Conditions With Symptoms Similar To Dementia
Remember that many conditions have symptoms similar to dementia, so it is important not to assume that someone has dementia just because some of the above symptoms are present. Strokes, depression, excessive long-term alcohol consumption, infections, hormonal disorders, nutritional deficiencies and brain tumours can all cause dementia-like symptoms. Many of these conditions can be treated.
Managing Movement Problems In Ftd
Medications and physical and occupational therapy may provide modest relief for the movement symptoms of FTD. A doctor who specializes in these disorders can guide treatment.
For people with corticobasal syndrome, Parkinsons disease medicines may offer some temporary improvement. Physical and occupational therapy may help the person move more easily. Speech therapy can help them manage language symptoms.
For people with progressive supranuclear palsy, sometimes Parkinsons disease drugs provide temporary relief for slowness, stiffness, and balance problems. Exercises can keep the joints limber, and weighted walking aids such as a walker with sandbags over the lower front rung can help maintain balance. Speech, vision, and swallowing difficulties usually do not respond to any drug treatment. Antidepressants have shown modest success. For people with abnormal eye movements, bifocals or special glasses called prisms are sometimes prescribed.
People with FTD-ALS typically decline quickly over two to three years. During this time, physical therapy can help treat muscle symptoms, and a walker or wheelchair may be useful. Speech therapy may help a person speak more clearly at first. Later on, other ways of communicating, such as a speech synthesizer, can be used. The ALS symptoms of the disorder ultimately make it impossible to stand, walk, eat, and breathe on ones own.
What A Doctor May Check And Ask
Most people with suspected dementia will go to a doctors surgery to see their GP. Some doctors, however, will prefer to make a home visit to observe and assess someones behaviour in their own environment. A GP will check a persons blood pressure, temperature and pulse, listen to their heart and lungs and collect blood and urine samples for further tests to be carried out. The doctor will ask what potential signs of dementia have been noticed and when they began, how often they occur and whether they are getting worse.
The GP may ask a series of questions designed to test the persons memory and reasoning skills. The doctor is also likely to carry out a detailed review of any medication taken and ask about personal and family medical history, diet, smoking, intake of alcohol and exercise. The doctor will welcome notes perhaps kept by the patient, a partner, close family member or a care worker that outline when any symptoms or changes first happened. The GP may feel able to make a diagnosis at the conclusion of the assessment or may refer the person to a memory clinic or specialist.
Cultural diversity is an important consideration in the assessment process. Dementia assessments need to be culturally appropriate and recognise the impact of culture on individual behaviour. An interpreter may be vital for a proper assessment.
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When Should I Use An At
According to the Centers for Disease Control and Prevention, you should get tested if you have COVID-19 symptoms or if you have been potentially exposed to an individual with COVID-19.
You can also consider doing a self-test before gathering indoors with others to minimize the risk of transmission. This is especially important before gathering with unvaccinated children, older individuals, or people who are immunocompromised.
The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.
This article was updated at 12:30 p.m. on January 14 to reflect a correction in the question about HSA/FSA reimbursements.
Stage : Mild Cognitive Impairment
Clear cognitive problems begin to manifest in stage 3. A few signs of stage 3 dementia include:
- Getting lost easily
- Noticeably poor performance at work
- Forgetting the names of family members and close friends
- Difficulty retaining information read in a book or passage
- Losing or misplacing important objects
- Difficulty concentrating
Patients often start to experience mild to moderate anxiety as these symptoms increasingly interfere with day to day life. Patients who may be in this stage of dementia are encouraged to have a clinical interview with a clinician for proper diagnosis.
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Alzheimers / Dementia Testing Alternatives
Despite the lack of an FDA-approved blood test, families who suspect their loved one may have Alzheimers have a well-trod, if meandering, path to a diagnosis. To begin the process, there are online tests for Alzheimers that can be downloaded, printed, completed and taken to your doctor, and even some interactive tests that might provide immediate results. However, these online tests do not actually test for Alzheimers or dementia. Instead, they offer families answers to these questions: Are my concerns about my loved one justified?Is this just normal aging or is there something more going on? Officially, the tests are looking for Mild Cognitive Impairment . These tests are not definitive, but they can help a family figure out what their next step should be.
If a doctor suspects a patient may have Alzheimers, there are more definitive approaches. Brain scans and tests on extracted spinal fluid when coupled with multiple physicians consultations can make a diagnosis of Alzheimers with upwards of 90 percent accuracy. Families should expect their loved one to be evaluated by a neurologist, a psychiatrist, and very likely a psychologist as well. Since Alzheimers is so common among the elderly, a diagnosis is less about finding a condition which fits and more about eliminating other possibilities.
