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What is the difference between Alzheimer's disease and dementia?
“Dementia” is a term that has replaced a more out-of-date word, “senility,” to refer to cognitive changes with advanced age.
Dementia includes a group of symptoms, the most prominent of which is memory difficulty with additional problems in at least one other area of cognitive functioning, including language, attention, problem solving, spatial skills, judgment, planning, or organization.
These cognitive problems are a noticeable change compared to the person’s cognitive functioning earlier in life and are severe enough to get in the way of normal daily living, such as social and occupational activities.
A good analogy to the term dementia is “fever.”
Fever refers to an elevated temperature, indicating that a person is sick. But it does not give any information about what is causing the sickness. In the same way, dementia means that there is something wrong with a person’s brain, but it does not provide any information about what is causing the memory or cognitive difficulties. Dementia is not a disease; it is the clinical presentation or symptoms of a disease.
There are many possible causes of dementia. Some causes are reversible, such as certain thyroid conditions or vitamin deficiencies. If these underlying problems are identified and treated, then the dementia reverses and the person can return to normal functioning.
However, most causes of dementia are not reversible. Rather, they are degenerative diseases of the brain that get worse over time. The most common cause of dementia is AD, accounting for as many as 70-80% of all cases of dementia.
Dementia is the gradual deterioration of mental functioning that effects memory, mood, thinking, concentration, and judgment. These changes often affect a person’s ability to perform normal daily activities.
Dementia is a an illness that usually occurs slowly over time, and usually includes a progressive state of deterioration. The earliest signs of dementia are usually memory problems, confusion, and changes in the way a person behaves and communicates.
Cognitive symptoms of dementia can include poor problem solving, difficulty learning new skills, and impaired decision making. Behavior changes can include fear, insecurity, anger, and often, depression like symptoms.
Dementia is caused by various diseases and conditions that result in damaged brain cells. Brain cells can be destroyed by brain diseases, such as Alzheimer’s disease, or strokes (called vascular or multi-infarct dementia), which decrease blood flow to the brain.
Alzheimer's disease is the most common cause of dementia.
The First Sign of Alzheimer's Short Term Memory Loss
Increasing forgetfulness or mild confusion may be the first symptoms of Alzheimer's disease and memory loss that you notice. But over time, Alzheimer's robs you of more of your memory, especially recent memories. The rate at which symptoms progress varies from person to person.
First, short term memory loss is hard to detect in the early stages of dementia. Second, long term memory, memories of information stored long ago, still resides in the brain. If you try patiently you can still bring this information out, and it is sometimes fascinating. One of the first signs of dementia is short term memory loss. Alzheimer's is the most common form of dementia. Short term memory loss occurs when neural passages in the brain become severed and no longer work properly. New information enters the brain through the entorhinal cortex, and then is relayed to the hippocampus for short term memory storage. When the neural pathways that allow for this transfer of information become blocked, or cloggged, by beta amyloid the transfer of information in the brain is no longer possible. As Alzheimer's worsens nerve cells in the entorhinal cortex begin dying and the connection to the hippocampus is short circuited. In essence, when the hippocampus stops working properly, new memories no longer get converted and stored in the brain. One night I was having an interesting conversation at the dinner table with my mother. She had just finished eating a small steak, mashed potatoes, and broccoli. The conversation turned to south Philadelphia the place where my mother was born (1916) and raised. I asked her, where did you go to first grade? She answered without hesitation, Saint Monica's. My mother attended Saint Monica's in the 1920s. Later in the conversation, and with her dinner plate sitting directly in front of her, my mother asked, are we going to eat today? She had forgotten that she just ate. This explain in part why Alzheimer's can be so difficult to understand for persons who do no live with a person living with dementia. It was not unusual for my mother to hold long conversations with a person without skipping a beat. They never suspected my mother lived with dementia because they didn't discuss any current events, instead they spoke only in very general terms. Most of the discussion revolved around information that was already stored in my mother's brain before the breakdown in the short term memory mechanism that allow for the storage of memories.
Very early on, Alzheimer's patients can hold full and complete conversations. However, if a person were to ask, how old are you they probably won't be able to answer this question? This happens because they no longer know what year it is? Interestingly, in the early stages it is likely that they will be able to tell you their birth date. I was always fascinated when my mother was asked when she was born. She would answer 6-29-1916. Not June 16, 1916. If I asked you when you were born in person, you would probably tell me the month, day, and year. But if you were asked by a person filling out a form on a computer what would you say? You would probably answer like my mother 6-29-1916. So my mother still remembered the numerical version when asked because this information was still stored in her brain. So the understanding, and even the detection, that a person is living with Alzheimer's is often very elusive because it is hard to understand that a person that still has memories, that can remember events from the distant pass, can't remember what they just did a few minutes ago. The loss of short term memory is hard to understand, and hard to detect unless you are looking for the loss of short term memory. This difference in memory, short versus long term memory, also explains why so many caregivers will tell you in the early stage of Alzheimer's that family, relatives, and friends will often refuse to believe that a person is suffering from Alzheimer's. After all, outsiders, those outside the home rarely see the confusion and challenging behaviors that come with short term memory loss. How many of you can say that your loved one acted completely different in public than they do at home? How many of you can say that your Alzheimer's patient acted completely different when they went to the doctor, then they did at home. Did you feel like they were able to "pull the wool" over the doctors eyes? Even at the age of 95, my mother would tell a person she had never met before in her life that she had never taken a medication. Not a single pill. Yes, they believed her. They would often become animated, amazed, and happy for her. She told this little untruth with such great passion that they believed her. Could a person that never took a medication in their life be sick? I want to make two points here. First, short term memory loss is hard to detect in the early stages of dementia. Second, long term memory, memories of information stored long ago, still resides in the brain. If you try patiently you can still bring this information out, and it is sometimes fascinating. Fascinating like the time my mother started singing a song I had never before heard in my life. A song that was first sung and made famous by Billie Holiday in 1932. My mother was 16 years old at the time. My mother sang this song in the most beautiful voice you ever heard. If you would have asked me if that was possible before it happened I would have told you, not a Ghost of a Chance. And then it happened.