What is Dementia?

One of the biggest questions that I get is what is dementia and how does that differ from Alzheimer's disease? So, I first want to acknowledge the fact that dementia is not a disease, it's actually a syndrome meaning it's a collection of symptoms that are caused by various diseases and conditions. So, dementia itself is the symptom that's being caused by something else — other diseases, other conditions.  

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So, think of it this way. Let's think of a rash. A rash is a symptom. It's usually a red, bumpy, scaly, itchy type of patch of skin. But, there are different things that can cause a rash, right? You can have an allergic reaction and that can cause a rash. You can have an infection and that can cause a rash. You can have psoriasis or eczema, and that can cause a rash. So, all those things can cause a rash, right?

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In the case of dementia, dementia is our symptom, which is a loss of thinking, remembering, reasoning and behavioral abilities to the extent that it interferes with daily functioning. So, what can cause the symptom of dementia? Alzheimer's disease can cause dementia. Alzheimer's disease is characterized by plaques and tangles in the brain, which can result in dementia. Lewy bodies (abnormal proteins) can cause dementia — think of Lewy body type dementia. Parkinson's disease can cause dementia. Brain disorders affecting the frontal and temporal lobes can cause dementia — think frontotemporal types of dementia. Changes in the blood flow in the brain can cause dementia — think of vascular dementia. Alcohol abuse or B vitamin deficiencies can cause dementia — think of Korsakoff syndrome which causes dementia, and an infection can cause dementia — think of Creutzfeldt-Jakob disease which can cause dementia.  

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So, when we think of the question, how does Alzheimer's disease differ from dementia? The answer is that Alzheimer's disease is just one disease, one condition that can cause the symptom of dementia. Now, I know this can be confusing because you often see things that say, Alzheimer's disease and dementia as if they're two separate things, but really what they should say to be more accurate is: Alzheimer's disease and other dementias, because there's so many things that can cause the symptom of dementia.

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A fun, but not so fun fact is that there's actually over 100 different conditions and diseases that can result in the symptoms of dementia. Now, the most common type of dementia is Alzheimer's disease. That's why you see so much attention and media around Alzheimer's disease — because it's the most common, it's the most researched and well known. Alzheimer's disease actually makes up about two-thirds of the accounts of dementia.  

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Now, let's go ahead and discuss some of the things that dementia can impact. Unfortunately, many people think that dementia is simply just impairment in memory, some confusion, and impaired thinking. Therefore, when these other things start emerging, they're in for a shocker because they didn't know that dementia could come along and impact so many things.  

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So dementia can impact:

• Memory
• Abstract and critical thinking
• Problem solving abilities
• Impulse control
• Judgment and insight
• Reasoning skills
• Planning skills
• Attention skills
• Language and comprehension skills
• Behavior, personality, and mood
• Coordination and motor function
• Vision, perception and spatial skills

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Now, with dementia, the symptoms are usually gradual, and so they emerge over time. So, in the beginning, they usually can tell that something is a little bit off, but they don't too much worry about it in the beginning. They might contribute it to something like old age or being tired or something like that. But then, things start getting more challenging for them. They start compensating for the things that they're beginning to lack and struggle with. But people around them might not yet be able to notice really anything out of the ordinary. But, as the dementia progresses, and it starts impacting their functioning and their daily activities more and more, then those around them may start to notice that something might not quite be right. But even still, those around them, especially depending on that person's age, might contribute it to something like old age.

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So with that being said, there are a few things that I want to make sure that you know and understand. Number one, is that dementia is not a normal part of aging. Okay, it's not. Now, it is common for there to be a slowing in thinking. So, it wouldn't be out of the ordinary for someone to forget a word every once in a while or to misplace something or to forget that they've done something or forget that somebody told them something, or they might even forget to do something. But, I think we can all say that we've had that experience from time to time, right? But, dementia is so much more than that and it actually affects a person's daily functioning in a very significant way. With the slowing in thinking, which is a part of normal aging, it usually isn't severe enough to impact the person's everyday functioning. Whereas with dementia, it does and that's not normal. That is not a normal part of aging.

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The second thing that I want to make sure that you know, and understand is that true dementia is progressive and it worsens over time. So, unfortunately, with true dementia, it's only going to get worse. This is because whatever disease, whatever condition is causing the dementia, it's doing so by slowly damaging and killing brain cells. So, to put it quite plainly, the brain is slowly dying. That is why dementia has such a profound effect on the person living with it — it's affecting the brain, it's killing the brain.

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When we think about it, the brain controls all of our functions. So, as the brain dies, so will our functioning. Now, depending on the type of dementia, different things are preserved. That's why dementia presents differently in some people, depending on the type of dementia that they have because different parts of the brain are being affected and dying first. So that saying, "When you've met one person with dementia, you've met one person with dementia" is true because it can vary because of how it's impacting the brain.  

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The third thing that I want to make sure that you know and understand is that there is no cure or treatment for dementia. There's nothing that's going to magically take away true dementia. Now with that being said, there are 5 FDA approved drugs that help manage some of the symptoms of dementia. So, for some of the issues with the memory and the thinking and the attention, there are some drugs approved by the FDA to try to manage some of those symptoms. And of course, like any drug, they do come with side effects and they do have varying effectiveness depending on the person.

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The five FDA approved drugs for symptom management include:  

• Aricept
• Razadyne
• Namenda
• Exelon
• Namzaric

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The way these drugs are categorized is by the stage of dementia that the person is in and that's also how they are prescribed. So, the one drug that is okay for all stages and shows some type of effectiveness for all stages is Aricept.  

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The one thing I want you to understand if you took nothing else away from this blog post is that dementia is being caused by some disease or condition that is triggering brain cell death, and the brain is slowly dying. And, I don't say this to scare you, but simply to inform you because I truly believe that the more that you understand about dementia, the better you can prepare for it and be the best dementia care partner that you can be.