I’ve had several close family members develop dementia in recent years, and it’s a very difficult and heartbreaking deterioration to witness firsthand. Some received the diagnosis of Alzheimer's disease while others didn’t, and I wondered about the difference between the two. Many people believe that dementia and Alzheimer’s disease are one in the same. I discovered these disorders differ in that dementia is not a distinct disease, but is instead a general term describing cognitive decline, while Alzheimer’s is a specific brain disease that causes dementia. Let’s dig deeper…
Dementia is an umbrella term used to describe a group of symptoms that affect an individual’s ability to perform everyday activities independently (Graff-Radford, n.d.). Dementia is not a normal part of aging but increasing age is the strongest known risk factor. Other risk factors include family history, race/ethnicity (higher risk in African Americans and Hispanic individuals), hypertension, high cholesterol, smoking, and severe traumatic brain injury.
Symptoms of dementia include:
- Deterioration in memory
- Alteration in thinking/reasoning skills and judgment
- Reduction in focus and attention
- Changes in speech and demeanor
Certain causes or types of dementia cause a progressive physiologic change to neurologic function. These include (Alzheimer’s Association, n.d.; Graff-Radford, n.d.):
- Alzheimer’s disease
- Lewy body dementia
- Frontotemporal dementia
- Vascular dementia
- Chronic traumatic encephalopathy
- Parkinson’s disease dementia
- Hippocampal sclerosis (HS)
- Creutzfeldt-Jakob disease
- Huntington’s disease
- Mixed dementia (brain changes are associated with more than one cause)
Some individuals develop dementia-like symptoms without
progressive brain changes. The causes of dementia-like symptoms include depression, untreated sleep apnea, delirium, medication side effects, Lyme disease, thyroid issues, vitamin deficiencies, and excessive alcohol use (Alzheimer’s Association, n.d.). These conditions may be reversed with treatment.
Alzheimer’s disease (AD) is a neurodegenerative disorder and the most common form of dementia (Wolk & Dickerson, 2021). According to the Alzheimer’s Association (n.d.), there were approximately 6.5 million people in the U.S. age 65 and older living with Alzheimer’s dementia in 2022. Symptoms can first appear after age 60, and the risk increases with age (Centers for Disease Control and Prevention, 2020). Younger individuals may develop Alzheimer’s, but it is much less common.
Researchers continue to uncover various brain changes that develop with Alzheimer’s disease. Two of these changes are the accumulation of the protein beta-amyloid into clumps (plaques) outside of neurons and the accumulation of an abnormal form of the protein tau (tau tangles) inside neurons. This accumulation of proteins results in damage and destruction of neurons (Alzheimer’s Association, n.d.). The proteins can also trigger additional brain abnormalities such as inflammation and atrophy or loss of brain cells. In addition, a rare genetic mutation called dominantly inherited Alzheimer’s disease (DIAD) has been identified in some individuals.
Management of Alzheimer’s Disease and Dementia
The Alzheimer’s Association provides several recommendations to proactively manage Alzheimer’s and other dementias to improve the quality of life of patients and their caregivers.
- Seek available treatment options (i.e., new drugs, physical activity, diet, and cognitive training).
- Manage coexisting conditions (i.e., heart disease, stroke, other types of dementia)
- Manage common behavioral symptoms (i.e., insomnia, agitation, anxiety, and aggression).
- Provide family caregivers with training in managing the daily life of the patient.
- Coordinate care among health care providers and professionals.
- Encourage activities that are meaningful to the individual with dementia.
- Help the individual maintain a sense of self identity and relationships with others.
- Connect the individual and family with others through support groups and services.
- Educate caregivers about the disease.
- Help the individual and caregivers plan for the future.
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