Is it Alzheimer’s? Maybe Not

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Thanks to the Alzheimer’s Association, many Americans are well aware of the symptoms of Alzheimer’s disease, what happens as it progresses, what kinds of medical treatments are available or in development, and how to seek support and professional help.

While Alzheimer’s may be a household word, less well known is the fact that there are several other causes of age-related dementia — and that all of these need to be considered and ruled out before an Alzheimer’s diagnosis is made.

Vascular disease can affect the brain

A diverse group of vascular diseases constitute a major cause of cognitive decline among elderly Americans and Europeans. Among these diseases are mild cognitive impairments such as memory problems, multi- and single infarct dementias, lacunar lesions, hemorrhagic lesions, Binswager’s disease, and Alzheimer’s disease compounded by vascular problems.

“For decades, vascular causes of cognitive impairment in the elderly were most commonly known as senile dementia and arteriosclerosis,” observes Meg Borders, R.N., director of health services at Candle Light Cove Assisted Living and Alzheimer’s Care. Hypertension is present in about half the cases, and stroke certainly increases risk, but Borders notes that there are also small vessel problems, such as Binswager’s and lacunar disease, and large vessel cardiac diseases that can cause dementia.

Getting an accurate diagnosis is important, given the many treatments available for vascular conditions. Although Alzheimer’s cannot be diagnosed through magnetic resonance imaging (MRI) or other non-invasive technology, vascular disease (as well as tumors or other problems) can. Some of the newer drugs for Alzheimer’s disease also help manage the symptoms of vascular dementia.

Neurological conditions causing dementia

In addition to vascular conditions, Parkinson’s disease and Lewy Bodies Syndrome are two significant causes of dementia. In dementia with Lewy Bodies (DLB), microscopic deposits in the brain cause damage to nerve cells.

“Overall, people with this kind of dementia seem more ‘in and out’ – they may be reasonable and lucid in the morning, and extremely disoriented and confused a few hours later – whereas Alzheimer’s patients have a more consistent cognitive disability,” Borders observes. “DLB patients not only have the reasoning and memory losses that Alzheimer’s disease causes, they also suffer delusions and visual hallucinations.”

Compounding these are physical symptoms such as slowness, stiffness, and tremor that impair their ability to take care of their personal needs and increase their risk of falling.

Traumatic brain injury such as those caused by accident or severe seizures also can cause dementia in people of any age, as can HIV and incurable diseases such as Multiple Sclerosis, Huntington’s Disease and Pick’s Disease.

The role of alcohol abuse

Borders also has managed many cases of alcohol dementia. The most severe form, Korsakoff’s Syndrome, results from heavy drinking over a long period of time, which causes a thiamine deficiency that damages a small area of the brain. Once alcohol consumption stops, a patient can make a total or partial recovery, unless he or she also suffers from a broader form of alcohol dementia.

“Damage to the stomach lining and poor vitamin absorption can result from long-term alcohol abuse, and in turn, these can cause severe short-term memory loss and impairment in a wide range of cognitive skills,” Borders explains.

The importance of early diagnosis

On a more positive note, Borders points out that confusion and memory loss can be caused by easily treatable conditions such as severe depression, thyroid deficiency, and severe deficiencies in B-vitamins.

“It’s important for families to avoid jumping to the Alzheimer’s conclusion,” says Borders. “And to avoid jumping to the conclusion that confusion, forgetfulness, or personality changes are merely inevitable effects of aging that can’t be treated. Seeking assessment and pursuing diagnosis sooner rather than later will most likely result in a treatment plan that addresses the symptoms and maybe even halts, or at least slows, the disease progression.”

Kate Gallagher is marketing director for Candle Light Cove.

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