From an article by Markus MacGill on the website Medical News Today
Dementia: Symptoms, stages, and types
Dementia is a collective term used to describe various symptoms of cognitive decline, such as forgetfulness. It is a symptom of several underlying diseases and brain disorders.
Dementia is not a single disease in itself, but a general term to describe symptoms of impairment in memory, communication, and thinking.
While the likelihood of having dementia increases with age, it is not a normal part of aging.
An analysis of the most recent census estimates that 4.7 million people aged 65 years or older in the United States were living with Alzheimer’s disease in 2010. The Alzheimer’s Association estimates that:
- just over a tenth of people aged 65 years or more have Alzheimer’s disease
- this proportion rises to about a third of people aged 85 and older
- Alzheimer’s accounts for 60-80 percent of all cases of dementia
This article discusses the potential causes of dementia, the various types, and any available treatments.
Fast facts on dementia
- there are an estimated 47.5 million dementia sufferers worldwide
- one new case of dementia is diagnosed every 4 seconds
- dementia mostly affects older people but is not a normal part of aging
Dementia symptoms include memory loss, disorientation, and mood changes.
A person with dementia may show any of the symptoms listed below, mostly due to memory loss.
Some symptoms they may notice themselves, others may only be noticed by caregivers or healthcare workers.
The signs used to compile this list are published by the American Academy of Family Physicians (AAFP) in the journal American Family Physician.
Possible symptoms of dementia:
- Recent memory loss – a sign of this might be asking the same question repeatedly.
- Difficulty completing familiar tasks – for example, making a drink or cooking a meal.
- Problems communicating – difficulty with language; forgetting simple words or using the wrong ones.
- Disorientation – getting lost on a previously familiar street, for example.
- Problems with abstract thinking – for instance, dealing with money.
- Misplacing things – forgetting the location of everyday items such as keys, or wallets, for example.
- Mood changes – sudden and unexplained changes in outlook or disposition.
- Personality changes – perhaps becoming irritable, suspicious or fearful.
- Loss of initiative – showing less interest in starting something or going somewhere.
As the patient ages, late-stage dementia symptoms tend to worsen.
Sometimes, dementia is roughly split into four stages:
Mild cognitive impairment: characterized by general forgetfulness. This affects many people as they age but it only progresses to dementia for some.
Mild dementia: people with mild dementia will experience cognitive impairments that occasionally impact their daily life. Symptoms include memory loss, confusion, personality changes, getting lost, and difficulty in planning and carrying out tasks.
Moderate dementia: daily life becomes more challenging, and the individual may need more help. Symptoms are similar to mild dementia but increased. Individuals may need help getting dressed and combing their hair. They may also show significant changes in personality; for instance, becoming suspicious or agitated for no reason. There are also likely to be sleep disturbances.
Severe dementia: at this stage, symptoms have worsened considerably. There may be a loss of ability to communicate, and the individual might need full-time care. Simple tasks, such as sitting and holding one’s head up become impossible. Bladder control may be lost.
There are several types of dementia, including:
- Alzheimer’s disease is characterized by “plaques” between the dying cells in the brain and “tangles” within the cells (both are due to protein abnormalities). The brain tissue in a person with Alzheimer’s has progressively fewer nerve cells and connections, and the total brain size shrinks.
- Dementia with Lewy bodies is a neurodegenerative condition linked to abnormal structures in the brain. The brain changes involve a protein called alpha-synuclein.
- Mixed dementia refers to a diagnosis of two or three types occurring together. For instance, a person may show both Alzheimer’s disease and vascular dementia at the same time.
- Parkinson’s disease is also marked by the presence of Lewy bodies. Although Parkinson’s is often considered a disorder of movement, it can also lead to dementia symptoms.
- Huntington’s disease is characterized by specific types of uncontrolled movements but also includes dementia.
Other disorders leading to symptoms of dementia include:
- Frontotemporal dementia also known as Pick’s disease.
- Normal pressure hydrocephalus when excess cerebrospinal fluid accumulates in the brain.
