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.
The Overall Economic Impact Is Staggering
- Worldwide dementia care is estimated to cost upwards of US$1 trillion.4 According to the World Bank, thats roughly the same as the gross domestic product of Pakistan in 2017. According to public financial statements, that is more than the 2017 profits of Apple, J.P Morgan Chase and Berkshire Hathaway combined.7
What Causes Alzheimer’s Disease
The cause of Alzheimer’s disease is not known. The “amyloid cascade hypothesis” is the most widely discussed and researched hypothesis about the cause of Alzheimer’s disease. The strongest data supporting the amyloid cascade hypothesis comes from the study of early-onset inherited Alzheimer’s disease. Mutations associated with Alzheimer’s disease have been found in about half of the patients with early-onset disease. In all of these patients, the mutation leads to excess production in the brain of a specific form of a small protein fragment called ABeta . Many scientists believe that in the majority of sporadic cases of Alzheimer’s disease there is too little removal of this A protein rather than too much production. In any case, much of the research in finding ways to prevent or slow down Alzheimer’s disease has focused on ways to decrease the amount of A in the brain.
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What Are The Average Life Expectancy Figures For The Most Common Types Of Dementia
The average life expectancy figures for the most common types of dementia are as follows:
- Alzheimers disease around eight to 10 years. Life expectancy is less if the person is diagnosed in their 80s or 90s. A few people with Alzheimers live for longer, sometimes for 15 or even 20 years.
- Vascular dementia around five years. This is lower than the average for Alzheimers mostly because someone with vascular dementia is more likely to die from a stroke or heart attack than from the dementia itself.
- Dementia with Lewy bodies about six years. This is slightly less than the average for Alzheimers disease. The physical symptoms of DLB increase a persons risk of falls and infections.
- Frontotemporal dementia about six to eight years. If a person has FTD mixed with motor neurone disease a movement disorder, their dementia tends to progress much quicker. Life expectancy for people who have both conditions is on average about two to three years after diagnosis.
To find out about the support available to someone at the end of their life, and to their carers, family and friends, see our End of life care information.
You can also call Alzheimers Society on 0333 150 3456 for personalised advice and support on living well with dementia, at any stage.
Dementia Connect support line
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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Age Is The Top Alzheimers Risk Factor
Most people associate Alzheimers disease and dementia with older people, and theres a good reason for that: advanced age is the conditions biggest known risk factor. Most individuals who have Alzheimers disease are 65 and older, and the risk for the disease doubles every five years after age 65. At age 85, almost one-third of people have Alzheimers.
But its clear that age isnt the only factor, since some people live into their 80s, 90s, and even 100s without showing any signs of Alzheimers disease or dementia.
What Are The Stages Of Alzheimers
Alzheimers disease slowly gets worse over time. People with this disease progress at different rates and in several stages. Symptoms may get worse and then improve, but until an effective treatment for the disease itself is found, the persons ability will continue to decline over the course of the disease.
Early-stage Alzheimers is when a person begins to experience memory loss and other cognitive difficulties, though the symptoms appear gradual to the person and their family. Alzheimers disease is often diagnosed at this stage.
During middle-stage Alzheimers, damage occurs in areas of the brain that control language, reasoning, sensory processing, and conscious thought. People at this stage may have more confusion and trouble recognizing family and friends.
In late-stage Alzheimers, a person cannot communicate, is completely dependent on others for care, and may be in bed most or all the time as the body shuts down.
How long a person can live with Alzheimers disease varies. A person may live as few as three or four years if he or she is older than 80 when diagnosed, to as long as 10 or more years if the person is younger. Older adults with Alzheimers disease need to know their end-of-life care options and express their wishes to caregivers as early as possible after a diagnosis, before their thinking and speaking abilities fail.
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Stage : Normal Outward Behavior
Alzheimerâs disease usually starts silently, with brain changes that begin years before anyone notices a problem. When your loved one is in this early phase, they won’t have any symptoms that you can spot. Only a PET scan, an imaging test that shows how the brain is working, can reveal whether they have Alzheimer’s.
As they move into the next six stages, your friend or relative with Alzheimer’s will see more and more changes in their thinking and reasoning.
Changes In Mood Emotions And Perceptions
Changes in mood remain in the later stages of dementia. Depression and apathy are particularly common.
Delusions and hallucinations are most common in the late stage of dementia. They are not always distressing but they can explain some changes in behaviour because the persons perception of reality is altered.
People with later stage dementia often respond more to senses than words. They may like listening to songs or enjoy textures. For example, they may like the feel of different types of material.
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Why Do People Get Dementia Heres What We Know
If you walk through a retirement community and spend a day talking to different residents of similar ages, youll find each persons brain health is unique. Some residents may show signs of dementia, like trouble remembering and reasoning, while others seem mentally sharp. But why? The short answer is that no one knows for sure.
