Alzheimer's vs. Dementia

Alzheimer's disease is the most common form of dementia, accounting for 60 to 80% of all cases. Dementia is a broad term for neurological conditions that involve some form of serious mental impairment, such as memory loss, confusion, and/or personality changes. Around 20% of dementias can be cured or at least treated, but many dementias that become progressively worse over time are incurable, as is currently the case with Alzheimer's. As such, the outcome for Alzheimer's disease and many forms of dementia is ultimately death. Note: Alzheimer's disease (AD) is also known as Senile Dementia of the Alzheimer Type (SDAT) or simply Alzheimer's.

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Alzheimer's

Dementia

About Disrupts normal brain function, causing dementia. Memory, mental clarity, and at times even language capabilities become increasingly impaired over time. Produces physical changes in the brain, with some areas shrinking and others widening. Not a specific disease, but rather a term that refers to symptoms of mental and communicative impairment found in a variety of brain conditions and diseases, including Alzheimer's. About 20% of dementia can be reversed.
Occurrence Chance of developing Alzheimer's doubles every five years from age 65 to 85. About 5% of cases are caused by a rare and hereditary genetic mutation that results in early onset of the disease, usually between age 30 and 50. Percentage of elderly suffering from some form of dementia increases with age, with 2% of those aged 65-69, 5% of those aged 75-79, and over 20% of those aged 85-90 experiencing symptoms. One third of those 90+ have moderate to severe dementia.
Causes The cause of Alzheimer-related dementia is not known at this time, though hypotheses do exist. Genes, brain injuries, etc. may play major or minor role. Mainly affects elderly, but not a normal part of aging. Dementia can be caused by a variety of illnesses, some potentially very treatable (e.g., nutritional deficiency), others—like Alzheimer's—not. Age is not the cause of dementia, but rather correlated with it.
Symptoms Understood in three stages. Goes from slowly worsening memory loss (early stage), to personality changes and aggression (middle stage), to extreme physical and communicative deterioration (late stage). Memory loss is the earliest and most common sign. Irritability, depression, and other personality changes are also common. In more severe or worsening cases, language difficulties may occur, and spatial understanding deteriorates.
Prognosis Alzheimer's has no cure and slowly worsens until a patient dies. Most patients with Alzheimer's disease will live with the disease for 8-12 years. Depending on the root cause, some dementia (about 20%) may be treated and even cured. However, most dementia is related to Alzheimer's, which is incurable.
Treatment Treatment focuses on slowing the disease's progression through medication, consistent daily routines, cognitive therapy puzzles, gentle physical exercises if the patient is able, etc. Depends on the cause. If treatable or reversible, may be as simple as changing medication dosage or taking a supplement.
Prevention Cannot be prevented with certainty. Healthy eating, staying social, exercising / playing sports with low risk of brain injury, solving puzzles, continuing education may all help, however. Cannot be prevented with certainty. Healthy eating, staying social, exercising / playing sports with low risk of brain injury, solving puzzles, continuing education may all help, however.

Contents: Alzheimer's vs Dementia

edit What is Alzheimer's Disease?

Although early-onset Alzheimer's exists, Alzheimer's is a degenerative brain disease that usually affects the elderly. In a patient diagnosed with Alzheimer's, the brain develops plaques and tangles and loses neurons. Tangles consist of a tau protein, and the plaques result from another protein—amyloid beta—that folds in upon itself and forms long fibers that accumulate.

During Alzheimer's, the brain is disrupted from its normal function, causing dementia. A patient's memory, mental clarity, and at times even language capabilities become increasingly impaired over time. The disease produces physical changes in the brain, with some areas shrinking and others widening. When parts of the brain shrink or widen, the normal connections inside are broken, disrupting electrical signals in the brain.

For an interactive tour of the brain with Alzheimer's, see here.

edit What is Dementia?

Contrary to popular belief, dementia is not a specific disease, but rather a term that refers to symptoms of mental and communicative impairment found in a variety of brain conditions and diseases, including Alzheimer's. About 20% of dementia can be reversed, with the rest being irreversible and tending to worsen with time.

Though dementia and Alzheimer's are more common among the elderly, they are not a normal part of aging. Some cognitive impairment (e.g., minor forgetfulness) is to be expected with old age, but dementia is often the extreme end of impairment that decreases quality of life. In most all cases, older patients with dementia will eventually need long-term, full-time care.

edit Occurrence

Aging is intricately tied to symptoms of dementia and the development of Alzheimer's disease. A person's chance of developing Alzheimer's doubles every five years from age 65 to age 85. Typical symptoms of dementia that are not necessarily tied to Alzheimer's also tend to develop after age 65. The percentage of elderly suffering from some form of dementia increases with age, with 2% of those aged 65-69, 5% of those aged 75-79, and over 20% of those aged 85-90 experiencing symptoms. One third of those 90 and older experience moderate to severe dementia.