- Posterior cortical atrophy resembles changes seen in Alzheimer’s disease but in a different part of the brain.
- Down syndrome increases the likelihood of young-onset Alzheimer’s.
Holidays can be challenging for families affected by Alzheimer’s. Try these tips to make the holidays easier and enjoyable for everyone.
The holiday season can cause mixed feelings for a family affected by Alzheimer’s disease or other dementia.
While typically a time for celebration, families may experience a sense of loss for the way things used to be. For caregivers, the holidays may create added work. You’ll also have to consider the needs of the person with dementia during holiday decorating and gatherings.
By adjusting your expectations and modifying some traditions, you may find meaningful ways to celebrate holidays.
Creating a safe and calm space
To create an appropriate environment during the holidays for the person with dementia:
- Tone down decorations.Avoid blinking lights or large decorative displays that can cause confusion. Avoid decorations that cause clutter or require you to rearrange a familiar room.
- Avoid safety hazards.Substitute electric candles for burning candles. If you light candles, don’t leave them unattended. Avoid fragile decorations or decorations that could be mistaken for edible treats, such as artificial fruits. If you have a tree, secure it to a wall.
- Play favorite music.Familiar or favorite holiday music may be enjoyable. Adjust the volume to be relaxing and not distressing.
Adapting holiday activities
To help the person with dementia enjoy the holidays:
- Prepare together.Mix batter, decorate cookies, open holiday cards or make simple decorations. Focus on the task rather than the outcome.
- Host a small gathering.Aim to keep celebrations quiet and relaxed.
- Avoid disruptions.Plan a gathering at the best time of day for the person with dementia. Keep daily routines in place as much as possible.
- Provide a quiet place.If you are having guests over, provide a quiet place for the person with dementia to have time alone or to visit with one person at a time.
- Plan meaningful activities.You might read a favorite holiday story, look at photo albums, watch a favorite holiday movie or sing songs.
- Keep outings brief.If you’ll be attending a holiday gathering, plan to be brief or be prepared to leave early if necessary. Make sure there is a place to rest or take a break.
Celebrating at a care facility
If your family member lives in a nursing home or other care facility, try these ideas:
- Celebrate in the most familiar setting.Because a change in environment can cause distress, consider holding a small family celebration at the facility. You might participate in holiday activities planned for the residents.
- Minimize visitor traffic.Arrange for a few family members to drop in on different days. A large group may be overwhelming.
Preparing holiday visitors
To help visitors prepare for holiday time with a person with dementia:
- Provide an update.Let guests know ahead of time about any changes in behavior or memory since their last visit. Providing a recent photo can help people prepare for changes in appearance.
- Offer communication tips.Suggest ways for guests to listen patiently, such as not criticizing repeated comments, not correcting errors and not interrupting.
- Suggest activities.Tell guests ahead of time what activities you have planned or suggest something they might bring, such as a photo album.
Taking care of yourself
Self-care is crucial for caregivers during the holidays. To make the season enjoyable:
- Pick and choose.Focus on the holiday activities and traditions that are most important to you. Remember that you can’t do it all.
- Manage others’ expectations.Set realistic expectations for what you can contribute to family holiday celebrations.
- Let family and friends help with cleaning, addressing cards and shopping for gifts.
- Make time for yourself.Ask a family member or friend to give you a break so that you can enjoy a holiday outing without caregiving responsibilities.
Trusting your instincts
Simplifying celebrations, planning ahead and setting boundaries can help you minimize stress and create a pleasant holiday experience for you and the person with dementia.
The First Survivor is Out There
This year’s Walk to End Alzheimer’s was held on October 26, 2019 and according to Sonya Branco, Development Director at the local Alzheimer’s Association, it was a resounding success. The San Luis walk that began on a beautiful day in Mission Plaza is the largest in the county and gathered more than 600 participants.
“One of the largest teams is organized by the Sigma Kappa Sorority girls who raised almost $50,000 this year for the fifth year in a row,” said Branco.
