How Is Dementia Diagnosed
To diagnose dementia, doctors first assess whether a person has an underlying, potentially treatable, condition that may relate to cognitive difficulties. A physical exam to measure blood pressure and other vital signs, as well as laboratory tests of blood and other fluids to check levels of various chemicals, hormones, and vitamins, can help uncover or rule out possible causes of symptoms.
A review of a persons medical and family history can provide important clues about risk for dementia. Typical questions might include asking about whether dementia runs in the family, how and when symptoms began, changes in behavior and personality, and if the person is taking certain medications that might cause or worsen symptoms.
The following procedures also may be used to diagnose dementia:
Early detection of symptoms is important, as some causes can be treated. However, in many cases, the cause of dementia is unknown and cannot be treated. Still, obtaining an early diagnosis can help with managing the condition and planning ahead.
What Are The Causes Of Dementia
Dementia is caused by damage to your brain. Dementia affects your brains nerve cells, which destroys your brains ability to communicate with its various areas. Dementia can also result from blocked blood flow to your brain, depriving it of needed oxygen and nutrients. Without oxygen and nutrients, brain tissue dies.
Damage to your brain results in different symptoms, depending on the area of your brain affected. Some dementias arent reversible and will worsen over time. Other dementias are due to other medical conditions that also affect your brain. Another group of health issues can result in dementia-like symptoms. Many of these conditions are treatable, and the dementia symptoms are reversible.
All of the possible causes of dementia are discussed in the question, Are there different types of dementia?
What Are The Different Types Of Dementia
Various disorders and factors contribute to the development of dementia. Neurodegenerative disorders result in a progressive and irreversible loss of neurons and brain functioning. Currently, there are no cures for these diseases.
Types of dementia include:
- Alzheimers disease, the most common dementia diagnosis among older adults. It is caused by changes in the brain, including abnormal buildups of proteins, known as amyloid plaques and tau tangles.
- Frontotemporal dementia, a rare form of dementia that tends to occur in people younger than 60. It is associated with abnormal amounts or forms of the proteins tau and TDP-43.
- Lewy body dementia, a form of dementia caused by abnormal deposits of the protein alpha-synuclein, called Lewy bodies.
- Vascular dementia, a form of dementia caused by conditions that damage blood vessels in the brain or interrupt the flow of blood and oxygen to the brain.
- Mixed dementia, a combination of two or more types of dementia. For example, through autopsy studies involving older adults who had dementia, researchers have identified that many people had a combination of brain changes associated with different forms of dementia.
Learn more about how researchers are using neuropathology to address questions and complexities of dementia diseases in Inside the Brain: The Role of Neuropathology in Alzheimers Disease Research.
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What Is Known About Alzheimers Disease
Scientists do not yet fully understand what causes Alzheimers disease. There likely is not a single cause but rather several factors that can affect each person differently.
- Age is the best known risk factor for Alzheimers disease.
- Family historyresearchers believe that genetics may play a role in developing Alzheimers disease. However, genes do not equal destiny. A healthy lifestyle may help reduce your risk of developing Alzheimers disease. Two large, long term studies indicate that adequate physical activity, a nutritious diet, limited alcohol consumption, and not smoking may help people. To learn more about the study, you can listen to a short podcast.
- Changes in the brain can begin years before the first symptoms appear.
- Researchers are studying whether education, diet, and environment play a role in developing Alzheimers disease.
- There is growing scientific evidence that healthy behaviors, which have been shown to prevent cancer, diabetes, and heart disease, may also reduce risk for subjective cognitive decline. Heres 8 ways.
Who Can Diagnose Dementia
Visiting a primary care doctor is often the first step for people who are experiencing changes in thinking, movement, or behavior. However, neurologists doctors who specialize in disorders of the brain and nervous system are often consulted to diagnose dementia. Geriatric psychiatrists, neuropsychologists, and geriatricians may also be able to diagnose dementia. Your doctor can help you find a specialist.
If a specialist cannot be found in your community, contact the nearest medical school neurology department for a referral. A medical school hospital also may have a dementia clinic that provides expert evaluation. You can also visit the Alzheimers Disease Research Centers directory to see if there is an NIA-funded center near you. These centers can help with obtaining a diagnosis and medical management of conditions.
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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.
Support For Family And Friends
Currently, many people living with Alzheimers disease are cared for at home by family members. Caregiving can have positive aspects for the caregiver as well as the person being cared for. It may bring personal fulfillment to the caregiver, such as satisfaction from helping a family member or friend, and lead to the development of new skills and improved family relationships.
