognitive functions. But trouble with memory, critical thinking skills, and other aspects of daily life are a reality for many people over the age of 60. Some of this is indeed natural. But as various symptoms begin to add up, it is worth seeking medical advice to find out whether or not dementia or Alzheimer’s disease might be at play.

Symptoms of dementia go beyond minor inconveniences as they progress, they interfere more and more with day-to-day activities and undermine quality of life. There are many different dementia symptoms that indicate a range of possible conditions, from those affecting brain cells to those involving an excess of spinal fluid in the brain.

Many of these conditions are progressive, but some can be managed. Knowing the early warning signs can help you be prepared if medical care becomes necessary. Here is what you need to know about dementia vs. Alzheimer’s disease and other forms of cognitive decline.

Stages Of Alzheimers Disease

Some features of Alzheimers disease are commonly classified into three stages, or phases. Not all these features will be present in every person, and they might occur at different stages.

Mild Alzheimers disease

Sometimes this stage is only apparent in hindsight. The onset of Alzheimers disease is usually gradual and it is often impossible to identify exactly when it began.

Someone might:

• have difficulty shopping or preparing meals.

Moderate Alzheimers disease

At this stage, the impacts of the condition are more apparent and prevalent. A person may experience significant challenges to their independence and require daily support.

Someone might:

• be forgetful of current and recent events, although generally remember the distant past, even if details may be forgotten or confused
• often be confused regarding time and place
• become lost more easily
• forget the names of family or friends, or confuse family members
• forget saucepans or kettles left heating on the stove
• be less able to perform simple calculations
• show poor judgement and make poor decisions
• see or hear things that are not there or become suspicious of others

Also Check: Can Stress Bring On Alzheimer’s

The Effects Of Alzheimers On The Brain

In people with Alzheimers disease, brain cells die and connections between brain cells may break down. One of the hallmark symptoms is abnormal protein deposits in the brain called plaques and tangles.

Plaques are dense clusters of protein that can block communication between neurons. Tangles are proteins that twist together that lead to the death of healthy brain cells.

In advanced Alzheimers, the brain shows significant shrinkage. Changes in the brain may occur a or more before symptoms start.

Its impossible to diagnose Alzheimers with complete accuracy while a person is alive. The diagnosis can only be confirmed when the brain is examined under a microscope during an autopsy. However, specialists can make the correct diagnosis up to 90 percent of the time.

The symptoms of Alzheimers and dementia can overlap, but there can be some differences.

Both conditions can cause:

• behavioral changes
• difficulty speaking, swallowing, or walking in advanced stages of the disease

Some types of dementia will share some of these symptoms, but they include or exclude other symptoms that can help make a differential diagnosis.

Lewy body dementia , for example, has many of the same later symptoms as Alzheimers. However, people with LBD but are more likely to experience initial symptoms such as visual hallucinations, difficulties with balance, and sleep disturbances.

The Seven Stages Of Dementia

One of the most difficult things to hear about dementia is that, in most cases, dementia is irreversible and incurable. However, with an early diagnosis and proper care, the progression of some forms of dementia can be managed and slowed down. The cognitive decline that accompanies dementia conditions does not happen all at once – the progression of dementia can be divided into seven distinct, identifiable stages.

Learning about the stages of dementia can help with identifying signs and symptoms early on, as well as assisting sufferers and caretakers in knowing what to expect in further stages. The earlier dementia is diagnosed, the sooner treatment can start.

Recommended Reading: What Is Sundowning In Dementia

Related Conditions And Causes Of Alzheimers Disease

It is very common for people with Alzheimers disease to simultaneously experience brain abnormalities related to other types of dementia, a condition called mixed dementia.

Other types of dementia include:

• Vascular Dementia The most prevalent type of mixed dementia involves Alzheimers combined with vascular dementia, in which brain cells are deprived of essential nutrients and oxygen because of conditions that block or reduce blood flow to the brain.
• Lewy Body Dementia People with Alzheimers may also simultaneously experience Lewy body dementia, a disease marked by abnormal clumps of the protein alpha-synuclein in brain cells.

Some people may simultaneously experience brain changes related to all three conditions Alzheimers, vascular dementia, and Lewy body dementia.

How Alzheimer’s Disease Is Treated

There’s currently no cure for Alzheimer’s disease, but medicines are available that can help relieve some of the symptoms.

