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UNDERSTANDING DEMENTIA

Dementia is a descriptive term for a collection of symptoms that can be caused by a number of conditions affecting the brain. The prevalence of dementia is expected to rise, as the average life expectancy continues to increase and the baby boomer population ages. This does not mean that everyone will develop dementia.

Many adults over age 70 never receive a diagnosis of dementia. By age 85, approximately 35 out of 100 people are diagnosed with it. Alzheimer’s disease is the most common cause of dementia. The prevalence of Alzheimer’s has been estimated in some studies to be as high as 5 percent by age 70, 18 percent by age 80, and 50 percent by age 90. Other common causes of dementia are vascular dementia and mixed (Alzheimer’s plus vascular) dementia.

RISK FACTORS: family history, smoking, diabetes, high blood pressure, excessive alcohol, high LDL (“bad”) cholesterol and previous head injury.

SYMPTOMS: Cognitive changes such as forgetfulness, difficulty finding words and not knowing common facts such as the name of the current U.S. president. Psychiatric complications such as withdrawal, depression, suspiciousness, anxiety, insomnia, fearfulness, paranoia and hallucinations; Personality changes such as excessive flirtatiousness, easy frustration and explosive spells; Behaviors such as wandering, difficulty driving, forgetting recipes, neglecting personal cleanliness and household chores, difficulty handling money and trouble with shopping.

At some point, everyone forgets their keys or the name of an acquaintance. This is not necessarily a result of early stage dementia. Also, due to the slowing of our reflexes, physicians now recognize that many healthy individuals are also less able to remember certain types of information as they age. This is called “age-associated memory impairment” (AAMI) and describes minor memory difficulties that come with age. AAMI is neither progressive nor disabling.

Is it Alzheimer’s or Dementia?

Alzheimer’s disease is a form of dementia characterized by the gradual loss of several important mental functions. It is considered the most common cause of dementia in older Americans. Symptoms of Alzheimer’s include memory loss that is much more severe and more serious than age-related memory impairment, such as forgetting the names of your children or perhaps where you’ve lived for the last decade.

Dementia is a more general medical term used to describe a number of conditions, also characterized by the gradual loss of intellectual functions. This includes vascular, mixed, and other less common dementias. Symptoms of dementia include memory impairment, increased language difficulties, decreased motor skills, failure to recognize or identify objects and disturbance of the ability to plan or think abstractly.

Lawrence Rand, M.D., is an internist and geriatric medicine specialist at South Nassau Communities Hospital.

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