Natural Aging, Dementia or Alzheimer's: The Causes, Symptoms, and Diagnosis

There are several forms of dementia, with the most common one being Alzheimer's. Dementia is caused by the destruction of brain tissue and brain function including memory, reasoning, and learning. It is the progression, symptoms, and patient history that help the physician to determine the type of dementia. Medical tests and mental evaluations are needed in all cases to properly diagnose dementia symptoms.

Normal Aging or Dementia? As we get older, our memory often is not as sharp. How are normal aging symptoms different from more severe forms of dementia. Signs of normal aging may include misplacing keys, wallet, or purse at times; having trouble remembering names of people that you don't see often; more difficulty driving in unfamiliar places; and occasional difficulty with recall of names and information.

In normal aging, memory symptoms are mild and do not affect the individual's personality, job, hobbies, or activities. There is no problem remembering important events, conversations, and activities. Conversations, logical thinking, judgment and social skills are unaffected. My husband plays bridge. If he suddenly or slowly became unable to play, I would know something was wrong. Occasional memory problems may be a factor of stress, depression, adult ADHD, menopause, illness, or dyslexia. I have dyslexia so names, recall and directions have always been difficult. Car accidents and falls may cause temporary or long term memory loss. The loss of a loved one will impair ability in all these functions.

Memory Problems That Indicate A Serious Problem: Confusion driving in familiar places; problems remembering the names of family or friends; difficulty in dressing, making phone calls, cooking, solving simple math problems and making simple decisions; leaving your car without any recollection of where you left it; inability to remember daily events: inability to function at any normal daily task; personality and behavior changes; suspicious, paranoid, or odd behavior.

Tests To Diagnose The Cause of Dementia: Blood and urine tests are taken to rule out metabolic problems such as thyroid disorders, infection, Parkinson's, brain cancer and other medical problems. The patient is given a physical exam to test for physical sensation, balance, and central nervous function. A brain scan may be ordered to determine if the patient has suffered a stroke, vascular problem, or has brain cancer. A psychiatric exam (Mini-Mental State Examination or MMSE) is given to assess the person's mental state. The patient's medical and family history is evaluated.

Alzheimer's Disease: It is estimated that 5 million people have Alzheimer's which is not a normal part of aging. Alzheimer's is the cause of 50% of dementia cases in patients over 85 years of age. Symptoms may worsen quickly or get worse slowly over many years. There are many theories on what causes it with links to diabetes, obesity, genetics, aluminum toxicity, and lack of both mental and physical exercise. At this time, scientists are not absolutely sure what causes this form of dementia.

The Three Main Stages of Alzheimer's are mild, moderate, and severe. The Functional Assessment Staging Scale is one of the tools used to determine the stage the Alzheimer's patient is in. The scale determines the severity of the level of memory loss, agitation, behavior problems, intellect, reasoning problems, and ability to perform daily activities.

Mild Alzheimer's Symptoms include difficulty learning or remembering new information; increased difficulty in managing finances, meals, and medication; memory loss relating to familiar events, people, or activities. There may become anti-social or depressed.

Moderate Symptoms include forgetting past experiences; repeating stories or questions over and over; difficulty dressing, using the toilet or shower; increased problems in logical thinking and behavior; patient makes up stories about events or activities; restlessness; repetitive movements and behaviors; wandering; paranoia; delusions; hallucinations; inattention to appearance and cleanliness; insomnia and wandering at night.

Severe Symptoms include failure to recognize spouse, family and friends; anger and aggressive mental and physical behavior; incoherent speech and sounds; inability to control physical behavior; problems in eating; inability to dress, walk, talk, or take care of personal needs. Patient requires locked confinement to avoid wandering off. They have no memory left at all in the end. This progresses to death. The brain controls the ability to swallow and breathe. Certain drugs like Aricept and Nameda can delay the onset and progression of Alzheimer's.

Vascular Dementia: the 2^nd most common form of dementia (10-20%) after Alzheimer's. It is called 'multi-infarct dementia' and is usually caused by a stroke or TIA(mini-stroke). Multiple areas of the brain are damaged. The onset of the mental symptoms is usually sudden. Signs of a TIA or stroke include: one part of the face or eyelid droops; sudden inability or difficulty to talk; abnormal reflexes; sudden confusion in a person normally sharp; and decreased use of one area of the body or many areas. TIA's and strokes may cause Alzheimer's, or cause Alzheimer's to get worse. A stroke often precipitates mental and physical decline. This form of dementia can be diagnosed from a CT Head Scan or MRI of the brain. Often the patient has had a history of previous strokes, TIA's, hypertension, smoking, or diabetes.

Frontotemporal Dementia or Pick's Disease: caused from more than one factor including genetics. It affects women more often. This type of dementia causes severe atrophy in the frontal or anterior temporal area of the brain. Pick's Disease tends to start earlier than Alzheimer's and Vascular dementia. Symptoms include personality changes rather than memory impairment; vivid visual hallucinations; sensitivity to Neuroleptic drugs; dysphasia; fluctuating cognitive impairment; and lewy bodies present in the brain;

Huntington's Disease: can be present is patients as young as 20. It occurs in all age groups and has strong genetic links. Huntington's disease causes gradual damage to specific areas of the brain. Early onset symptoms include psychiatric symptoms, paranoia, and depression. Huntington's Disease is associated with chorea, a movement disorder. This form of dementia can be evaluated by genetic testing and medical tests.

Normal Pressure Hydrocephalus: caused by interference with the cerebrospinal fluid in the brain such as hemorrhage or meningitis. This fluid in the brain may cause memory impairment, gait disturbances and urinary incontinence. It is diagnosed by a neurosurgeon with a brain scan and brain pressure testing. The treatment is surgery to drain the excess fluid from the brain.

Secondary Dementia: associated with another medical problem such as poor nutrition, medication side effects, dehydration, Parkinson's Disease, HIV, cancer, deficiencies of Folic acid, thyroid hormone or B12. Memory and mental symptoms can also be related to mercury or heavy mental poisoning. I knew a couple both with early Alzheimer's whose main occupation for 20 years was creating stained glass for churches which involves lead. Other occupations that involve dangerous chemicals and metals should be considered.

Alcohol-Related Dementia (Korsakoff's Psychosis): usually associated with the chronic abuse of alcohol. This abuse of alcohol causes a deficiency of vitamins including Thiamine. It also causes interference with the metabolism of many vitamins. Symptoms include severe memory impairment, lack of short-term memory, disorientation, ataxia, tremors, and coma. Korsakoff''s Psychosis may also be caused from severe malnutrition, eating disorders, mercury poisoning and chemotherapy.

If you or your loved one is experiencing memory problems, see a physician for diagnosis. Don't wait until the symptoms become severe. There are references below to research this further. Early treatment can delay or slow down progression of dementia.

References:

www.webmd.com/alzheimers/guide/alzheimers-dementia

www.medicinenet.com/dementia/article.htm

http://www.helpguide.org/elder/alzheimers_dementias_types.htm

http://www.aricept.com/seeingsignsguide.asp

http://www.vivaprime.com/health/mental-health/alzheimers.aspx

psychcentral.com/lib/2006/what-is-dementia/

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