Various other types of support are also available to help people with Alzheimer’s live as independently as possible, such as making changes to your home environment so it’s easier to move around and remember daily tasks.

Psychological treatments such as cognitive stimulation therapy may also be offered to help support your memory, problem solving skills and language ability.

Read more about treating Alzheimer’s disease.

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Third Dementia Stage: Mild Decline

Family and friends may start noticing some cognitive and memory problems from the patient at the third dementia stage. Performance on both cognitive and memory tests is affected, and physicians can instantly identify impaired cognitive function. Senior citizens at third stage of dementia showcase some symptoms that may include:

• Trouble remembering names of people they meet
• Organizing and planning
• Asking the same question repeatedly
• Losing personal possessions which might include valuables

It is possible that affected adults can begin to experience mild or moderate anxiety during the third stage of dementia, primarily because of the symptoms getting in the way of their everyday life. Should one notice any of the symptoms, it is imperative that the affected individuals go through a clinical interview with a licensed clinician to receive the proper diagnosis. It helps to start an appropriate medical course of action.

Caregivers should also note that it is essential that they try and get rid of any stress that may be affecting the patient. Let them understand what is going on in a kind and loving manner so that they can prepare to embrace the journey ahead. They can also help the patients with memory in some ways such as reminding them to pay their bills and getting them to any appointments they may have on time.

Is Alzheimers Hereditary

Although the genes you inherit from your parents can raise your risk of developing Alzheimers, researchers say that only rarely is Alzheimers caused by mutations that are passed directly from parent to child.

Those cases almost always involve early-onset Alzheimers disease, an uncommon type that develops before age 65.

Alzheimers disease caused by gene mutations accounts for between 7 and 12 percent of all cases of early-onset Alzheimers and less than 1 percent of all Alzheimers cases, according to the Alzheimers Society.

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How Is Dementia Treated

Treatment of dementia depends on the underlying cause. Neurodegenerative dementias, like Alzheimers disease, have no cure, though there are medications that can help protect the brain or manage symptoms such as anxiety or behavior changes. Research to develop more treatment options is ongoing.

Leading a healthy lifestyle, including regular exercise, healthy eating, and maintaining social contacts, decreases chances of developing chronic diseases and may reduce number of people with dementia.

Duration Of Alzheimers Disease

The brain changes that result in Alzheimers disease may begin a decade or more before the first symptoms appear, as amyloid plaques and tau tangles start to form, neurons die, and other toxic changes in the brain begin to occur.

After diagnosis, a person with Alzheimers will live, on average, from 4 to 8 years, though some survive for as long as 20 years.

Recommended Reading: What Is Dementia Caused By

What To Do If A Loved One Is Suspicious Of Having Dementia

• Discuss with loved one. Talk about seeing a medical provider about the observed changes soon. Talk about the issue of driving and always carrying an ID.
• Medical assessment. Be with a provider that you are comfortable with. Ask about the Medicare Annual Wellness exam.
• Family Meeting. Start planning, and gather documents like the Health Care Directive, Durable Power of Attorney for Health Care, Estate Plan.

A Failing Sense Of Direction

A persons sense of direction and spatial orientation commonly starts to get worse with the onset of dementia. They may have difficulty recognizing once-familiar landmarks and forget how to get to familiar places they used to have no trouble finding.

It may also become more difficult to follow a series of directions and step-by-step instructions.

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Fourth Dementia Stage: Moderate Decline

Dementia symptoms are clear-cut at this point. Patients who at the fourth stage of dementia showcase some issues such as:

• Difficulties solving simple arithmetic
• Short-term memory loss, for instance, one may not remember what they had for lunch in the afternoon
• Forgetting information about their life history
• Reduced knowledge of recent or current events
• Inability to pay bills or even manage finances
• Trouble with routine chores or tasks
• Disorientation
• Challenges recognizing people and faces
• Trouble with traveling to a new location alone

To help efficiently deal with this dementia stage, loved ones can help out with daily tasks and make sure that the patient is safe at all times. Be on the lookout to make sure that they do not fall victim to unscrupulous individuals who may want to take advantage of the patient financially. For many patients, the fourth dementia stage usually lasts about two years.

Many patients at this time also tend to withdraw from the society mainly because they feel like what they are going through is embarrassing them. They could also face adverse changes in their moods and personality. Many patients also deny that they have any symptoms as a defense mechanism, even though the symptoms may be quite evident.

