This month, Blue Hills is putting a spotlight on dementia and Alzheimer's. Dementia is an umbrella term that describes a group of symptoms related in memory or other thinking skills severe enough to reduce a person’s ability to perform everyday activities. Alzheimer’s disease accounts for 60-80 % of cases. Vascular dementia, which occurs after a stroke, is the second most common dementia type.
To be considered dementia, at least two of the following core mental functions must be significantly impaired:
Communication and language
Ability to focus and pay attention
Reasoning and judgment
You will often see people with dementia having short-term memory problems such as keeping track of a purse or wallet, paying bills, planning and preparing meals, remembering appointments, or traveling out of the neighborhood.
Many dementias are progressive - symptoms start out slowly and gradually get worse. If you or someone you know is experiencing memory difficulties or other changes in thinking skills, don’t ignore them. Making an appointment with your doctor to determine the cause early, allows a person to get the maximum benefit from available treatments and provides an opportunity to volunteer for clinical trials or studies. It also provides time to plan for the future.
Dementia is sometimes referred to as senility or senile dementia. However, serious mental decline is not a normal part of aging.
There is no one test to determine if a person has dementia. Doctors make a diagnosis based on careful medical history, a physical examination, lab tests, and the characteristic changes in thinking, day to day function and behavior. Though doctors can determine if a person has dementia with a high level of certainty, it is much harder to determine the exact type of dementia as the symptoms and brain changes of different dementias can overlap.
Treatment and care
Unfortunately, there is no cure or treatment that slows or stops most progressive dementias. There are drug treatments that may temporarily improve symptoms.
Risk and prevention
Researches continue to explore the impact of other risk factors on brain health and prevention of dementia. Some of the most active areas of research in risk reduction and prevention include cardiovascular factors, physical fitness, and diet.
Cardiovascular risk factors:
Your brain is nourished by a vast network of blood vessels. Any damage to blood vessels anywhere in your body can damage blood vessels in your brain, depriving brain cells of vital food and oxygen. Researchers have found a link between blood vessel changes in the brain and vascular dementia. You can help protect your brain with the same strategies used to protect your hear - don’t smoke, take steps to keep your blood pressure, cholesterol, and blood sugar within recommended limits, and maintain a healthy weight.
Regular physical exercise may help lower the risk of some types of dementia. Evidence suggests exercise may directly benefit brain cells by increasing blood and oxygen flow to the brain.
What you eat may have the greatest impact on brain health through its effect on heart health. The best current evidence suggests that heart-healthy eating patterns may help protect the brain. Diets empathizing whole grains, fruits and vegetables, fish and shellfish, and nuts, olive oil, and other healthy fats are encouraged.
Alzheimer’s is a type of dementia that causes problems with memory, thinking, and behavior. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks.
Alzheimer’s is the most common cause of dementia. Alzheimer’s accounts for 60 to 80 percent of dementia cases. Though increasing age is the greatest known risk factor for Alzheimer’s, Alzheimer’s is not a normal part of aging. Approximately 200,000 Americans under the age of 65 have younger-onset Alzheimer’s disease.
The most common early symptom of Alzheimer’s is difficulty remembering newly learned information because Alzheimer’s changes typically begin in the part of the brain that affects learning.
As Alzheimer’s advances through the brain it leads to increasingly severe symptoms, including:
Mood and behavior changes
Deepening confusion about events, time and place
Unfounded suspicions about family, friends, and professional caregivers
More serious memory loss and behavior changes
Difficulty speaking, swallowing and walking
People with memory loss or other possible signs of Alzheimer’s may find it hard to recognize they have a problem. Signs of dementia may be more obvious to family members or friends. Anyone experiencing dementia-like symptoms should see a doctor as soon as possible.
Stages of Alzheimer's
Mild (early stage)
An individual in the early stage of Alzheimer's may still function independently. They may still drive, work, and go to social activities. However, the person may feel as if they are having memory lapses, such as forgetting familiar words or location of everyday objects.
Other common difficulties include:
Problems coming up with the right word or name
Trouble remembering names when introduced to new people
Challenges performing tasks in social or work settings
Forgetting material that one has just read
Losing or misplacing a valuable object
Increasing trouble with planning or organizing
Moderate (middle stage)
Moderate Alzheimer's is usually the longest stage and can last for several years. As the disease progresses, the person with Alzheimer's will require more care. In this stage, individuals with Alzheimer's may have a harder time performing tasks, such as paying bills, but may still remember significant details about their life.
They may often confuse words, get frustrated or angry, or act in unexpecting ways. Damage to the nerve cells in the brain can make it difficult to express thoughts and perform routing tasks,
Common symptoms include:
Forgetfulness of events or about one's own personal history
Feeling moody or withdrawn, especially in socially or mentally challenging situations
Being unable to recall their own address or telephone number or the high school or college from which they graduated
Confusion about where they are or what day it is
The need for help choosing proper clothing for the season or the occasion
Trouble controlling bladder and bowels in some individuals
Changes in sleep patterns, such as sleeping during the day and becoming restless at night
An increased risk of wandering and becoming lost
Personality and behavioral changes, including suspiciousness and delusions or compulsive, repetitive behavior like hand-wringing or tissue shredding
Severe (late stage)
The symptoms in the final stage of Alzheimer's are severe. Individuals lose the ability to respond to their environment, carry on a conversation, and eventually, control movement. Communicating becomes more difficult. As their memory and cognitive skills continue to decline, significant personality changes may take place. Individuals in this stage also need extensive help with daily activities. Common occurrences in this stage include:
Needing round-the-clock assistance with daily activities and personal care
Losing awareness of recent experiences as well as of their surroundings
Experiencing changes in physical abilities, including the ability to walk, sit and, eventually, swallow
Having increasing difficulty communicating
Becoming vulnerable to infections, especially pneumonia
Unfortunately, there is no cure or way to stop or slow Alzheimer's. But there are drug and non-drug options that can help treat symptoms. The earlier the signs are noticed, the more you can your loved ones can prepare for the future. If you are concerned for yourself or a loved one, make an appointment with your Blue Hills doctor today.