What Are The Symptoms Of Dementia
The symptoms of dementia can vary, depending on which parts of the brain are affected. Often, forgetfulness is the first symptom. Dementia also causes problems with the ability to think, problem solve, and reason. For example, people with dementia may
- Get lost in a familiar neighborhood
- Use unusual words to refer to familiar objects
- Forget the name of a close family member or friend
- Forget old memories
- Need help doing tasks that they used to do by themselves
Some people with dementia cannot control their emotions and their personalities may change. They may become apathetic, meaning that they are no longer interested in normal daily activities or events. They may lose their inhibitions and stop caring about other peoples’ feelings.
Certain types of dementia can also cause problems with balance and movement.
The stages of dementia range from mild to severe. In the mildest stage, it is just beginning to affect a person’s functioning. In the most severe stage, the person is completely dependent on others for care.
Icipating In Alzheimer’s Disease Clinical Trials
Everybody those with Alzheimers disease or MCI as well as healthy volunteers with or without a family history of Alzheimers may be able to take part in clinical trials and studies. Participants in Alzheimers clinical research help scientists learn how the brain changes in healthy aging and in Alzheimers. Currently, at least 270,000 volunteers are needed to participate in more than 250 active clinical trials and studies that are testing ways to understand, diagnose, treat, and prevent Alzheimers disease.
Volunteering for a clinical trial is one way to help in the fight against Alzheimers. Studies need participants of different ages, sexes, races, and ethnicities to ensure that results are meaningful for many people.
NIA leads the federal governments research efforts on Alzheimers. NIA-supported Alzheimers Disease Research Centers throughout the U.S. conduct a wide range of research, including studies of the causes, diagnosis, and management of the disease. NIA also sponsors the Alzheimers Clinical Trials Consortium, which is designed to accelerate and expand studies and therapies in Alzheimers and related dementias.
To learn more about Alzheimers clinical trials and studies:
- Talk to your health care provider about local studies that may be right for you.
Watch videos of participants in Alzheimers disease clinical trials talking about their experiences.
What Does Age Have To Do With It
The age you are diagnosed with AD may have the greatest impact on your life expectancy. The earlier you are diagnosed, the longer you may live. Researchers at Johns Hopkins School of Public Health have discovered that the average survival time for people diagnosed at age 65 is 8.3 years. The average life expectancy for people diagnosed at age 90 is 3.4 years.
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Are There Dna Tests To Determine Risk For Alzheimers Disease
The role DNA plays in Alzheimers disease risk is complicated, and you should discuss your decision to take a test, as well as the results, with a health care provider. At UW Health, genetic testing is available only to patients with a first-degree relative with early-onset Alzheimers disease . These tests look for rare genetic mutations associated with risk for early-onset Alzheimers disease. Researchers have found associations between genetic variants of the apolipoprotein E gene and risk for later-onset Alzheimers disease . APOE comes in several different forms, or alleles. Each person inherits two APOE alleles, one from each biological parent. APOE genetic tests are available through private companies that offer direct-to-consumer testing. Please be aware that when you seek testing through a private company, you are sharing your genetic information with a business. Review carefully the terms and conditions regarding what these companies can do with your genetic information. An APOE genetic test will not tell you if you will get dementia. In fact, only 40% of people who develop Alzheimers disease carry the APOE allele associated with increased risk for the disease. The Dementia Matters podcast episode DNA Is Not Your Destiny: Genetics and Alzheimers Disease Risk offers insight into the genetic and environmental factors that play a role in Alzheimers disease risk. You can listen to the episode or read the transcript of the interview on our website.
How Is Alzheimers Disease Diagnosed
Doctors use several methods and tools to help determine whether a person who is having memory problems has Alzheimers disease.
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 support an Alzheimers diagnosis or 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.
People with memory and thinking concerns should talk to their doctor to find out whether their symptoms are due to Alzheimers or another cause, such as stroke, tumor, Parkinsons disease, sleep disturbances, side effects of medication, an infection, or another type of dementia. Some of these conditions may be treatable and possibly reversible.
In addition, an early diagnosis provides people with more opportunities to participate in clinical trials or other research studies testing possible new treatments for Alzheimers.
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What Are The Treatments For Dementia
There is no cure for most types of dementia, including Alzheimer’s disease and Lewy body dementia. Treatments may help to maintain mental function longer, manage behavioral symptoms, and slow down the symptoms of disease. They may include
- Medicines may temporarily improve memory and thinking or slow down their decline. They only work in some people. Other medicines can treat symptoms such as anxiety, depression, sleep problems, and muscle stiffness. Some of these medicines can cause strong side effects in people with dementia. It is important to talk to your health care provider about which medicines will be safe for you.
- Occupational therapy to help find ways to more easily do everyday activities
- Speech therapy to help with swallowing difficulties and trouble speaking loudly and clearly
- Mental health counseling to help people with dementia and their families learn how to manage difficult emotions and behaviors. It can also help them plan for the future.
