Dementia is an impairment of thinking and memory that interferes with a person's ability to do things which he or she previously was able to do.
Alzheimer's disease is the common cause of dementia, and is particularly common in older people. Because it is the most common cause of dementia, Alzheimer's disease is commonly equated with the general term dementia. However, there are many other causes of dementia.
Distinguishing Alzheimer's disease from other causes of dementia is not always as easy and straightforward as defining these terms. In practice, people and their disorders of behavior are far more complex than simple definitions sometimes commonly imply.
Alzheimer's: Microscopic Brain Abnormalities
Alzheimer's disease is a specific form of dementia having very specific microscopic brain abnormalities. However, in typical medical practice, we do not have the ability to see microscopic brain abnormalities.
History and Examination for Alzheimer's
Therefore, distinguishing Alzheimer's disease from other forms of dementia requires a doctor to establish certain background information (the history) and define a patient's abilities (the examination), and then perhaps obtain results from certain tests.
The last step is guided by the results from the first two. Alzheimer's disease is typically a slowly progressive disorder that involves memory for recent information (short-term memory) and one or more other abilities, such as speech and language, personality, decision-making and judgment or awareness and ability to interact with the environment.
A doctor attempting to distinguish Alzheimer's disease from another form of dementia asks questions about these abilities and examines them as well. Additionally, the doctor also asks questions about and examines abilities that are typically not impaired in a patient with Alzheimer's disease. These abilities include, among others, memory for information of long ago (long-term memory), vision, ability to feel things and muscle strength. In doing these things, the doctor is attempting to determine if the pattern of impairments that the patient has are typical or not typical for Alzheimer's disease.
CT Scan or MRI for Alzheimer's
After the history and examination are completed, the doctor will commonly obtain a scan of the brain, using either a CT scan or MRI scan. The scans look at brain large-scale (macroscopic rather than microscopic) structure. (Newer scan types are being developed to begin to examine brain function and microscopic structure. In the future, these are likely to help better diagnose Alzheimer's disease.) Also, the doctor, after the history and physical examination are completed, will commonly obtain certain blood tests. Which blood tests are obtained will depend on the background history and physical examination.
Alternative Causes of Dementia
In attempting to make a diagnosis of Alzheimer's disease, the doctor will be considering alternative causes of dementia. For example, if a child, teenager or young adult has features of dementia, as described above, Alzheimer's disease is very unlikely. Therefore, the causes of dementia in a young person would be considered. Another setting of dementia that is not Alzheimer's disease would be someone who has dementia after a head injury. In an older person, the presence of a head injury does not exclude the possibility of Alzheimer's disease as well. However, any young person who was normal before a head injury and who had dementia after a head injury would be diagnosed with "post-traumatic (after injury) dementia."
Distinguishing Alzheimer's disease from other late-life causes of dementia is not as easy or as obvious as the examples given above. In fact, even the doctors most knowledgeable about Alzheimer's disease are not always accurate in making the diagnosis.
Parkinson's Disease with Dementia vs. Alzheimer's Disease with Dementia
There is a list of other forms of dementia that can occur in later life. Distinguishing some of these from Alzheimer's disease may be important. For example, the treatment of Parkinson's disease with dementia is different from the treatment of Alzheimer's disease, because there are specific treatments for the problems of movement seen in patients with Parkinson's disease.
Therefore, one of the goals of the doctor is to distinguish disorders that have different treatments and attempt to use that treatment most appropriate for that individual person. Another goal that the doctor has is to have enough information about the dementia to appropriately counsel the patient and family members about the diagnosis and treatment plan.
In summary, Alzheimer's disease is, by definition, a type of dementia. However, a diagnosis of dementia does not always mean that the person with that diagnosis has Alzheimer's disease. Sometimes these distinctions are easy, and sometimes they are not.
NO MATTER HOW SICK I AM,THERE IS ALWAY'S SOMEONE SICKER.
The following user gives a hug of support to BP2RC: luyingjie (01-24-2012)
The Following User Says Thank You to BP2RC For This Useful Post: luyingjie (01-24-2012)
Also it is found that those with Alzheimers fail at a faster rate than those diagnosed with Dementia. My cousin had Alzheimers identified as mid stage 5-6 when he was 57 years of age, he showed signs that we then knew was Alzheimers when he was 55. He died when he was 59.