The most common cause of dementia in older people is Alzheimers disease. Dementia can also develop due to other conditions, like brain damage from a stroke, injury, or infection. But Alzheimers disease is unique among dementia causes because we cant say for sure why it happens.
When someone develops dementia after a stroke or head injury, doctors can link the dementia to a clear cause. However, this isnt true for Alzheimers disease and since we cant link the disease to exact causes, we cant predict who will get Alzheimers or figure out how to stop it before it starts.
But even though we dont completely understand why some people develop Alzheimers disease, scientists have been working hard for decades to find the answers. Thanks to their work, we do have some clues about the factors that raise our risk of developing Alzheimers disease and dementia.
Risk Factors For Dementia
Researchers have identified several risk factors that affect the likelihood of developing one or more kinds of dementia. Some of these factors are modifiable, while others are not.
Age. The risk of Alzheimer’s disease, vascular dementia, and several other dementias goes up significantly with advancing age.
Genetics/family history. Researchers have discovered a number of genes that increase the risk of developing Alzheimer’s disease. Although people with a family history of Alzheimer’s disease are generally considered to be at a heightened risk of developing the disease themselves, many people who have relatives with Alzheimer’s disease never develop the disease, and many without a family history of the disease do get it.
In most cases, it is impossible to predict a specific person’s risk of the disorder based on family history alone. Some families with Creutzfeldt-Jakob disease, Gerstmann-Sträussler-Scheinker syndrome, or fatal familial insomnia have mutations in the prion protein gene, although these disorders can also occur in people without the gene mutation. Individuals with these mutations are at significantly higher risk of developing these forms of dementia.
Abnormal genes are also clearly implicated as risk factors in Huntington’s disease, FTDP-17, and several other kinds of dementia.
Many people with Down’s syndrome show neurological and behavioral signs of Alzheimer’s disease by the time they reach middle age.
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Very Mild Impairment Or Normal Forgetfulness
Alzheimers disease affects mainly older adults, over the age of 65 years. At this age, its common to have slight functional difficulties like forgetfulness.
But for stage 2 Alzheimers, the decline will happen at a greater rate than similarly aged people without Alzheimers. For example, they may forget familiar words, a family members name, or where they placed something.
Caregiver support: Symptoms at stage 2 wont interfere with work or social activities. Memory troubles are still very mild and may not be apparent to friends and family.
Early Symptoms Of Dementia
Although the early signs vary, common early symptoms of dementia include:
- memory problems, particularly remembering recent events
- increasing confusion
- apathy and withdrawal or depression
- loss of ability to do everyday tasks.
Sometimes, people fail to recognise that these symptoms indicate that something is wrong. They may mistakenly assume that such behaviour is a normal part of the ageing process. Symptoms may also develop gradually and go unnoticed for a long time. Also, some people may refuse to act, even when they know something is wrong.
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Common Forms Of Dementia
There are many different forms of dementia. Alzheimer’s disease is the most common form and may contribute to 6070% of cases. Other major forms include vascular dementia, dementia with Lewy bodies , and a group of diseases that contribute to frontotemporal dementia . The boundaries between different forms of dementia are indistinct and mixed forms often co-exist.
Living With Alzheimers Disease
In Alzheimers disease , significant numbers of nerve cells in the brain die, affecting patients ability to remember things and to think clearly resulting in confusion, behavioral changes and diminished communication skills. As life expectancy increases, it is expected that more and more people worldwide are at risk of developing Alzheimers.
The sooner a person is diagnosed with AD the better, for both the patient and his or her family, allowing for appropriate treatment and for necessary care planning.
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A Person With Dementia Doesnt Always Fit Into One Stage
Dementia affects each person in a unique way and changes different parts of the brain at different points in the disease progression.
Plus, different types of dementia tend to have different symptoms.
For example, someone with frontotemporal dementia may first show extreme behavior and personality changes. But someone with Alzheimers disease would first experience short-term memory loss and struggle with everyday tasks.
Researchers and doctors still dont know enough about how these diseases work to predict exactly what will happen.
Another common occurrence is for someone in the middle stages of dementia to suddenly have a clear moment, hour, or day and seem like theyre back to their pre-dementia abilities. They could be sharp for a little while and later, go back to having obvious cognitive impairment.
When this happens, some families may feel like their older adult is faking their symptoms or just isnt trying hard enough.
Its important to know that this isnt true, its truly the dementia thats causing their declining abilities as well as those strange moments of clarity theyre truly not doing it on purpose.
