If our parents or grandparents have been increasingly struggling with changes in memory or personality, we may be worried that they have Alzheimer’s or dementia. Most people have heard of these diseases and may have had a grandparent or distant family member experience them before.

 

Still, though, until we are facing these diagnoses head-on, we may not understand exactly what to expect. How can we know the differences between dementia and Alzheimer’s? Do all dementias look the same or are there different types? Could my loved one’s memory problems be related to something else, like simple ageing, or do they have to mean a cognitive disease?

 

On today’s episode, we’ll examine Alzheimer’s and dementia through a closer lens. We’ll go over the varying types of dementia and what to expect from your loved one before and after a diagnosis. By the end, you should have a much clearer understanding of the world of dementia and Alzheimer’s and feel more prepared to face what’s ahead. While there is no cure for these diseases, the more you can prepare yourself and your loved one, the better you both will feel moving forward.

 

Dementia affects millions of people every single year. According to alz.org, “an estimated 50 million people worldwide are living with dementia, including 5 million Americans.” It’s an epidemic with no cure, which makes dementia especially devastating for families. Many families choose to care for their loved one at home, and nearly 80% of at-home patients are cared for by family members or unpaid caregivers.

 

Caring for a dementia patient can be exhausting for anyone – but especially for a family member who has to sacrifice so much to be there for their loved one, and who might find themselves mourning for the way things used to be. With the right knowledge and support, this process can be made easier for all involved.

 

Dementia and Alzheimer’s are not the same disease, although they are certainly related. Dementia refers to a person’s changes in memory or thinking – and one of the causes of dementia is Alzheimer’s. Neither dementia nor Alzheimer’s are “normal” parts of aging – they are diseases that require extra support, care, and treatment.

 

Dementia comes in many forms and can have its roots in a number of causes. Alzheimer’s, though, is the most common. According to alz.org, Alzheimer’s accounts for 60-80% of dementia cases. Alzheimer’s is a progressive brain disease that will take over a person’s ability to reason, speak, and care for themselves. To better understand this disease, let’s take a look at the way the brain works.

 

When a person has Alzheimer’s, their brains are no longer able to function normally. That’s because they are experiencing nerve cell death and tissue loss over a period of time – usually 4 to 8 years, though this fluctuates depending on the person. A person can live up to 20 years with Alzheimer’s disease. While it is not clear what causes this tissue loss, scientists understand that it has something to do with a build-up of plaque and tangles in the brain.

 

Plaques are protein fragment clusters that crowd between nerve cells. When a nerve cell is dying, or already dead, it contains tangles, or twisted protein strands. The clumps of plaques and tangles can block cell-to-cell signals in the brain. This mixed-up signaling sometimes triggers immune system cells, which consume the dead or dying cells and trigger inflammation.

 

When a brain is under siege of these tangles and plaques, the brain is unable to process nutrients or other important supplies throughout the cells. With nothing moving through them, the cells die. In the early stages of the disease, the plaques and tangles cluster in the areas of the brain that affect learning and memory, thinking and planning.

 

This is when you might notice your parent has forgotten where she put her purse, or has trouble planning for the week ahead. The symptoms at this point are subtle enough to be discounted or missed altogether. In the early stages, almost no one is officially diagnosed with Alzheimer’s. After all, momentary lapses in memory could be considered a normal part of aging.

 

In mild to moderate Alzheimer’s, the plaques and tangles begin to grow and spread. Learning and memory and planning and thinking become overwhelmed with them. You will notice your parent or grandparent struggle with expressing themselves, growing irritated or frustrated more easily, and having increased trouble with their short-term memory.

 

At this stage, it’s common for a person to confuse dress clothes for casual clothes, and struggle with social interactions. At this stage, their speech will also start to slow, and you might notice your parent forget certain words or speak nonsensically. Your parent also might start to wander, or even have trouble with their spatial awareness.