Sydney Creek Memory Care also made a good showing, raising $1500 and bringing three of its residents to the Walk. Community Relations Coordinator, Danny Danbom (pictured), led the team and carries the banner for quality care for residents and families at Sydney Creek.
There are about 10,000 people in our county who suffer from dementia. Your Alzheimer’s Association provides care and support to families dealing with any type of dementia. This includes 11 support groups each month county-wide, and more than 90 classes each year. They also offer a Respite grant for families who cannot afford home care.
This year’s goal for the county was $182,000. “We are currently at $142,000 and will be taking donations until the end of the year,” said Branco. “You can donate at act.alz.org/slo and it is completely tax deductible.”
Like the TV ad says, “The first survivor of Alzheimer’s Disease is out there. But we can’t do it without you.” # # #
Take a Walk with Us!
As the optimistic TV ad currently claims, “The first survivor of Alzheimer’s Disease is out there,” and in the next breath states, “But we won’t get there without you.”
In the U.S. alone, someone develops Alzheimer’s Disease every 65 seconds; more than 5 million Americans are already living with the disease; and it’s the 6th leading cause of death in this country.
The stats are daunting, and the ripple effects are impossible to calculate. Established in 1980, The Alzheimer’s Association has been working tirelessly to help those afflicted, support their loved ones, and find a cure. And they need your help. One of the best ways is by participating in their largest fundraiser, The Walk to End Alzheimer’s.
Held annually in more than 600 communities nationwide, the Alzheimer’s Walk is scheduled in our town, San Luis Obispo, on Saturday, October 26th. You can register online ahead of time at https://act.alz.org/site or just show up and register on site at 9 a.m. at Mission Plaza, 751 Palm Street. A moving ceremony will begin at 9:30 and the Walk itself starts at 10 a.m.
No matter your age, gender, or fitness level, the Walk to End Alzheimer’s welcomes all participants, and though it’s inspiring to join a team and the other walkers at the event, you don’t even have to actually walk to show your support. Just call Sonya Branco at 805-547-3830 or email her at Sbranco@alz.org for more information. The Village at Sydney Creek has formed a team of walkers (one of many!) and you can join them, too. Just Google The Walk to End Alzheimer’s in San Luis Obispo and you’ll be taken to a website where you can find a team and join it.
“When you participate in the Walk,” says the website, “your fundraising dollars fuel our mission, and your participation in the event helps to change the level of Alzheimer’s awareness in your community.”
Take a walk with us on October 26th and help us find the first survivor of Alzheimer’s Disease.
This article is reprinted from the Alzheimer’s Associations website: www.alz.org dated Chicago, June 2019
New Alzheimer’s Campaign Encourages Families to Discuss Cognitive Problems Sooner, Enabling Early Diagnosis
It’s a conversation no family wants to have — talking to a loved one about memory loss or cognitive decline. Close family members are typically the first to notice memory issues or cognitive problems, but they are often hesitant to say something – even when they know something is wrong. A new survey released today by the Alzheimer’s Association reveals that nearly 9 in 10 Americans say they would want others to tell them if they were showing signs of memory loss, thinking problems or other symptoms of cognitive decline. However, nearly 3 in 4 Americans say that talking to a close family member about memory loss, thinking problems, or other signs of cognitive problems would be challenging for them.
During Alzheimer’s & Brain Awareness Month this past June, the Alzheimer’s Association aimed to bridge the current communication gap with tools to help people talk about cognitive concerns sooner. A new national campaign created in partnership with the Ad Council is the first-ever collaboration between the two groups and features real stories of people who noticed cognitive changes in a family member and took the first, difficult step to initiate a conversation. Designed to help encourage conversations that may be difficult but could prevent a crisis and improve health options and outcomes, the campaign was created pro-bono by the community.
“Discussing Alzheimer’s is challenging for families and this campaign tackles the issue directly,” said Michael Carson, Chief Marketing Officer, Alzheimer’s Association. “Initiating conversations sooner can enable early diagnosis, which offers many important benefits, including allowing more time for critical care planning, better disease management and providing diagnosed individuals a voice in their future care. The ad campaign is designed to encourage and empower people to have productive conversations before a crisis occurs.”