- Music or art therapy to reduce anxiety and improve well-being
Stage 6 Middle Dementia/moderately Severe Alzheimers Disease
People in this stage are often no longer aware of present events and unable to accurately remember the past. They progressively lose the ability to take care of daily living activities like dressing, toileting, and eating, but are still able to respond to nonverbal stimuli, and communicate pleasure and pain via behavior.
Agitation and hallucinations often show up in the late afternoon or evening. Dramatic personality changes such as wandering or suspicion of family members are common. Many cant remember close family members, but know they are familiar.
Duration: approximately 2.5 years.
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Dont Forget The Children And Teens
With so much focus on the person who has dementia, sometimes younger family members donât get the attention they need, or the illness is not explained in a way they can understand.
Children often experience a wide range of emotions when a parent or grandparent has Alzheimerâs disease. Younger children may be fearful that they will get the disease or that they did something to cause it. Teenagers may become resentful if they must take on more responsibilities or feel embarrassed that their parent or grandparent is âdifferent.â College-bound children may be reluctant to leave home.
Reassure young children that they cannot âcatchâ the disease from you. Be straightforward about personality and behaviour changes. For example, the person with Alzheimerâs may forget things, such as their names, and say and do things that may embarrass them. Assure them that this is not their fault or intentional, but a result of the disease.
Find out what their emotional needs are and find ways to support them, such as meeting with a counsellor who specializes in children with a family member diagnosed with Alzheimerâs disease. School social workers and teachers can be notified about what the children may be experiencing and be given information about the disease. Encourage children and teens to attend support group meetings, and include them in counselling sessions.
Here are some examples that might help you cope with role changes within the family:
Managing Memory Changes In Dementia
- avoiding stressful situations providing emotional support, reducing background noise and distractions, and exercise can all help to reduce stress and improve memory
- maintaining a regular routine keeping to a routine can help with a sense of security and reduce confusion
- trying memory aids using memory aids like lists, diaries and clear written instructions, can help if the person with dementia is happy to use them.
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Pillar #: Healthy Diet
In Alzheimers disease, inflammation and insulin resistance injure neurons and inhibit communication between brain cells. Alzheimers is sometimes described as diabetes of the brain, and a growing body of research suggests a strong link between metabolic disorders and the signal processing systems. By adjusting your eating habits, however, you can help reduce inflammation and protect your brain.
Manage your weight. Extra pounds are a risk factor for Alzheimers disease and other types of dementia. A major study found that people who were overweight in midlife were twice as likely to develop Alzheimers down the line, and those who were obese had three times the risk. Losing weight can go a long way to protecting your brain.
Cut down on sugar.Sugary foods and refined carbs such as white flour, white rice, and pasta can lead to dramatic spikes in blood sugar which inflame your brain. Watch out for hidden sugar in all kinds of packaged foods from cereals and bread to pasta sauce and low or no-fat products.
Enjoy a Mediterranean diet. Several epidemiological studies show that eating a Mediterranean diet dramatically reduces the risk of decline from cognitive impairment and Alzheimers disease. That means plenty of vegetables, beans, whole grains, fish and olive oiland limited processed food.
Tips For Starting And Sticking With An Exercise Plan
If youve been inactive for a while, starting an exercise program can be intimidating. But remember: a little exercise is better than none. In fact, adding just modest amounts of physical activity to your weekly routine can have a profound effect on your health.
Choose activities you enjoy and start smalla 10-minute walk a few times a day, for exampleand allow yourself to gradually build up your momentum and self-confidence.
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What Is Mild Cognitive Impairment
Mild cognitive impairment is an intermediate stage between the expected cognitive decline of normal aging and the more pronounced decline of dementia. People with MCI have more memory problems than other people their age, but their symptoms are not as severe as those associated with Alzheimer’s disease. People with MCI are still able to carry out their normal daily activities. MCI may progress to Alzheimer’s disease, however some patients regain normal memory and cognition, while others may remain stable with MCI for years. Signs of MCI include:
- Having more trouble coming up with words or names of familiar people than others of the same age
- Forgetting recent conversations, events or appointments
- Losing things often
Healthy Living with MCI is a free series sponsored by the Wisconsin Alzheimer’s Disease Research Center and Alzheimer’s Association Wisconsin Chapter. Classes offers patients and families support, guidance and science-backed strategies for living with a diagnosis of mild cognitive impairment .
When Should You Call Your Doctor
Alzheimer’s disease tends to develop slowly over time. If confusion and other changes in mental abilities come on suddenly, within hours or days, the problem may be delirium. Delirium needs treatment right away.
Seek care now if:
- Symptoms such as a shortened attention span, memory problems, or seeing or hearing things that aren’t really there develop suddenly over hours to days.
- A person who has Alzheimer’s disease has a sudden, significant change in normal behavior or if symptoms suddenly get worse.
