Can Dementia Suddenly Get Worse
The progression of dementia depends on the underlying disease. Some diseases have a rapid progression. Others progress more slowly. Any sudden change with either slow or rapid progression should be evaluated for another cause. In most cases, changes with dementia may seem like they came out of the blue when they actually may have been slowly developing in the background. The best way to prepare for changes and manage expectations is through information. Your doctor and medical team will be a valuable resource. There are a variety of educational resources that are also available through the Alzheimer’s Association.
Referral To A Dementia Specialist
Dementia can be difficult to diagnose, especially if your symptoms are mild.
If the GP has been able to rule out other causes for your symptoms, they’ll refer you to a healthcare professional who specialises in diagnosing dementia, such as:
- a psychiatrist with experience of treating dementia
- a doctor specialising in elderly care
- a doctor specialising in the brain and nervous system
The specialist may work in a memory clinic with other professionals who are experts in diagnosing, caring for, and advising people with dementia, and their families.
It’s important to make good use of your time with the specialist. Write down questions you want to ask, make a note of any medical terms the doctor uses, and ask if you can come back if you think of more questions later. Taking the opportunity to go back can be very helpful.
They may also do further, more detailed memory tests.
If the specialist is still not certain about the diagnosis, you may need to have further, more complex tests. But most cases of dementia can be diagnosed after these assessments.
What Is Dementia And What Causes It
Dementia is a syndrome that causes a person to develop difficulty and problems with their memory or their ability to think. Unlike the normal changes that happen in a persons memory and thinking over time, dementia affects someones ability to function in their daily life activities and their normal routine .There are different causes of dementia. These causes are typically underlying neurological conditions . One common cause of dementia is Alzheimers disease. Other causes include diseases that impact brain blood vessels. For example, strokes may cause what is commonly termed Vascular Dementia. Some causes include Lewy Body Disease and Parkinsons disease.
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How Alzheimers Disease Hurts Your Brain
Alzheimers is a progressive brain disorder that slowly destroys your memory and cognitive function.
Its likely due to harmful changes that occur within your brain: For reasons experts dont completely understand, bits of a protein called amyloid inside your brain cells start to stick together in waxy clumps called plaques.
Another proteintaumisfolds like a preschoolers origami project, forming crumpled growths called tangles in the spaces between neurons, or nerve cells.
These changes interfere with the message-carrying chemicals in your brain, says Keith Fargo, Ph.D., director of scientific programs & Outreach at the Alzheimers Association. As a result, messages cant be received, scrambling your thoughts and erasing your memories.
Whats more, when the connection between the neurons is compromised, those brain cells begin to die. Brain cells in the hippocampus tend to go first, which harms your ability to recall recent experiences or new information, Fargo says.
You might miss important events, repeatedly ask the same questions, or rely on your smartphone for reminders even more than you used to.
As damage spreads, tasks that once seemed simplehandling numbers, following a plan or a recipe, remembering the rules of a gamegrow difficult, he says. Often, youll struggle to find the right words , keep up with conversations, read, or judge distance. You might be confused about where you are and how you got there, or forget what time, day, or even season it is.
When Do Signs Of Alzheimers Become More Noticeable
Alzheimers disease is often classified into seven stages, from stage 1 to stage 7 . In stages 1 and 2, symptoms may not be seen or may be subtle and easily dismissed. It is usually by stage 3 that signs are more noticeable, such as forgetting something that has just been said, asking the same question over and over, or having trouble with routine tasks like paying bills or keeping appointments.
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What Conditions Can Be Mistaken For Dementia
The term dementia refers to a specific group of symptoms related to a decline in mental ability. Often, people who experience subtle short-term memory changes, are easily confused, or exhibit different behaviors or personality traits are mistakenly thought to have dementia. These symptoms could be the result of a variety of other conditions or disorders, including other neurocognitive disorders such as Parkinsons disease, brain growths or tumors, mild cognitive impairment , and mood disorders, like depression.
How Is Alzheimer’s Disease Diagnosed
To diagnose Alzheimers, doctors may:
- Ask the person and a family member or friend questions about overall health, use of prescription and over-the-counter medicines, diet, past medical problems, ability to carry out daily activities, and changes in behavior and personality
- Conduct tests of memory, problem solving, attention, counting, and language
- Carry out standard medical tests, such as blood and urine tests, to identify other possible causes of the problem
- Perform brain scans, such as computed tomography , magnetic resonance imaging , or positron emission tomography , to rule out other possible causes for symptoms
These tests may be repeated to give doctors information about how the persons memory and other cognitive functions are changing over time. They can also help diagnose other causes of memory problems, such as stroke, tumor, Parkinsons disease, sleep disturbances, side effects of medication, an infection, mild cognitive impairment, or a non-Alzheimers dementia, including vascular dementia. Some of these conditions may be treatable and possibly reversible.