My mother showed signs in her late 50's, but she was able to work through it most times and it didn't get bad until she was in her mid-70's It was a 15 year nightmare for her. Her failings were very spaced apart and not close. Just when we fooled ourselves that things were fine, wham- she'd have another failure. The worst of it was when she lost the ability to communicate.
God how I wanted to pull the words out of her mouth for her. I remember when it first started, I asked her if she knew she was doing it and she looked at me like i was the one nuts. She wasn't aware of her failings at that point.
She lost the ability to talk about 4-5 years before her death. it was hard because while she may have been able to understand us, she couldn't let us know that she understood. I always wondered if she was 'awake' but trapped in that body but then I'd say "no, she couldn't have been cognizant of what was happening because she wouldn't have been so angry at my sister when my sister tried to do something as simple as go to the bathroom or sit and watch a TV show"
With the disease -- whichever it is -- one never knows what is truly being felt by the patient. And that is the shame of the whole thing.
The following user gives a hug of support to caringsister54: luyingjie (01-24-2012)
The Following User Says Thank You to caringsister54 For This Useful Post: luyingjie (01-24-2012)
I knew daddy was "slipping" 5 years ago, when he was still living in Oregon. I used to call him every day (we live in Colorado), and one day, he told me that he went to get the mail (around the corner in a mobile home park), took it home, sat down at the table to open it and realized he was not in his own house. He had walked into someone else's home.
We moved him to CO 4 weeks later. He lived next door to us, and it was the doctor here that used, for the first time, the dreaded word, "dementia". I had made an appt for him to meet a new doctor, a general medicine doctor. I waited in the waiting room while daddy went back for his appointment. Not ten minutes later, the doctor came to the waiting room and asked me to come on back. It seems that daddy did not know where he lived, where he USED to live, my name, his phone #, nuthin'. And she said to me, (and I almost passed out) "Your dad is quite demented, isn't he?"
I think I KNEW it. But somehow, putting the word on it was really devastating to me. THEN. On the way home, daddy asked me what she said. And I told him. I said, "Daddy, she said you have dementia. You knew that, didn't you?" And he nodded. My eyes puddled up, because now I had proof that we were in for a long, bumpy road.
And over the next 3 years, function was lost. Slowly. Un-evenly. Sometimes, he knew how to write a check. Most times, not. Which leaves you with the questions, "Do I write the check, or let him try and fail? Do I take that last little bit of independance away? Do I take the keys? Do I let him have a minor accident so HE knows it's time? Do I let him live alone? Do I move him?"
Until May of this year, I let him try and do everything he could. I finished his sentences until 3 days before he died. He got used to it, and I got super good at it. Three days before he died, though, he lost all ability to speak. We went to hand squeezes. Once for "yes", twice for "no".
And there is no doubt in my mind that daddy was "trapped" in there for a long time. Towards the end, he wasn't - there was no one in there. But for waaay too long, he KNEW what he wanted to say, and couldn't. He KNEW what he wanted to do, and couldn't. A month before he died, he spent 2 hours getting from our front door to his car door. A distance of 20 feet. Because he wanted to sit in the driver's seat - one last time. I remotely unlocked the door and watched him shuffle 3" at a time, to the car, open the door, and s l o w l y sit himself down. And he just sat there. Till supper time. Then I went out and helped him back into the house.
And therein lies the cruelty of this horrid, awful disease. Makes this Christian woman want to swear - a lot.
Enough venting from me. I am sad now - missing him ever so much. For all the work, for all the tears, for all the rough times we had, I would give everything I have, and most of my husband's stuff () just to hold his hand one more time..
Mom's ALZ has been diagnosed for 3 years and probably should have been diagnosed at least 3 years before that. So her's has already been 6 years and she's still going strong. Dad's Vascular Dementia has been diagnosed for over 10 years.
The rule of thumb for Alz (other than early onset) is that they have it half of what their normal life expectancy would be if they didn't have it. So the older they get it the shorter the life expectancy.
That's a very interesting statistic. Mom got her first dementia symptoms at around age 90, and lived to be 99. Does this mean that without Dementia (which defnitely killed her, as she stopped eating) she could have lived to be 108?
Or perhaps the statistic doesn't work for the extremely aged population?