Alzheimer’s Disease and Dementia
By Mary Anne Molinari, RN, MN, GNCS-BC
When some people age and become a little forgetful, we commonly joke that they have “Old Timer’s Disease” aka Alzheimer’s Disease. If the behavior worsens we often conclude that the person must indeed have this disease. Unfortunately, there exists the idea that dementia is always due to Alzheimer’s Disease (AD). The truth is that AD falls under the broad term “Dementia” so not all dementia is AD nor are they the result of AD.
Dementia is a term which describes a group of a neurological symptoms which result from a disease process or condition. It is usually a chronic, progressive brain cell alteration affecting one’s ability to think, speak, reason, remember and move. Although dementia and aging are not synonymous, the incidence of dementia does increase with age. Some estimate that 50% of those 80 years and older have some form of dementia.
Alzheimer’s Disease is a progressive and irreversible disorder in which brain cells deteriorate. The ultimate cause is unknown but abnormal clumps of protein are found in the brain upon autopsy. Currently there is no cure but some medications, diet and physical therapies have shown to help alleviate symptoms and/or slow its advancement.
While AD accounts for about 50-65% of all dementias, over 50 other causes have been documented. In addition, a significant number of disorders can mimic the symptoms of dementia.
Common dementia conditions incorrectly diagnosed as Alzheimer’s disease include:
Vascular disorders (blood flow related), such as CVA (cerebral vascular disorder). A common type is dementia associated with arthrosclerosis (fatty buildup) which causes blockage of small blood vessels deep in the brain. This is also referred to as Multi-infarct Dementia. Risk factors are high blood pressure, cholesterol, diabetes and heart rhythm problems.
Parkinson’s Disease. While a less common feature, approximately 20% of people with Parkinson’s will develop Parkinson’s Disease Dementia.
Frontal Lobe Dementia. This is a degenerative disease affecting the frontal lobe of the brain which governs mood and behavior. A disorders called Pick’s Disease affects both the frontal and temporal lobes.
AIDS Dementia Complex, and Huntington’s disease both cause dysfunction in parts of brain responsible for sensory information and control of motor movement.
Conditions that mimic dementia symptoms such as confusion and personality changes and memory impairment.
Metabolic abnormalities such as hypothyroidism, hypoglycemia (low blood sugar) and Vitamin B-12 deficiency (pernicious anemia).
Medications. Symptoms result from interactions among medications and side effects, especially when taking multiple types of drugs, or when there is liver /kidney impairment causing interference with drug metabolism and elimination.
Nutrition Deficiencies. Severe vitamin B deficiencies can result from chronic alcoholism, although excessive drinking can actually cause several types of dementia.
Brain tumors that can be removed or some neurological illnesses such as multiple sclerosis.
Dehydration which commonly manifests as confusion.
Emotional problems with symptoms of depression which can be mistaken for dementia.
Infections such as those which affect the brain or brain membranes, Urinary tract infections have high incidence of dementia—like symptoms in older adults.
Chronic drug use. Long term abuse can change the brain’s chemical systems.
Trauma from head injury, bleeding or increased pressure alters brain tissue.
Early and accurate diagnosis is important. Some conditions will get worse and are not curable, but others respond to treatment and become controllable. Others are potentially reversible, especially non-dementia disorders. Even those with irreversible dementia can benefit from early therapy which could slow its progression and maximize quality of life.