People with memory problems should return to the doctor every 6 to 12 months.
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How Is Alzheimer’s Disease Diagnosed And Evaluated
No single test can determine whether a person has Alzheimer’s disease. A diagnosis is made by determining the presence of certain symptoms and ruling out other causes of dementia. This involves a careful medical evaluation, including a thorough medical history, mental status testing, a physical and neurological exam, blood tests and brain imaging exams, including:
Information For Your Doctor
Itâs a good idea to put together the following for your first appointment:
- A list of symptoms — include everything youâre feeling, even if you donât think it could be related to dementia
- Any sources of major stress or recent life changes
- A list of all medications you take, including vitamins and supplements, and the dosage
- A list of any questions you have
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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.
Schedule An Mri For Alzheimers Today
Early diagnosis is critical to slowing the progression of Alzheimers, and an MRI of the head is one of the best ways to do it. At Envision Imaging, were dedicated to providing world-class diagnostic imaging to enhance the quality of life for our patients.
No matter which of our many locations you visit, youll receive only the very best service from our staff of professionals who understand the stress that can surround a persons visit, so we ensure each client gets focused service with an excellent quality of care.
Find a location near you to schedule your MRI appointment today.
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How Is Alzheimers Disease Diagnosed
Alzheimers is usually diagnosed based on a persons behavior along with a review of their medical history and family history. The NINCDX-ADRDA Alzheimers Criteria specifies eight domains that must be impaired for a person to have Alzheimer’s: memory, language, perceptual skills, attention, constructive abilities, orientation, problem-solving, and functional abilities. Cognitive tests are commonly used to measure the degree of cognitive impairment.
What Is The Clock Test For Dementia
The clock test is a non-verbal screening tool that may be used as part of the assessment for dementia, Alzheimers, and other neurological problems. The clock test screens for cognitive impairment. The individual being screened is asked to draw a clock with the hour and minute hands pointing to a specific time. Research has shown that six potential errors in the clock testthe wrong time, no hands, missing numbers, number substitutions, repetition, and refusalcould be indicative of dementia.
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Stage : Age Associated Memory Impairment
This stage features occasional lapses of memory most frequently seen in:
- Forgetting where one has placed an object
- Forgetting names that were once very familiar
Oftentimes, this mild decline in memory is merely normal age-related cognitive decline, but it can also be one of the earliest signs of degenerative dementia. At this stage, signs are still virtually undetectable through clinical testing. Concern for early onset of dementia should arise with respect to other symptoms.
What Type Of Tests Might Be Done
A consultation with a doctor will also include the following tests:
- Physical exam The doctor will ask about your diet and alcohol consumption, check your blood pressure and temperature, take your pulse, listen to your heart and lungs, and may perform other relevant parts of a physical exam to assess your overall health.
- Diagnostic tests Screening tests and blood and urine analysis can rule out health problems with symptoms mirroring those of Alzheimers, such as depression, untreated sleep apnea, delirium, medication side effects, thyroid problems, certain vitamin deficiencies, and excessive alcohol consumption.
- Neurological exam By testing reflexes, eye movement, speech, sensation, coordination, muscle tone, and strength, a doctor looks for evidence of stroke or other conditions that may cause Alzheimers-like symptoms.
- Mental status tests A health professional may ask a series of questions to assess your basic cognitive skills. You may be asked to remember a short list of words, follow a set of simple instructions, do simple calculations, or draw a clockface with the hands pointing to a specific time. Some doctors may use computer-based tests.
- Brain imaging The doctor might order a CT or MRI scan to look for tumors, evidence of stroke or severe brain injury, a buildup of fluid, or other issues that create symptoms resembling those of Alzheimers disease but that require different treatment.
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Imaging Biomarkers In A Research Setting
Diffusion Tensor Imaging
Diffusion tensor imaging is an MRI imaging technique visualizing the diffusion of water molecules throughout the brain. It is used as a technique for white matter tractography .
Studies have shown that white matter damage is an early marker for disease in FTD, and DTI may be used as a tool to screen for such abnormalities at the presymptomatic stage . Reduced integrity of the uncinate fasciculus and anterior corpus callosum is typical for FTD, and the degree of damage is correlated to age and disease severity . Even here, specific patterns can be recognized for different clinical subtypes, and for carriers of different causal mutations. These abnormalities are consistent with characteristic brain atrophy distributions . The increase in white matter damage over time has been reported to be greater than that of gray matter atrophy, although only at the symptomatic stage, indicating the possible use of this technique as a marker for disease progression .