When Is Genetic Testing For Dementia Appropriate
In some cases, it may seem likely that a persons dementia is caused by a single-gene change for example, if the person has a very strong family history of dementia. In these cases, it may be appropriate to offer genetic testing to the person and to their family.
However in most families dementia will not be caused by a single-gene change. In these cases, genetic testing will not be appropriate. This is because testing for risk variants does not provide any certainty about the persons chances of developing dementia.
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Screening Tests For Cognitive Impairment
During the initial visit, quick assessment tools can be used as a screening test to help decide whether further evaluation is warranted .1315 One of the following tests should be performed during the initial visit, with further evaluation if the result is abnormal.
Summary of Screening Tests for Cognitive Impairment
| Test | ||||
|---|---|---|---|---|
|
Ask patient to name as many animals as possible in 60 seconds Patient receives one point for each unique animal named |
Score < 15 = suggestive of dementia |
|||
|
Consider lowering cutoff score to 12 for persons with one to seven years of education |
||||
|
Consider lowering cutoff score to 9 for persons with no education |
||||
|
Mini-Cognitive Assessment Instrument |
Two to four minutes |
Three-item recall combined with clock drawing test Patient receives one point for each correctly recalled word and two points for normal clock drawing test |
Score of 0 to 2 = high likelihood of dementia |
|
|
Score of 3 to 5 = low likelihood of dementia |
||||
|
Sweet 16 |
Three-item recall, eight-item orientation, and backward digit span Patient receives one point for each correct item, for a maximal score of 16 |
Score < 14 = suggestive of dementia |
Information from references 13 through 15.
Summary of Screening Tests for Cognitive Impairment
Information from references 13 through 15.
When Testing Is Worthwhile
While screening for dementia when you don’t have any symptoms doesn’t make sense, Dr. Nelson states, “Any memory or cognitive changes that concern youor the people close to youwarrant a visit to a geriatrician, neurologist, or neuropsychologist.”
Normal, age-related memory lapseslike forgetting the name of your high school English teacher, or having trouble recollecting where you had dinner on a trip to Parisshouldn’t be cause for concern.
But call your doctor if you start to forget information you once knew well, or memory loss is interfering with your daily function. “When you’re beginning to forget the name of your high school or your grandchild, or whether a close family member is dead or alive, or you have difficulty with tasks that were once familiar, like becoming disoriented in your own home or neighborhood, those types of episodes are concerning,” Dr. Nelson says.
When you see a doctor, you’ll go through a series of tests, including a neurological exam to determine how well your brain and nervous system are functioning. The doctor will check your reflexes, eye movements, speech, and coordination.
He or she will also ask you a variety of questions that will assess your visuospatial abilities .
Your evaluation may involve tests for other conditions that can cause memory loss. These include
-
poor sleep
-
underactive thyroid gland
-
vitamin deficiencies, including B1 and B12.
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Epidemiology And Risk Factors
After 65 years of age, the lifetime risk of developing dementia is approximately 17 to 20 percent 70 percent of patients with dementia have Alzheimer disease, 17 percent have vascular dementia, and 13 percent have a combination of dementia with Lewy bodies, Parkinson-related dementia, alcoholic dementia, or frontal lobe dementia.4,5 The transitional state between normal cognition and early Alzheimer disease is called mild cognitive impairment, which is defined as memory impairment without meeting criteria for dementia. Each year, 10 to 15 percent of patients with mild cognitive impairment develop Alzheimer disease.6 Alzheimer disease affects 5.3 million Americans, and is the sixth leading cause of death.4 Median survival time after diagnosis of dementia is 4.5 years.7
Risk factors for dementia include age, family history of dementia, apolipoprotein E4 genotype, cardiovascular comorbidities, chronic anticholinergic use, and lower educational level.810 The greatest risk factor for dementia is increasing age. In persons 71 to 79 years of age, the prevalence is approximately 5 percent, increasing to 37 percent in persons older than 90 years.5 Having a college education has been shown to delay cognitive dysfunction by two years, compared with having less education.10 The presence of the apolipoprotein E4 genotype can increase the risk of dementia two- to 10-fold, and chronic anticholinergic use is associated with a somewhat increased risk .5,9
What Does Pgd Involve
PGD involves the following steps:
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What Causes Dementia To Progress So Quickly
Dementia symptoms are typically mild at first and progress over time to moderate and then severe, over several years. The speed as which dementia progresses varies between individuals, but some factors can cause dementia to progress more quickly. These include the persons age, the type of dementia, and other long term health problems. Dementia tends to progress more slowly in people over 65 compared to younger people below 65.