Every 65 seconds someone in the United States develops Alzheimer’s disease. It is America’s sixth leading cause of death, affecting more than 5 million Americans and 16 million caregivers. Despite Alzheimer’s growing impact, many families struggle with discussing the issue.
Ed Ortiz, 52, from St. Helena, Calif., featured in the ad campaign, recalls the moment he knew it was time to have a conversation with his mother Cynthia Guzman. “My mom stopped at a stop sign and didn’t know what to do next,” he said. “It was an unsettling moment for both of us, but I knew she needed help.”
Guzman’s indecisive moment behind the wheel helped start a conversation that ultimately led to her Alzheimer’s diagnosis at age 63; she has had the diagnosis for eight years. “As difficult as it was receiving my diagnosis, I was grateful to have my son’s support,” she said. “He reassured me and he has been there for me ever since.”
“It’s understandable that many families are reluctant to express their concerns and initiate a conversation, but there are good reasons to do so,” said Ruth Drew, director of information and support services, Alzheimer’s Association. “Early detection and diagnosis puts individuals and families in the best position to navigate a devastating disease. Avoiding the conversation and letting problems progress is the worst thing you can do.”
The campaign demonstrates the importance of family members trusting their instincts and proactively raising concerns. The message, “When something feels different, it could be Alzheimer’s – now is the time to talk,” will be important for shifting people from being passive when they observe potential symptoms, to taking an important step and having a conversation.
By highlighting heartfelt, relatable stories of people who have been diagnosed with Alzheimer’s, this new critical campaign will help ease the challenges associated with starting this difficult conversation. We hope it will encourage audiences to notice the signs early, trust their gut, and have a talk. Having this conversation early can make a big difference in the lives of those who have been diagnosed and their families,” said Lisa Sherman, president and chief executive officer of the Ad Council.
Video stories of caregivers, including Ortiz, who saw the signs and started a conversation, are designed to help illustrate how other families can do the same. Additionally, the campaign’s website (ourstories.alz.org) offers families tools and resources, including customizable conversations starters, a list of early signs and symptoms of Alzheimer’s, benefits of early diagnosis, a downloadable discussion guide and other resources.
In addition, the Alzheimer’s Association helps families and friends navigate challenges and considerations at each stage of the disease, through face-to-face conversations with experts in local communities, our free 24/7 Helpline (800.272.3900) and comprehensive support and resources on alz.org. # # #
Last month, experts from around the world gathered to discuss the very latest studies, findings, and clinical trials in the field of Alzheimer’s Disease and other dementias. Here is just one highlight among many. (repinted from the website www.alz.org)
LOS ANGELES, JULY 14, 2019 — Research presented at the Alzheimer’s Association International Conference (AAIC) 2019 in Los Angeles suggests adopting multiple healthy lifestyle habits provides high levels of benefit for brain health, and may offset genetic and environmental risks of Alzheimer’s disease and other dementias. These reports were some of the most promising and hopeful among a record number of scientific studies presented at the conference that use diverse approaches to uncover the causes, progression, risk factors, treatment and prevention of Alzheimer’s disease and other dementias.
Lifestyle Interventions Can Offset Elevated Alzheimer’s Risk
New research reported at AAIC 2019 suggests that adopting multiple healthy lifestyle choices, including healthy diet, not smoking, regular exercise and cognitive stimulation, may decrease the risk of cognitive decline and dementia. One study reported that participants who adopted four or five low-risk lifestyle factors had about 60% lower risk of Alzheimer’s dementia compared with participants who did not follow any or only one of the low-risk factors.
Two studies showed that actionable lifestyle changes could potentially counteract elevated risk for Alzheimer’s disease. In one report, researchers showed that participants with a high genetic risk for Alzheimer’s following a “favorable” lifestyle had a 32% lower risk of all-cause dementia compared with an “unfavorable” lifestyle. Another report confirmed that living in locations with high air pollution increased the risk for Alzheimer’s and other dementias. However, it also found that older women with higher cognitive reserve – based on cognitive function scores, years of education, job status and physical activity – only showed a 21% increased environmental risk compared with a 113% increased risk for those with lower cognitive reserve.