Dementia's associated mental and physical decline can be very slow. Most patients with Alzheimer's disease will live with the disease for 8-12 years. A more rapidly progressing form of Alzheimer's known as early-onset Alzheimer's can also affect adults in their late 30s and early 40s. In general, Alzheimer's is thought to be hereditary, but it may skip generations in a family.

edit Causes

Dementia can be caused by a variety of illnesses, some very treatable, others—like Alzheimer's—not. The most difficult factor in either untreatable dementia or Alzheimer's is age and how symptoms worsen with time. Age, however, is not the cause of dementia, but rather correlated with it. The cause of Alzheimer-related dementia is not known at this time, though hypotheses do exist.

The "amyloid cascade hypothesis" has been popular among scientists since the early 1990s as a possible explanation for Alzheimer's. The hypothesis points to beta-amyloid's effects on the brain when the peptides of the protein clump together and form oligomers that may be toxic to brain cells and lead to the development of plaques and tangles. Despite the popularity of this hypothesis and the evidence that supports it, the amyloid cascade hypothesis is not without challenge. In particular, some have pointed out that it is possible for tangles and plaques to develop independently of the beta-amyloid's oligomers.

A smaller camp in Alzheimer's research focuses on tau, the specific protein that forms tangles in the brain, as a cause for Alzheimer's. Tangles are formed in all brains as they age, not just the brains of patients who get Alzheimer's. From The Alzheimer's Enigma, a recently published article in Mosaic:

The spread of tangles [the protein tau] in the brain is much more closely related than plaques [the protein amyloid beta] to the progress of dementia in Alzheimer’s disease. When it was discovered that tau could cause damage, the amyloid hypothesis was updated to accommodate the idea that it might be tau, not amyloid beta, that actually kills nerve cells and causes dementia. “You could call the APP [amyloid] dysfunction the initiator of the whole thing but the tau dysfunction is the executioner,” says Goedert. There are some who go further, however, saying that tau is the real driving force behind Alzheimer’s disease. According to them, the reason the tau gene has not been linked to the disease is that tangles are a natural phenomenon of ageing in the brain. For most of us, this only becomes a problem in old age when the tangles have blocked lots of pathways, similar to the way our muscles become weak in old age. In Alzheimer’s disease, some other factor – maybe faulty or excessive amyloid beta – causes problems to occur earlier and progress faster.

About five percent of Alzheimer-related dementia is caused by a rare and hereditary genetic mutation—sometimes known as familial Alzheimer's disease, or FAD. Early onset symptoms are usually involved with these cases, with those aged 30 to 50 experiencing Alzheimer's symptoms. Mutations on three genes—PS1, PS2, and APP—have been linked to FAD, with PS1 being the most likely culprit. Those with a family history of this form of Alzheimer's or those with independent symptoms at a young age may find out more through genetic testing and genetic counseling.

Traumatic brain injuries are associated with dementia and the development of Alzheimer's. In the U.S., the NFL has come under fire for the high rate of Alzheimer's among retired players.

edit Treatable Causes

While Alzheimer's disease is incurable and its progression is difficult to slow and treat, some of the other illnesses or injuries that cause dementia are treatable, even to the point of full reversal. Some common, treatable causes are found below.

edit Diagnosis

Those concerned that they may be developing cognitive problems should seek medical attention as soon as possible. Only a medical doctor will be able to determine whether impairment is caused by some treatable health problem or by a more serious, degenerative disease, like Alzheimer's.

edit General Dementia Symptoms

It is important to remember that while some forms of dementia are treatable and even reversible, the vast majority of dementia—60% to 80%—is related to Alzheimer's disease.

edit Alzheimer's Symptoms

Alzheimer's disease usually develops late in life and, in some cases, very slowly. This can easily result in the impression that an individual is just aging normally. Because Alzheimer's is a degenerative disease, its symptoms are best understood in stages.

Early stage symptoms may seem relatively normal and harmless at first, but worsen over time. During this stage, a person with Alzheimer's will begin to experience short-term memory problems and will likely struggle to remember recent events, manage personal tasks (e.g., finances, cooking, shopping), and keep track of items. He or she may also become disoriented in once comfortable and familiar places, which can lead to feelings of detachment and depression.

In July 2014, it was announced that scientists in the U.K. have produced a major breakthrough in early diagnosis of Alzheimer's disease. They identified a set of proteins whose presence in the blood can predict the start of the dementia with 87% accuracy.

The middle stage of Alzheimer's is when family members are most likely to notice significant changes in a loved one and will likely need to organize round-the-clock care. Anger, paranoia, inappropriate sexual behavior, hallucinations, and violence can be common in this stage. Questions or phrases may be repeated numerous times, and once simple decisions and activities (e.g., choosing what to wear, remembering to take a bath or eat) become difficult. As the stage progresses, there may be a loss of reading, writing, and arithmetic; verbal and spatial comprehension and abilities may decrease considerably. At this stage, the person with Alzheimer's may no longer consistently remember friends and family.