Alzheimers Blood Tests Available In The Future
Another test thats shown promise is called the Simoa that also tests for proteins in blood plasma. Its the same idea as other blood tests: identify biomarkers in the blood that can usually only be seen via expensive or difficult exams including PET brain scans, MRIs, and spinal taps. The specific protein Simoa can detect is called ptau181, and has been linked to the changes caused by dementia in the brain.
In studies, the Simoa was found to be as good at predicting the development of dementia as PET scans and a spinal tap, without the cost, pain, or radioactivity associated with those tests. And the test can also detect upcoming dementia-caused brain changes in both the short and longer terms. Right now, this technology is used by researchers to identify people who are good candidates for clinical trials. It is not yet available for most patients.
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Dementia Care Tips From Experienced Caregivers
Caring for someone with dementia isnt intuitive and doesnt come naturally. Theres a lot to learn, but you dont have to figure everything out the hard way.
In a helpful article at Verywell, social worker Esther Heerema shares 12 dementia care tips that caregivers have learned and wished theyd known sooner.
This advice isnt meant to add pressure or expectations to your already tough job. Theyre tips from caregivers who have been there and done that that can lighten your load, reduce stress, and help you cope with the challenges.
Here, we share highlights from Esthers article along with some of our own insights.
1. Its not worth it to argue with someone who has dementiaAlzheimers and dementia causes your older adults brain to malfunction. When they say things that dont make sense or are clearly untrue, they believe what theyre saying because its what their brain is telling them.
Its frustrating to hear things that arent true and instinctive to try to correct or remind. But that will only lead to both of you arguing or getting upset. And you simply cant win an argument with someone who can no longer use reason or logic consistently.
2. Ignoring symptoms wont make them go awayWhen you notice your older adult struggling with memory, thinking, or judgement, its scary to think that they might have dementia. Because it can be so hard to accept, many people hope that the symptoms will go away on their own or that theyre mistaken.
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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Who Can Take A Diagnostic Genetic Test
To see whether genetic testing might be useful, the doctor will collect information on the persons medical history and that of their close family. If possible, the doctor will collect information on at least three generations of the family. The medical history will include details of:
- any family members diagnosed with dementia
- any family history of mental illness
- any family history of strokes or neurological conditions .
Diagnostic testing for familial dementia is only normally recommended if the person has developed symptoms very early on or if there is a particular familial pattern.
If the doctor does not find a strong family history of dementia, they will not recommend that the person take a diagnostic genetic test.
Predictive testing for dementia
Asking For More Information About Your Dementia Diagnosis
If you’re diagnosed with dementia, you can ask the doctor:
- which type of dementia you have
- about tests or investigations you should have
- how long you’ll have to wait until you have the tests
- how long it will take to get the test results
- what will happen after you get the results
To read more about living well with dementia, go to the NHS website.
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Lewy Body Dementia Research
Many avenues of research are being explored to improve our understanding of LBD. Some researchers are working to identify the specific differences in the brain between the two types of LBD. Others are looking at the disease’s underlying biology, genetics, and environmental risk factors. Still other scientists are trying to identify biomarkers , improve screening tests to aid diagnosis, and research new treatments.
Scientists hope that new knowledge about LBD will one day lead to more effective treatments and even ways to cure and prevent the disorder. Until then, researchers need volunteers with and without LBD for clinical studies.
NIH and other groups help people learn about clinical trials and studies and find research opportunities near them. Visit the following websites for details:
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.
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Who Else May A Person With Dementia See
A person with suspected dementia may come into contact with a range of health and social care professionals. Consultants usually operate within specialist teams, including nurses, psychologists, occupational therapists and social workers. Nurses who work with people with dementia, and those caring for them, include: community mental health nurses , who work in the community, providing treatment, care and support for people with mental health problems and dementia district or community nurses, who provide care and advice for people living at home and practice nurses, who work with doctors in GP practices.
Clinical psychologists, who often work with consultants in memory clinics, assess memory and learning abilities. Occupational therapists can advise people on ways of maintaining their independence including carrying out adaptations and using special equipment. Social workers may be involved in assessing someones need for care services and home care workers may be brought in to help with personal and other care. Physiotherapists may be asked to advise on exercise for people, particularly in the early stages of dementia. Dieticians may be asked to provide guidance on nutrition, poor appetite, weight loss or weight gain.