Understanding Dementia and Alzheimer’s Disease

Cognitive decline is a complicated and scary subject. It’s something that happens in some degree to everyone and is a normal part of aging. For many people, the decline is slow and characterized by difficulty concentrating or multitasking, finding the right word, or remembering things. These symptoms have no serious impact on a person’s ability to carry out activities of daily living.

However, more severe symptoms are not normal and are considered signs of dementia. These include forgetting things, getting lost while driving or walking, difficulty solving simple problems, changes in eating habits, increased apathy, and doing things that are not considered socially acceptable. In addition, a person with dementia may also experience physical symptoms, including a loss of motor skills leading to tremors or excessive trips and falls.

People who have dementia, explains Dr. Ken Dolkart, a geriatrician at Mount Ascutney Hospital, “not only have these impairments, but they also have impairment of function. A person with dementia may no longer be able to perform activities of daily living,” including things like shopping, cooking, or taking care of their hygiene.

Dementia is not considered a normal part of aging. However, the older people get, the more likely they are to develop dementia. More than half of all people age 85 and older suffer from it. Family history, high blood pressure, diabetes, alcoholism, and factors that increase the risk for cardiovascular disease, like limited physical activity, increase the likelihood that a person will develop dementia.

Dementia is a catch-all term that covers several disorders in which severe memory impairment is a common symptom. One of those disorders is Alzheimer’s disease, the most common form of dementia. Of people diagnosed with dementia, Alzheimer’s disease is the cause in 60% to 80% of cases.

The difference between some types of dementia and Alzheimer’s disease, Dr. Dolkart explains, has to do with the nature of changes to the brain and with memory. The brain of a person with some types of dementia can make a memory but has a hard time accessing it. For a person with Alzheimer’s disease, the brain often does not create the memory, and therefore, it cannot access it.

Making a diagnosis

“A lot of times, a clinician following a patient may not pick up that the person has dementia,” says Dr. Dolkart, “unless he or she has input from family members.” That is because people with dementia don’t often recognize their cognitive decline or may simply not report it to the doctor. It’s crucial, then, for family members to attend appointments to discuss their loved one’s cognition, impairments in function, and physical symptoms.

For Alzheimer’s disease,” Dr. Dolkart says, “the first signs are short-term memory deficits.” For people with dementia, the other symptoms mentioned above (getting lost or solving simple problems), are telltale signs

If dementia is suspected, the patient should visit his or her primary care physician. The doctor will do tests to evaluate his or her short-term memory. In some of these tests, the patient is asked to remember a list of words or answer simple questions about items on that list. The doctor will also try to rule out other conditions like thyroid problems, kidney failure, vitamin B12 deficiency, or depression. A CAT scan or MRI can help exclude other issues or identify abnormalities to the brain that point to dementia. After making a diagnosis, the doctor may refer the patient to a specialist, such as a neurologist, a geriatrician, or a psychiatrist.

Though there is no cure for dementia or Alzheimer’s disease, a diagnosis can help the doctor and patient manage these conditions and their impacts on the patient’s life.

Here are some organizations and resources to help you learn more about dementia, Alzheimer’s disease, and support for patients and caregivers.

Local resources
Alzheimer’s Association: alz.org/Vermont

Information for caregivers
Alzheimer’s Association: alz.org/help-support/caregiving

Information on aging
Senior Solutions seniorsolutionsvt.org/resources

This information is presented by the Ottauquechee Health Foundation. The foundation strives to improve the health and well-being of people living in the towns it serves.