Other new data presented at the conference included: Advances in emerging blood biomarkers that may support early detection, improved diagnosis and enhanced clinical trial recruitment for Alzheimer’s and other dementias, and other neurodegenerative diseases.
Visit www.alz.org to read more about the conference and all that the Alzheimer’s Association is doing to study, treat, and find a cure.
CBD Oil and the Treatment of Alzheimer’s Disease
~ from the May, 2019 issue of the Alzheimer’s Association Newsletter, Caregiver Tips & Tools
Cannabidiol (or CBD) is one of over a hundred cannabinoids (or compounds) found in the cannabis plant, commonly known as marijuana. CBD is a non-intoxicating compound that has some therapeutic attributes, including relief for chronic pain, anxiety, inflammation, depression and other conditions. Earlier this month the Food and Drug Administration (FDA) sent letters to manufacturers of CBD products who it says are making claims their products prevent, treat, or cure serious diseases, such as cancer, Alzheimer’s disease, psychiatric disorders and diabetes.
The Alzheimer’s Association does not take a position for or against the legalization of marijuana for medical or personal use. It is not currently an issue in our mission. The Alzheimer’s Association’s mission is to eliminate Alzheimer’s disease through the advancement of research, to provide and enhance care and support for all affected, and to reduce the risk of dementia through the promotion of brain health. The chemical components of marijuana have been studied in relationship to Alzheimer’s/dementia for many years. Research findings to date have been inconclusive, and sometimes contradictory.
The Alzheimer’s Association welcomes the commitment of the FDA in cracking down on unlawful marketing of cannabidiol products. There is no credible research that supports the claim that a CBD product or other cannabinoids help prevent, treat or cure Alzheimer’s disease or other dementias. Furthermore, these products and compounds are not approved by the FDA for the treatment, cure or prevention of Alzheimer’s or other dementias.
The Alzheimer’s Association supports all legitimate avenues of research – from basic research through clinical trials. This includes investigating the chemical components of marijuana and many other plants; plants have historically been an important source for medicines. In the last several years, the Alzheimer’s Association funded two clinical trials in this area. Some preliminary studies have identified:
- possible anti-inflammatory and antioxidant effects,
- possible reduced production and increased clearance of beta amyloid from the brain,
- possible protection of brain cells and
- suggestions of benefits for age-related memory loss in animal models of Alzheimer’s.
There is some research to suggest certain cannabinoids are useful in treating the noncognitive symptoms in dementia, including agitation, depression and anxiety. Research reported at the Alzheimer’s Association’s International Conference in 2018 included the results of a randomized, double-blind clinical trial of nabilone – a synthetic cannabinoid – that may be effective in treating agitation in people with moderate to severe Alzheimer’s.
Neither nabilone nor marijuana is approved by the FDA for the treatment or management of Alzheimer’s disease or other dementias. The Alzheimer’s Association believes that more research in this area is needed. # # #
Maybe It’s Something Else [from the May 2019 issue of Caregiver, published by the Alzheimer’s Association]
By Marcy Maher, MA
Maybe it’s something else: That’s what might come to mind if an older person begins to lose her memory, repeat herself, see things that aren’t there, lose her way on routes she’s traveled for decades. Maybe it’s not dementia. And sometimes, thankfully, it is indeed some other problem, something that mimics the cognitive destruction of Alzheimer’s disease or another dementia—but, unlike dementia, is treatable and fixable.
Sudden changes in a person’s mental state in the course of a few days or weeks, are not typical of a degenerative disease.
- Depression and anxiety are among the leading culprits. Like dementia, they can interfere with the ability to concentrate and remember.
- Thyroid problems are suspect as well. The thyroid has a huge effect on the brain and can be relatively easily tested for and relatively easily fixed with daily medication.
- Vitamin deficiencies probably qualify as the most hoped-for scenario. Cognitive problems caused by lack of vitamin B1 (thiamine) or B12 are reversible with pills or injections.