What Kind Of Doctor Tests For Dementia
A primary care doctor can perform a physical exam and find out more about your symptoms to determine what may be the cause. They will likely refer you to one or several specialists that can perform specific tests to diagnose dementia. Specialists may include neurologists, who specialize in the brain and nervous system psychiatrists or psychologists, who specialize in mental health, mental functions, and memory or geriatricians, who specialize in healthcare for older adults.
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Stage : Moderate Decline
During this period, the problems in thinking and reasoning that you noticed in stage 3 get more obvious, and new issues appear. Your friend or family member might:
- Forget details about themselves
- Have trouble putting the right date and amount on a check
- Forget what month or season it is
- Have trouble cooking meals or even ordering from a menu
- Struggle to use the telephone
- Not understand what is said to them
- Struggle to do tasks with multiple steps like cleaning the house.
You can help with everyday chores and their safety. Make sure they aren’t driving anymore, and that no one tries to take advantage of them financially.
What Causes Alzheimer Disease
Lots of research is being done to find out more about the causes of Alzheimer disease. There is no one reason why people get it. Older people are more likely to get it, and the risk increases the older the person gets. In other words, an 85-year-old is more likely to get it than a 65-year-old. And women are more likely to get it than men.
Researchers also think genes handed down from family members can make a person more likely to get Alzheimer disease. But that doesn’t mean everyone related to someone who has it will get the disease. Other things may make it more likely that someone will get the disease, such as high blood pressure, high cholesterol, Down syndrome, or having a head injury.
On the positive side, researchers believe exercise, a healthy diet, and taking steps to keep your mind active may help delay the start of Alzheimer disease.
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Social And Economic Impact
Dementia has significant social and economic implications in terms of direct medical and social care costs, and the costs of informal care. In 2015, the total global societal cost of dementia was estimated to be US$ 818 billion, equivalent to 1.1% of global gross domestic product . The total cost as a proportion of GDP varied from 0.2% in low- and middle-income countries to 1.4% in high-income countries.
What Is The Burden Of Alzheimers Disease In The United States
- Alzheimers disease is one of the top 10 leading causes of death in the United States.2
- The 6th leading cause of death among US adults.
- The 5th leading cause of death among adults aged 65 years or older.3
In 2020, an estimated 5.8 million Americans aged 65 years or older had Alzheimers disease.1 This number is projected to nearly triple to 14 million people by 2060.1
In 2010, the costs of treating Alzheimers disease were projected to fall between $159 and $215 billion.4 By 2040, these costs are projected to jump to between $379 and more than $500 billion annually.4
Death rates for Alzheimers disease are increasing, unlike heart disease and cancer death rates that are on the decline.5 Dementia, including Alzheimers disease, has been shown to be under-reported in death certificates and therefore the proportion of older people who die from Alzheimers may be considerably higher.6
Aging
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How Can Alzheimer’s Disease Be Diagnosed
Traditionally it was accepted that only a brain biopsy or an autopsy was able to confirm the diagnosis of Alzheimer’s disease. This is still valid today however the past 20 to 25 years have seen an increase in the study and evaluation of methods that can help to diagnose Alzheimer’s disease in individuals before clinical symptoms are observed. The goal is to identify the persons that will develop Alzheimer’s disease in the preclinical stages in order to be able to treat them before the disease develops to the clinical stage.
There are functional and structural changes in the areas of the brain were the senile plaques and the neurofibrillary tangles deposit. These structural changes as well as the functional changes can be documented by specific imaging tests.
Among these tests are those that measure structural changes in the brain like a CT scan and MRI those that measure functional changes like brain glucose metabolism, as is the case with Positron Emission Tomography , and more recently those tests that can specifically measure biochemical changes that are related to Alzheimer’s disease as is the deposition of amyloid in the brain with special markers .
Besides, new studies in biological fluids, specifically in the cerebrospinal fluid have also added useful information that might help to predict who may develop Alzheimer’s disease.
Who should get the tests?
Will I Get Alzheimer’s
After hearing all this information, the question we’ve probably all asked ourselves remains: will I get Alzheimer’s?
The simple answer is that, unfortunately, there’s no real way to tell. There are a number of risk factors that can increase your chances of developing the condition, but it is very rare that these factors will guarantee that you will get Alzheimer’s at some point.
Much more research is needed into the causes and risk factors associated with Alzheimer’s disease, but the good news is that this research is going on right now. The Jackson Laboratory is one such institution leading the charge with cutting edge discoveries, a strong focus on personalized medicine, and our renowned JAX Center for Dementia and Alzheimer’s Research.
Another institution internationally known for its research and charity is the Alzheimer’s Association. If you are concerned about signs or symptoms of dementia in yourself or a loved one, we recommend turning first to the Alzheimers Association Help & Support page. This page includes a many helpful articles, ways to connect with local support groups, and a 24/7 hotline for any Alzheimers and dementia related questions.
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