By Bob DeMarco
Alzheimer's Reading Room
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DEMENTIA: Definition and Specific Types
Dementia is caused by various diseases and conditions that result in damaged brain cells or connections between brain cells. When making a diagnosis of dementia, physicians commonly refer to the criteria given in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).(1) To meet DSM-IV criteria for dementia, the following are required:
Symptoms must include decline in memory and in at least one of the following cognitive abilities:
1. Ability to generate coherent speech or understand spoken or written language;
2. Ability to recognize or identify objects, assuming intact sensory function;
3. Ability to execute motor activities, assuming intact motor abilities, sensory function and comprehension of the
required task; and
4. Ability to think abstractly, make sound judgments and plan and carry out complex tasks.
The decline in cognitive abilities must be severe enough to interfere with daily life.
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It is important for a physician to determine the cause of memory loss or other dementia-like symptoms. Some symptoms can be reversed if they are caused by treatable conditions, such as depression, delirium, drug interaction, thyroid problems, excess use of alcohol or certain vitamin deficiencies.
When dementia is not caused by treatable conditions, a physician must conduct further assessments to identify the form of dementia that is causing symptoms. Different types of dementia are associated with distinct symptom patterns and distinguishing microscopic brain abnormalities.
Although Alzheimer’s disease is the most common type of dementia, increasing evidence from long-term observational and autopsy studies indicates that many people with dementia have brain abnormalities associated with more than one type of dementia.
Alzheimer’s disease was first identified more than 100 years ago, but research into its symptoms, causes, risk factors and has only gained momentum in the last 30 years. While research has revealed a great deal about Alzheimer’s, with the exception of certain inherited forms of the disease, the cause or causes of Alzheimer’s disease remain unknown.
SYMPTOMS of Alzheimer’s Disease
Alzheimer’s disease can affect different people in different ways, but the most common symptom pattern begins with gradually worsening difficulty in remembering new information. This is because disruption of brain cell function usually begins in regions involved in forming new memories. As damage spreads, individuals experience other difficulties. The following are warning signs of Alzheimer’s:
Individuals progress from mild Alzheimer’s disease to moderate and severe disease at different rates. As the disease progresses, the individual’s cognitive and functional abilities decline. In advanced Alzheimer’s, people need help with basic activities of daily living, such as bathing, dressing, using the bathroom and eating. Those in the final stages of the disease lose their ability to communicate, fail to recognize loved ones and become bed-bound and reliant on around-the-clock care. The inability in late-stage Alzheimer’s disease to move around can make a person more vulnerable to infections, including pneumonia (infection of the lungs).
Alzheimer’s disease is ultimately fatal, and Alzheimer related pneumonia is often the cause.
Although families generally prefer to keep the person with Alzheimer’s at home as long as possible, most people with the disease eventually move into a nursing home or another residence where around-the-clock professional care is available.
DIAGNOSIS of Alzheimer’s Disease
A diagnosis of Alzheimer’s disease is most commonly made by an individual’s primary care physician. The physician obtains a medical and family history, including psychiatric history and history of cognitive and behavioral changes. Ideally, a family member or other individual close to the patient is available to provide input. The physician also conducts cognitive tests and physical and neurologic examinations. In addition, the patient may undergo magnetic resonance imaging (MRI) scans to identify brain changes that have occurred so the physician can rule out other possible causes of cognitive decline.
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More Insight and Advice for Caregivers
- How Alzheimer's Destroys the Brain -- Video
- Test Your Memory for Alzheimer's (5 Best Self Assessment Tests)
- What is Alzheimer's Disease?
- What is Dementia?
- What’s the Difference Between Alzheimer’s Disease and Dementia
- Communicating in Alzheimer's World
- How the Loss of Memory Works in Alzheimer’s Disease, and How Understanding This Could Help You
- Learning How to Communicate with Someone Suffering From Alzheimer's Disease
- Alzheimer's World -- Trying to Reconnect with Someone Suffering from Alzheimer's Disease
- Does the Combination of Aricept and Namenda Help Slow the Rate of Decline in Alzheimer's Patients
- About the Alzheimer's Reading Room
Original content Bob DeMarco, the Alzheimer's Reading Room