- Heavy drinking also causes memory loss. After years of alcoholism, one may not be able to repair the damage, but one can prevent it from getting worse.
Older people can suffer from any of these problems along with the actual symptoms of dementia. Treating secondary causes may at least slow, although not stop, the progression of cognitive decline. Often medical professionals will scan the brain, do blood tests, and look for other conditions that may be causing dementia-like symptoms in the event that treatment of these can be effective.
On the other hand, realistically, it might not be something else. Even though the list of other possible explanations is long, so are the odds against restoring a patient to normal functioning. When it looks like dementia, most of the time it is.
Almost 40 percent of people over the age of 65 experience some form of memory loss. When there is no underlying medical condition causing the memory loss, it is known as “age-associated memory impairment,” which is considered a part of the normal aging process. However, diseases like Alzheimer’s and other dementias are different and they progress very slowly over time.
The first symptoms of progressive dementia may vary from person to person. Memory loss is typically among the first signs of cognitive impairment related to progressive dementia. As the disease progresses, people experience even greater memory loss as well as other cognitive difficulties.
FDA Warns Against False Alzheimer’s Cures
By Susan Stewart
Given the rising numbers of people affected by Alzheimer’s Disease and other dementias, it’s natural to want to grab onto anything that claims to stop, treat, or cure it. Today, Alzheimer’s Disease affects more than 5 million Americans, and that doesn’t count the millions more (loved ones and family members) also affected. But please, don’t be fooled by false or fake claims that any drug or supplement can cure or stop Alzheimer’s.
In an article from the April, 2019 issue of AARP Bulletin, the FDA is quoted, issuing a strong warning to the $40 billion-dollar dietary supplements industry. “These products may prevent a person from seeking an appropriate diagnosis and treatment,” it says, referring to companies that claim their products can cure Alzheimer’s. “So far, NO DRUG [or supplement] has proved effective at stopping or treating the disease.”
While we await the ongoing research and subsequent hopes for a cure (or at least a proven effective treatment), we can take heart in knowing that communities do exist that offer respite, peace, and quality of life for people with dementia. Expert staffs, compassionate caregivers, and warm, homelike settings can greatly improve the day-to-day lives of dementia sufferers and their families.
Our best hope lies in being informed, engaged, and supportive. At Sydney Creek, we pride ourselves on staying abreast of all the newest developments and we’re glad to act as a resource for our families and the public. When in doubt, ask!
MCI … or Dementia? Understanding the difference
By Susan Stewart
As we seek out housing and care for our aging loved ones, it’s important to understand the difference between Mild Cognitive Impairment (MCI) and dementia. Some communities can accept residents with MCI but not dementia. Others can accept both. Here is what the California Assisted Living Association (CALA) and the Alzheimer’s Association have to say about them.
“Mild Cognitive Impairment (MCI) refers to people whose cognitive abilities are in a “conditional state” between normal aging and dementia. Normal age-related memory changes can include forgetting a person’s name or the location of an object; however, individuals with MCI have difficulty with short-term memory loss. MCI is a state in which at least one cognitive function, usually short-term memory, is impaired to an extent that is greater than would be anticipated in the normal aging process. MCI is characterized by short-term memory problems, but no other symptoms of dementia (e.g. problems with language, judgment, changes in personality or behavior) that affect a person’s daily functioning. Individuals with MCI may experience some difficulty with intellectually demanding activities, but lack the degree of cognitive and functional impairment required to meet the diagnostic criteria for dementia.”
“Dementia means the loss of intellectual function (such as thinking, remembering, reasoning, exercising judgment and making decisions) and other cognitive functions, sufficient to interfere with an individual’s ability to perform activities of daily living or to carry out social or occupational activities. Dementia is not a disease itself, but rather a group of symptoms that may accompany certain conditions or diseases, including Alzheimer’s Disease. Symptoms may include changes in personality, mood, and/or behavior. Dementia is irreversible when caused by disease or injury, but may be reversible when caused by depression, drugs, alcohol, or hormone/vitamin imbalances.”