Alzheimer's & Dementia

The word dementia means deprived of mind. It is a catchall term that covers memory loss, confusion, changes in personality, a decline in thinking skills, and dwindling ability to perform everyday activities.

There are many types of dementia. Alzheimer's disease is the most common. Half or more of people with dementia have Alzheimer's disease. It is caused by the accumulation of tangles and clumps of protein in and around brain cells. These tangles and clumps make it difficult for brain cells to communicate with one another, and can eventually kill them.

Vascular dementia, the second most common type, develops when cholesterol-clogged arteries can't deliver enough oxygen-rich blood to the brain. Sometimes small blockages completely cut off the blood supply to a part of the brain, causing nearby brain cells to die.

The terms dementia and Alzheimer's are often used interchangeably. In part, that's because it is very hard to tell them apart. Usually, a specific type of dementia can only be diagnosed by an autopsy after someone has died.

Dementia affects areas of the brain involved in learning and memory. So a common symptom is difficulty in recalling new information. Memory loss disrupts daily life. An individual with dementia may get lost in a once-familiar neighborhood. He or she may have increasing trouble making decisions, solving problems, or making good judgments. Mood and personality may change. A person with dementia can become more irritable or hostile, or lose interest in almost everything.

Once dementia has developed, it is usually hard to reverse. The goal of treatment is to manage symptoms and slow its progression. Some medications can help slow the intellectual decline in mild to moderate dementia. Psychotherapy techniques like reality orientation and memory retraining can also help people with this condition.

A small percentage of people with dementia develop the condition because of medical issues such as an underactive thyroid gland, an infection, not getting enough vitamin B12, medication side effects, or drinking too much alcohol. In these cases, treating the underlying cause can reverse the dementia.

Alzheimer's & Dementia Articles

Depression: Early warning of dementia?

Researchers have discovered that older people who are depressed are more likely to develop dementia. The two conditions appear to share common causes. Many older adults miss the signs of depression, believing it to be an inevitable consequence of aging. It’s important for older adults who are depressed to get treated with antidepressant medicines, talk therapy, and cognitive behavioral therapy, and to get evaluated for dementia. More »

Do antidepressants work in the damaged brain?

In contrast to the disappointing results for Alzheimer's disease, antidepressants are showing real promise as medications that might help people recover from strokes — and their positive effects may go beyond depression. Successful treatment of depression may have "downstream" benefits that go beyond mental health. Antidepressants may also positively affect areas and networks in the brain that improve other impaired functions, not just mental outlook and depression. In 2011, French investigators reported that fluoxetine and physical therapy improved people's recovery from stroke-induced paralysis and muscle weakness. And at about the same time, a team of researchers from Japan and the University of Iowa published findings that showed fluoxetine or nortriptyline (Aventyl, Pamelor, other brands), one of the tricyclic antidepressants, helped with overall disability. (Locked) More »

Mild cognitive impairment: More than the usual forgetfulness

Some difficulty with remembering things (like names) and forgetting where you put things (like keys) is so typical that it's considered a normal part of aging. But some people experience a middle ground of cognitive impairment that's worse than normal age-related problems but not as bad as dementia from Alzheimer's disease or other brain diseases. Researchers labeled this intermediate state "mild cognitive impairment" in the 1980s, and the name stuck. Mild cognitive impairment stays mild in many cases. At the same time, studies have shown that people with the condition are about three times more likely to develop full-blown dementia than those without it. The problem is that doctors really don't yet have a reliable way of predicting who is going to "progress" to dementia and who isn't. (Locked) More »

Sleep apnea increases dementia risk in older women

More than half of adults ages 65 and over have sleep apnea, a disorder characterized by abnormal pauses in breathing during sleep. Chronic sleep apnea is associated with many health risks, including high blood pressure, heart disease, and stroke. Older women with sleep apnea may be at higher risk of developing cognitive problems and dementia. (Locked) More »

Regular exercise may ward off cognitive decline in women with vascular disease

A study provides one more reason to carve out time every day for a brisk walk or similar exercise, especially if you have vascular disease or are at risk for developing it. Vascular disease, including heart disease and other conditions that affect blood vessels, increases the risk of age-related problems with memory and thinking, known as cognitive decline. (Locked) More »

Diagnosing Alzheimer’s disease

Doctors take a two-pronged approach to diagnosing Alzheimer's disease. First, they ask patients questions and perhaps have them fill out one of the standardized questionnaires used to assess memory and other parts of thinking. The purpose is to evaluate people's cognitive problems to see if what they're experiencing is consistent with Alzheimer's. Second, doctors will order various tests to rule out other conditions that can affect mental functioning. Any CT or MRI brain scans or blood tests that might be done are part of this process of elimination. There is no direct test for Alzheimer's, or for the risk of developing it, in the way that, say, a blood sugar test can be used to assess whether someone has diabetes. (Locked) More »

Diagnosing Alzheimer's disease

New guidelines for diagnosing Alzheimer's disease aim to identify changes in the brain that are associated with the development of the disease. The guidelines put a new emphasis on tests that measure changes in the brain that are, at the very least, associated with Alzheimer's disease and may play a role in causing it. These tests — grouped under the heading "biomarkers" — include positron emission tomography (PET) scans of the brain as well as tests of the cerebrospinal fluid, which surrounds the brain and spine and may contain clues to what is going on in the brain. No one is saying that the tests can be used by themselves to diagnose Alzheimer's. But there's the suggestion in the guidelines that PET scans and other tests could be used to improve predictions about whether someone with mild cognitive impairment is going to develop full-fledged dementia. They might also be used to make the diagnosis of dementia due to Alzheimer's more reliable. More »