Although most people willingly provide care to their loved ones and friends, caring for a person with Alzheimers disease at home can be a difficult task and may become overwhelming at times. Each day brings new challenges as the caregiver copes with changing levels of ability and new patterns of behavior. As the disease gets worse, people living with Alzheimers disease often need more intensive care.
You can find more information about caring for yourself and access a helpful care planning form.
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Driving Combines Conscious And Unconscious Brain Activity
“Wow,” you may be thinking, “how can I do all of these activities while Im driving and still sing along with the radio, listen to an audiobook, or speak with my friend sitting in the passenger seat?” The answer is that, once youve learned to drive, most of your routine driving occurs automatically and unconsciously. In fact, theres increasing evidence that you go through most of your daily routines automatically, without conscious effort controlling your actions. This is why, if you become distracted while you are driving, you may find yourself heading to work on autopilot when you meant to go to the grocery store.
Your conscious mind takes control, however, whenever the situation requires it. So if you are driving in a snowstorm, when it is raining, or on an icy road, your conscious mind will devote its attention to your driving. Thats why youll stop singing, pause the audiobook, and ask your friend to hold on for a minute during these situations.
When To Hospitalize A Loved One With Alzheimers Disease
When family members notice potential signs of Alzheimers disease, they often wonder if its time to take their loved one to the hospital. This can be a difficult decision to make. Many people with Alzheimers disease eventually need to be hospitalized, usually for problems such as pneumonia or dehydration. But hospitalization isnt always the best option, especially in the early or middle stages of the disease. If youre trying to decide whether to take your loved one to the hospital, here are some factors to consider: The severity of symptoms. If your loved one is having difficulty eating or drinking, is losing weight, or has developed a sudden onset of confusion, hospitalization may be necessary. The presence of other medical conditions. If your loved one has other health problems, such as heart disease or diabetes, hospitalization may be needed to manage those conditions. The ability to care for the person at home. If youre no longer able to provide the care your loved one needs, hospitalization may be the best option. If youre unsure whether to take your loved one to the hospital, talk to the doctor. He or she can help you make the best decision for your loved ones individual situation.
When someone has dementia, they are more likely to die in the hospital, have falls, functional decline, spatial disorientation, malnutrition and dehydration, and rely more heavily on caregivers, depression, and delirium .
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What Is Memory Loss
We all have times when we forget where we put our keys. But memory loss can take many different formsfrom mild memory lapses to longer-term memory loss.
Memory loss is a term that describes a variety of different cognitive complaints, says Jason Karlawish, M.D., professor of medicine, medical ethics and health policy, and neurology at the University of Pennsylvania in Philadelphia, co-director of the Penn Memory Center and author of The Problem of Alzheimers: How Science, Culture, and Politics Turned a Rare Disease Into a Crisis and What We Can Do About It.
One of those complaints may be trouble remembering information, says Dr. Karlawish. But folks who complain about memory loss are often having troubles with other cognitive abilities like attention or concentration or language. Whatever the actual problem, its concerning if its creating inefficiencies or disabilities in daily activities.
There are different kinds of memory loss, each with its own symptoms and causes.
What Are The Warning Signs Of Alzheimers Disease
Watch this video Memory Loss is Not a Normal Part of Aging
Alzheimers disease is not a normal part of aging. Memory problems are typically one of the first warning signs of Alzheimers disease and related dementias.
In addition to memory problems, someone with symptoms of Alzheimers disease may experience one or more of the following:
- Memory loss that disrupts daily life, such as getting lost in a familiar place or repeating questions.
- Trouble handling money and paying bills.
- Difficulty completing familiar tasks at home, at work or at leisure.
- Misplacing things and being unable to retrace steps to find them.
- Changes in mood, personality, or behavior.
Even if you or someone you know has several or even most of these signs, it doesnt mean its Alzheimers disease. Know the 10 warning signs .
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Signs Of Memory Loss And How To Help
For some people, the presence of this symptom is a sign that something more serious is going on. When you notice that someone you know is struggling to remember recent events, it is critical that you speak with them. The sooner you get them checked out, the better chance they have of recovering fully and successfully.
Who Gets Alzheimers Disease
Anyone can develop Alzheimers disease, but it is more common in older age.
Genetics, lifestyle and health factors are associated with an increased risk of developing dementia.
In a few cases, Alzheimers disease is inherited, caused by a genetic mutation. This is called familial Alzheimers disease, with symptoms occurring at a relatively young age. This is usually when someone is in their 50s, but sometimes younger.