Late stage symptoms render a person with Alzheimer's nearly unrecognizable to friends and family. The ability to communicate, walk, recognize familiar people and objects, and even smile are likely to disappear. Extreme weight loss may occur, and most of the time the person will only want to sleep. In some cases, he or she will lose the ability to swallow and may suffer seizures. Ultimately, this stage of Alzheimer's, or the variety of other health issues that old age or Alzheimer's itself causes, leads to death.

edit Prognosis and Treatment

Click to enlarge. Later in life, more people die due to Alzheimer's disease.
Click to enlarge. Later in life, more people die due to Alzheimer's disease.

Depending on the root cause, some dementia may be treated and even cured. Alzheimer's, however, has no cure. Alzheimer's treatment instead focuses on slowing the disease's progression through medication (see antidementia agents), consistent daily routines, cognitive therapy puzzles, gentle physical exercises if the patient is able, etc. Consistent, safe emotional and logistic support is best implemented by primary caregivers. For those in care centers, studies have shown that routine visits are beneficial to the patient.

edit Alzheimer's Drugs

The pharmaceutical industry has tried various drugs over the last 15 years to treat or slow down the progression of Alzheimer's disease. A research paper published in July 2014 reached a pessimistic conclusion:

...relatively few clinical trials are undertaken for AD therapeutics, considering the magnitude of the problem. The success rate for advancing from one phase to another is low, and the number of compounds progressing to regulatory review is among the lowest found in any therapeutic area.

Alzheimer's drugs have focused on beta-amyloid protein but have failed to be effective. Some have been withdrawn because their side-effects were too detrimental; others did not show enough of an effect slowing patients’ mental decline. Solanezumab is one of the most recent drugs undergoing testing; it has shown only mild promise but is the first drug to have provided solid evidence that targeting beta-amyloid can slow the disease.

edit The Tau Protein

There is one drug that approaches Alzheimer's treatment by dissolving the tau protein instead of focusing on amyloid beta. This drug — called LMTX and manufactured by TauRx Therapeutics — showed promise in a 2008 trial of 321 patients and is currently under another phase of testing, results for which will be reported in 2015. However, critics and skeptics have asked for results from the 2008 study to be published so they can be peer-reviewed by the scientific community. Until that happens, there is only the manufacturer's word that the drug works.[1]

edit Prevention

Good nutritional and lifestyle choices, including nurturing brain health, may delay, slow, or possibly even prevent Alzheimer's. Evidence suggests several basic measures of prevention may go a long way.

edit Recent News

edit References

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Comments: Alzheimer's vs Dementia

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Anonymous comments (7)

September 30, 2012, 1:10am

If the diagnosis is sure, assisted suicide should be available as an option.

— 99.✗.✗.165
3

November 16, 2012, 10:15pm

I watched my uncle die not long ago of Creutzfeldt-Jacob, and my MIL was just diagnosed with AD. I have told my spouse that if I get it, I will kill myself way before it gets to that stage...and I expect him to help. I would of course do the same for him.

— 74.✗.✗.151
2

July 12, 2012, 5:53am

I recently found out my grandfather has dementia and it's substantially worsening. It's tearing my grandmother and my mother apart. It's so terrible to watch this happen to such an amazing and important person in my life. I think he knows something is wrong but doesn't understand it.

— 108.✗.✗.127
0

June 7, 2012, 5:07pm

I feel bad for people who have this

— 98.✗.✗.201
-1

February 27, 2013, 5:01pm

I am very sorry for your illness, or anyone's illness for that matter. I do not however agree with taking ones life. God gives life and only He has the right to end it. You must endeavor to accept what comes to you. After all He did the worst thing of all for us. Let Himself be crucified for all of us and he was without guilt. My mom has late stage AD and I know how I feel about her and wish her suffering to be over. There is a good reason for all and only God knows why. He does make goodness come out of the bad. Never feel like your suffering is in vain and please do not ever contemplate taking your precious life that was given to youl. Leave it in God's hands and He will guide and be your strengh, even though you may have none of your own. My prayers are with you and for you.

— 71.✗.✗.166
-2

August 31, 2012, 6:01pm

Both my husbands mother and my mother had alzhiemers. To say is scares me to death that it may be in my future is an understatement! I would rather have ANY other form of illness than this. It takes away your dignity and is a very cruel way to have to live your life both for yourself and your loved ones. I pray they find a cure

— 184.✗.✗.12
-2

April 20, 2014, 4:55am

My Mother started exhibiting signs of dementia at the age of 75. She is now 89 and we were forced to enter her into a nursing home about 1 month ago. I was her caregiver for all those years. I've never seen such a slow death. She suffers all the symptoms of the late stages of the disease. She is still mobile (shuffles). My heart breaks every time I visit her. It is so scary to think that I might get this. I've read all the info I can but that doesn't stop the disease. My Father was a minister and when he died of heart failure 30 yrs ago, my Mother, who had been studying for the ministry, was voted in by the church and she was still ministering when this started happening at age 75. It was all down hill from there. Just little bits of her started disappearing. This is a HORRENDUS disease. I just wish it was all over now and she was at rest. She would absolutely hate what she has become. My heart goes out to anyone that has to watch this disease take over someone's body.

— 74.✗.✗.216
-3

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