Memory loss and dementia

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Defining dementia and Alzheimer’s disease

Dementia is a general term related to decline in mental ability that interferes with a person’s everyday activities. Dementia affects an individual’s memory as well as the ability to think, reason, speak and move. Dementia symptoms often start out slowly and worsen over time.

The two most common forms of dementia that can’t be reversed are:

• Alzheimer’s disease, accounting for 60 to 80 percent of cases
• Vascular dementia, occurring after a stroke and due to blocking or reduction of blood to the brain

Some other types of irreversible dementia include:

• Lewy body dementia
• Frontal-temporal lobe dementia
• Huntington’s disease
• Creutzfelt-Jakob disease

Although these dementias have some common symptoms, each type affects the brain differently. “Mixed dementia” is when an individual has more than one dementia. Examples include:

• Alzheimer’s disease and vascular dementia
• Lewy body and vascular dementia

Some conditions such as thyroid problems, vitamin deficiencies or interactions with medications can cause dementia symptoms. However, these conditions can be treated.

Dementia is not a part of normal aging. However, your risk for dementia increases as you age. It is often referred to as “senility” or “senile dementia.” These terms wrongly imply that mental decline is a normal part of aging.

Common warning signs of Alzheimer’s disease

Alzheimer’s disease or other dementia affects people differently. However, there are some common warning signs. As we age it is normal to have some memory problems; an example is forgetting the name of a person we recently met. However, dementia symptoms tend to start gradually and worsen over time. The person eventually finds it hard to carry out daily tasks.

A physician should evaluate a person who shows any of the following signs:

• Memory loss
  It is hard to remember recent events or new information, important appointments or names of people seen every day. Objects are misplaced.
• Confusion about time and place
  Person loses track of dates, seasons, time and location.
• Hard to do familiar tasks at home, work or leisure
  It is hard to complete normal daily tasks such as cooking, laundry, dressing or teeth brushing. Doing hobbies may be difficult.
• Problems with speaking and/or understanding
  The person has a hard time finding the right words, completing sentences and following conversations and directions.
• Decreased or poor judgment
  Changes in judgment may cause the person to be open to scams. Examples are those that lead to giving away large amounts of money.
• Difficulty with complex mental tasks
  It may be hard to balance a checkbook or do other complex tasks.
• Changes to mood and personality
  It’s hard for the person to understand what is happening to him or her.
  Mood and personality changes such as confusion, depression, suspicion, fearfulness and anxiety may result. The person may be easily upset at home, work or places outside a comfort zone. He or she may withdraw from social activities.
• Trouble understanding images and relationship to spaces
  It may be hard to read, judge distance and determine color or contrast. This can cause problems with driving. The person is also a greater fall risk.

Diagnosis

Family or friends may first notice these symptoms. People with memory loss may resist going to a doctor. You can often find free screenings at health fairs or other places. They can help people understand the value of seeing a physician.

Most people will contact their own physician. That doctor will often oversee the diagnosis process. The physician may refer the person to a specialist who diagnoses and treats dementia. The person must feel comfortable with the doctor.

No single test determines whether a person has Alzheimer’s disease or most other types of dementia. However, physicians can almost always decide if the person has dementia by:

• Doing a thorough medical history
• Testing the person’s mental status
• Examining physical and brain functions
• Doing blood and other tests and brain imaging to rule out other causes besides dementia

Bring the physician a list of questions and the person’s symptoms. Go to www.alz.org for tips on the diagnosis process and how to prepare for the visit.