- Symptoms such as a shortened attention span, memory problems, or false beliefs develop gradually over a few weeks or months.
- Memory loss and other symptoms start to interfere with the person’s work or social life or could cause injury or harm to the person.
- You need help caring for a person with Alzheimer’s disease.
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Alzheimers Disease Vs Mild Cognitive Impairment
Early dementia, also known as mild cognitive impairment , involves problems with memory, language, or other cognitive functions. But unlike those with full-blown Alzheimers, people with MCI are still able to function in their daily lives without relying on others.
According to the Alzheimers Association, about 15 to 20 percent of people over the age of 65 experience mild cognitive impairment. Many people with MCI eventually develop Alzheimers disease or another type of dementia. However, others plateau at a relatively mild stage of decline and are able to live independently. Some people with mild cognitive impairment even return to normal.
Symptoms of MCI include:
- Frequently losing or misplacing things.
- Frequently forgetting conversations, appointments, or events.
- Difficulty remembering the names of new acquaintances.
- Difficulty following the flow of a conversation.
It is not yet fully understood why MCI progresses to Alzheimers disease in some, while remaining stable in others. The course is difficult to predict, but in general, the greater the degree of memory impairment, the greater the risk of developing Alzheimers down the line.
Medications To Maintain Mental Function In Alzheimer’s Disease
Several medications are approved by the U.S. Food and Drug Administration to treat symptoms of Alzheimers. Donepezil, rivastigmine, and galantamine are used to treat the symptoms of mild to moderate Alzheimers. Donepezil, memantine, the rivastigmine patch, and a combination medication of memantine and donepezil are used to treat moderate to severe Alzheimers symptoms. All of these drugs work by regulating neurotransmitters, the chemicals that transmit messages between neurons. They may help reduce symptoms and help with certain behavioral problems. However, these drugs dont change the underlying disease process. They are effective for some but not all people and may help only for a limited time.
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Adls In A Person With Mild Dementia
In the early stage of dementia most people are independent with basic ADLs. Most people with mild dementia will begin to need help with some instrumental ADLsespecially complex tasks requiring multiple steps or extensive planning. Basic ADLs such as eating, dressing, and bathing are likely still independent.
At this stage, a person will instinctively try to cover up confusion by turning to others for help with simple tasks. This is a natural response and denial, anger, and excuses are common defense mechanisms. There may be some loss of interest in hobbies and activities. Mood changes, such as depression and anxiety, can occur. Learning new tasks may be difficult and complex tasks may be left uncompleted. Faulty judgment and mild changes in personality become obvious to caregivers.
Those with mild dementia may need very little help, if any with basic ADLs. Nevertheless, it is good to keep certain core principles in mind:
Dressing
- Encourage choice in the selection of clothes.
- Assist as needed but allow resident to direct the activity.
Grooming
- Allow residents to groom themselves, provide tools if needed.
- Monitor progress and provide assistance as needed.
Eating
- Ask the person to help with meal preparation and meal set-up.
- Provide adaptive utensils if needed.
- Provide assistance as needed.
- Give choice as to when, where, and what type of bathing.
- Assist in the decision to bathe.
- Assist with bathing or shower as needed.
- Monitor for safety and comfort.
Toileting*
The Brain And Body Connection
Though the cause of Alzheimerâs is not known, doctors think the symptoms of the disease are caused by a buildup of harmful proteins in your brain called amyloid and tau. These proteins form large clumps, called tangles and plaques. They get in the way of normal brain function and kill healthy cells.
The damage usually starts in the area of your brain that forms memories. People with early-stage Alzheimer’s disease often have trouble remembering things. As the disease gets worse, the plaques and clusters also appear in the parts of the brain in charge of bodily behaviors.
Everyday activities like walking, eating, going to the bathroom, and talking become harder.
The effects of the disease will differ for each person as it gets worse. The pace can be slow. Some people live up to 20 years after a diagnosis. The average life expectancy, though, is 4 to 8 years.
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Imaging And Other Tests
- Brain imaging tests, such as a CT head scan or an MRI of the head.
- A lumbar puncture to test for certain proteins in the spinal fluid.
- An electroencephalogram, or EEG.
- Brain imaging studies, such as positron emission tomography or single photon emission tomography .
In some cases, examining the brain after death is done if the family wants to confirm that the person had Alzheimer’s disease.
Understanding The Different Stages Of Alzheimers Disease
Understanding the different stages of Alzheimers can help you to track the progression of symptoms and plan appropriate care. However, its important to remember that everyone with Alzheimers disease progresses differently and there are steps you can take to slow the onset of symptoms at each stage.
Also, cognitive, physical, and functional phases often overlap, the time in each stage varies from patient to patient, and not everyone experiences all symptoms.
Two commonly used models of Alzheimers progression are the 3-stage model and 7-stage model.
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