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Friends And Relatives Are Concerned
People with early-onset Alzheimer’s disease may not recognize their declinebut those closest to them could notice changes. “If a loved one expresses concern, says that you seem really different, is worried that something is going on, that’s a legitimate basis for a medical evaluation,” says Dr. Tariot. Don’t dismiss these concerns, since they may be the key to getting an early diagnosis, along with early treatment that perhaps can slow the progression of cognitive changes.
Beyond Memory Loss: How To Handle The Other Symptoms Of Alzheimer’s
There is a lot of talk about the emotional pain patients and caregivers suffer when a loved one loses memories to Alzheimers. But what about the other symptoms? Here are tips from a Johns Hopkins expert on what to watch for and how to manage.
#TomorrowsDiscoveries: From Dysfunctional Cells to Disease Dr. Rong Li
Dr. Li and her team investigate how cells consolidate their damaged proteins and prevent them from spreading freely, in order to understand how to better treat diseases such as Alzheimers and ALS. Another of their interests is how chromosomes are divided up when one cell becomes two. Learning more about how the process can go wrong could lend insight into cancer development.
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Alzheimer’s Disease And Other Dementias Impair Driving
Alzheimer’s disease and other forms of dementia affect a variety of different brain regions, including all four lobes of the brain. For this reason, people with Alzheimer’s disease often show impaired visual, auditory, attention, and decision-making abilities. However, not everyone with Alzheimer’s must stop driving. It depends on both the overall severity of the disease, as well as the specific cognitive abilities that are impaired.
Alzheimer’s disease begins silently, with an accumulation of plaques and tangles in the brain but without any symptoms. When the disease begins to affect thinking and memory but function is normal, it has reached the mild cognitive impairment stage. When function is impaired, it has reached the dementia stage. When only one or two complicated activities are impaired , Alzheimer’s is in the very mild dementia stage.
One study found that people with Alzheimer’s had an average of 0.09 car crashes per year, compared to 0.04 crashes in age-matched healthy adults. Another study found that individuals with Alzheimer’s disease in the mild cognitive impairment and very mild dementia stages had impairments similar to 16-to 20-year-old drivers. So on the one hand, people with Alzheimer’s are at increased risk for driving. On the other hand, when the Alzheimer’s is very mild, accident rates are like those of new drivers — a group who we as a society allow to drive with few or no restrictions.
Risk Factors And Prevention
Although age is the strongest known risk factor for dementia, it is not an inevitable consequence of biological ageing. Further, dementia does not exclusively affect older people young onset dementia accounts for up to 9% of cases. Studies show that people can reduce their risk of cognitive decline and dementia by being physically active, not smoking, avoiding harmful use of alcohol,controlling their weight, eating a healthy diet, and maintaining healthy blood pressure, cholesterol and blood sugar levels. Additional risk factors include depression, social isolation, low educational attainment, cognitive inactivity and air pollution.
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Are There Different Types Of Dementia
Dementias can be divided into three groups:
- Reversible dementia-like symptoms caused by other illnesses or causes.
Primary dementia
Types of primary dementia include:
Dementia due to other diseases and conditions
Other causes of dementia include:
Dementias due to reversible causes
Some conditions can cause dementia-like symptoms that can be reversed with treatment, including:
What Are The Risk Factors For Dementia
Risk factors for dementia include:
- Age: This is the strongest risk factor. Your chance of dementia increases as you age. Most cases affect people over the age of 65.
- Family history: If you have biological parents or siblings with dementia, youre more likely to develop dementia.
- Down syndrome: If you have Down syndrome, youre at risk of developing early-onset Alzheimers disease by middle age.
- Poor heart health: If you have high cholesterol levels, high blood pressure, atherosclerosis or smoke, you increase your risk of dementia. These health problems, as well as diabetes, affect your blood vessels. Damaged blood vessels can lead to reduced blood flow and strokes.
- Race and ethnicity: If youre a Black person, you have twice the risk as a white person for developing dementia. If youre a Hispanic person, youre 1.5 times more likely than a white person to develop dementia.
- Brain injury: If youve had a severe brain injury, youre at a higher risk for dementia.
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How Is Alzheimers Disease Treated
Medical management can improve quality of life for individuals living with Alzheimers disease and for their caregivers. There is currently no known cure for Alzheimers disease. Treatment addresses several areas:
- Helping people maintain brain health.
- Managing behavioral symptoms.
- Slowing or delaying symptoms of the disease.