Can Dementia Be Prevented

Although dementia cant be prevented, living a health-focused life might reduce risk factors for certain types of dementia.

Keeping blood vessels clear of cholesterol buildup, maintaining normal blood pressure, maintaining healthy blood sugar levels, staying at a healthy weight basically, staying as healthy as you can can keep your brain fueled with the oxygen and nutrients it needs to function at its highest possible level. Specific healthful steps you can take include:

• Follow a Mediterranean diet, which is one filled with whole grains, vegetables, fruits, fish and shellfish, nuts, beans, olive oil and only limited amounts of red meats.
• Exercise. Get at least 30 minutes of exercise most days of the week.
• Keep your brain engaged. Solve puzzles, play word games and try other mentally stimulating activities. These activities may delay the start of dementia.
• Stay socially active. Interact with people, discuss current events, and keep your mind, heart and soul engaged.

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Life Expectancy By Stage Of The Disease

The average number of years a person lives with Alzheimers disease is about 10. Keep in mind, however, that theres a gap between when symptoms begin and when a diagnosis is actually sought. The first symptoms of Alzheimers diseaseforgetting names, misplacing items, difficulty concentrating at work or performing simple tasksarrive an average of almost three years before the diagnosis is made.

The scale most commonly used by health professionals for the stages of dementia is the Global Deterioration Scale , also called the Reisberg Scale. The table below shows a patients average life expectancy by the stage of dementia. These are averages based on studies of large numbers of Alzheimers patients.

Differences Between Dementia And Alzheimer’s

Dementia is the general term used to describe a decline in cognitive function. It includes problems with thought processing, judgement, reasoning, memory, communication, and behavior control that have an impact on a person’s ability to live a normal life.

Recommended Reading: How Long Is Life Expectancy With Vascular Dementia

Are There Treatments For Alzheimers And Dementia

There are some non-medical treatment options, which can help you live well with dementia. These include emotional support and activities to support your physical and mental health.

There are also medical treatments available for some causes of dementia, and Alzheimers disease. The aim of treatment is to help your brain function. They can help you live independently and manage your symptoms.

Current treatments can slow the progress of Alzheimers disease. But they wont stop it completely or reverse its effects. Its also important to know that treatment doesnt work for everyone.

How To Understand The Difference And Why It Matters

by Kathleen Fifield, AARP, Updated June 15, 2020

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Doctors usually rely on observation and ruling out other factors to diagnose Alzheimer’s.

En español | The terms dementia and Alzheimers have been around for more than a century, which means people have likely been mixing them up for that long, too. But knowing the difference is important. In the simplest terms, one is broader than the other. If the two were nesting dolls, Alzheimers would fit inside dementia, but not the other way around. While Alzheimers disease is the most common form of dementia , there are several other types. The second most common form, vascular dementia, has a very different cause namely, high blood pressure. Other types of dementia include alcohol-related dementia, Parkinsons dementia and frontotemporal dementia each has different causes as well. In addition, certain medical conditions can cause serious memory problems that resemble dementia.

A correct diagnosis means the right medicines, remedies and support. For example, knowing that you have Alzheimers instead of another type of dementia might lead to a prescription for a cognition-enhancing drug instead of an antidepressant. Finally, you may be eligible to participate in a clinical trial for Alzheimers if youve been specifically diagnosed with the disease.

Recommended Reading: What Condition Mimics The Symptoms Of Dementia

How Important Are The Stages Of Dementia

The stages of dementia are just a guide and there is nothing significant about the number three. Equally, dementia doesnt follow an exact or certain set of steps that happen in the same way for every person with dementia.

It can be difficult to tell when a persons dementia has progressed from one stage to another because:

• some symptoms may appear in a different order to the stages described in this factsheet, or not at all
• the stages may overlap the person may need help with some aspects of everyday life but manage other tasks and activities on their own
• some symptoms, particularly those linked to behaviours, may develop at one stage and then reduce or even disappear later on. Other symptoms, such as memory loss and problems with language and thinking, tend to stay and get worse with time.

It is natural to ask which stage a person is at or what might happen next. But it is more important to focus on the person in the present moment. This includes their needs and how they can live well, and how to help them with this.

For more support on living well with dementia see The dementia guide: living well after diagnosis or Caring for a person with dementia: a practical guide .

And for more information about treatment and support for the different types of dementia go to the following pages:

• What is frontotemporal dementia ?