Studies comparing FTD cohorts with AD patients and with normal controls found significantly more white matter pathology mostly in bilateral uncinate fasciculus, cingulum bundle, and corpus callosum in FTD compared to both other groups . More studies are needed to consolidate these findings and define the diagnostic accuracy for FTD of DTI, as well as its power to distinguish FTD from other types of neurodegenerative brain diseases.
Tau PET Imaging
Is Alzheimers Disease Genetic
Especially in younger patients, family history plays a large role. If an immediate family memberyour parent or siblinghas Alzheimers disease, your lifetime risk doubles to 20 percent, says Dr. Maraganore, M.D.
Mutations of three genes that affect amyloid production have been linked to early-onset Alzheimers disease: APP, presenilin 1, and presenilin 2. If you inherit one or two copies of these mutations, youll almost always develop Alzheimers disease.
Only a few thousand people worldwide have these genes, and most of them have widespread dementia in their families that begins at a younger age, says Fargo. A far more common mutation, called apolipoprotein-E4 or APOE4, doubles your risk of Alzheimers disease if you receive one copy from either of your parents.
Many of these cases occur after age 65commonly known as late-onset Alzheimers diseasethough people with APOE4 sometimes tend to be diagnosed slightly earlier than those without a genetic predisposition.
If you have two copies, youre about 10 times as likely to get it, Fargo says. People with a family history of Alzheimers can get genetic testing before they have symptoms to see if they carry the certain mutations that predispose them to the brain disease, says Dr. Maraganore.
Still, even if you test positive for the APOE4 mutation, it doesnt definitively prove youll develop Alzheimers. In fact, many people with the mutation never develop the disease and many without it do, says Dr. Shah.
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What You Can Do And When To See A Doctor
If you are concerned about yourself or a loved one and think you see signs of Alzheimers disease, you should consult with a doctor. Your doctor can make a thorough assessment, as well as explain options for managing symptoms. Today, many new diagnostic techniques are available to help with the early detection and treatment of Alzheimers. For example, a blood test can determine the presence of specific proteins that may indicate whether there are plaques associated with Alzheimers disease in the brain.
While there is no cure or treatment for this condition, drugs may help slow down the disease progression. Different rehabilitation programs and services can also help affected people and their caregivers.
Take The Sage Test At Home
Anyone can take the SAGE test anytime. Its free and you can get it here on the Ohio State University website.
Print the test and take it with a pen or pencil. Theres no time limit, but most people finish in about 15 minutes.
Sample questions from the test:
- How many nickels are in 60 cents?
- You are buying $13.45 of groceries. How much change would you receive back from a $20 bill?
- Write down the names of 12 different animals.
- Draw a large face of a clock and place in the numbers.Position the hands for 10 minutes after 11 oclock. On your clock, label L for the long hand and S for the short hand.
Key Symptoms Of Dementia
Dr. Kernisan describes the 5 issues that people with dementia typically experience:
- Difficulty with one or more types of mental function, like learning, memory, language, judgement
- Problems that are a change compared to the persons usual abilities
- Problems that make it difficult for them to manage everyday life responsibilities, like work or family
- Problems that arent caused by another mental disorder, like depression
Stage : Moderate Dementia
Patients in stage 5 need some assistance in order to carry out their daily lives. The main sign for stage 5 dementia is the inability to remember major details such as the name of a close family member or a home address. Patients may become disoriented about the time and place, have trouble making decisions, and forget basic information about themselves, such as a telephone number or address.
While moderate dementia can interfere with basic functioning, patients at this stage do not need assistance with basic functions such as using the bathroom or eating. Patients also still have the ability to remember their own names and generally the names of spouses and children.
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If Youre Worried About Possible Dementia
Lets say youre like the man I spoke to recently, and youre worried that an older parent might have dementia. Youre planning to have a doctor assess your parent. Heres how you can help the process along:
- Obtain copies of your parents medical information, so you can bring them to the dementia evaluation visit. The most useful information to bring is laboratory results and any imaging of the brain, such as CAT scans or MRIs. See this post for a longer list of medical information that is very helpful to bring to a new doctor.
Discuss Test Results With A Doctor
Dont assume that the test results are equal to a diagnosis of any kind.
The SAGE test is a screening tool that helps doctors detect early signs of cognitive impairment that are typically not noticeable during a normal office visit.
When the test is repeated over time, doctors can watch for changes in cognitive ability. Being able to measure changes helps them detect and treat health conditions early.
Thats why its important to bring the completed test to the doctor to have it reviewed. If there are signs of cognitive impairment, they may recommend further testing.
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