 

At this stage, the plaques and tangles have now found their way to the portion of the brain that controls speaking and understanding speech, as well as where your body is compared to your surroundings.

 

In the severe stages of Alzheimer’s disease, the brain has begun to shrink, due to the death of so many cells. At this point, a person may be unable to communicate at all and cannot care for themselves. They might struggle to recognize important people in their lives.

 

Alzheimer’s is a devastating disease. If your loved one has been diagnosed, you might find yourself getting frustrated, overwhelmed, or even exhausted when it comes to their care. After all, it’s difficult and heartbreaking to struggle to communicate with your parent, and it’s all too easy to become irritated or even angered with your loved one’s mood swings or forgetfulness.

 

If you understand what is happening inside their brains – that it is quite literally shrinking – it might help you to better understand what your parent is dealing with. In any case, it will give you a better idea of why your parent’s disease is progressing, and what you can expect as time goes on.

 

To learn more about how to care for a loved one with Alzheimer’s, and what to specifically expect from the disease, check out our previous episodes on the stages of Alzheimer’s and supporting a loved one with dementia. There, you’ll find insight into how to best care for your loved one, what to expect int their behavior and cognitive ability as time goes on, and tips for how to keep their lives as full as possible.

 

While Alzheimer’s is the most common cause of dementia, there are many other types of dementia that your parent or grandparent might be diagnosed with. Having an understanding not just of dementia alone, but of the specific types, will better prepare you for what to expect on an individual basis, and the types of care you should consider. It will also help you understand what type of support your loved one requires.

 

Before we get into the other types of dementia, let’s look at dementia in broader terms. While dementia looks different in every case, most people will face memory loss, difficulties with problem-solving, language struggles, and thinking struggles. In some cases, a person might experience mood swings or changes in personality. Like Alzheimer’s, dementia will progress over time. 

 

A human brain looks different depending on the type of dementia a person has. Just like a brain suffering with Alzheimer’s has a very specific trajectory, the varying types of dementia impact the brain in different, but similar, ways.

 

The second most common type of dementia is Vascular dementia. This disease accounts for about 5 to 10% of all dementia cases. Vascular dementia occurs when the brain receives a reduced blood supply, due to diseased blood vessels. Without a ready supply of blood, brain cells are deprived of necessary oxygen and nutrients. The cells therefore die.

 

Vascular dementia causes problems in thinking, reasoning, and memory. It does not always affect all three, however, because it depends on where the blood supply is being blocked within the brain. Because of this, Vascular dementia is believed to be underdiagnosed. You might find that your parent struggles with mobility, like balance or walking, and may even experience numbness on one side of the face or body. They might not have a single issue with memory, though.

 

At the same time, your parent could be struggling deeply with memory issues, but be walking and moving around just fine. That’s why vascular dementia can be especially difficult to diagnose.

 

A person with vascular dementia might suffer from multiple small strokes that impact blood vessels and nerve fibers inside the brain. This could lead to changes in thinking, planning, and judgement. You might notice that your parent has been laughing or crying uncontrollably or is unable to function in social situations.

 

Because vascular dementia is so commonly undiagnosed, it is recommended that your loved one undergo cognitive testing – especially if they have suffered a stroke in the past. If your loved one has suffered a stroke, or is vulnerable to heart or blood vessel disease, there are ways to reduce the risk of developing vascular dementia.

 

Avoid anything that raises blood pressure or cholesterol, don’t smoke, and limit your drinking. Exercise and healthy eating also do wonders for reducing the risk of vascular dementia, along with a myriad of other health issues.

 

Treatment for vascular dementia is all about stopping the condition from worsening. This can be accomplished through eating a healthy, low-salt diet to manage high blood pressure, losing weight if necessary, quitting smoking, and cutting down on or cutting out alcohol. Therapies like physiotherapy and occupational therapy can help your loved one to get through daily tasks. Music and dance therapy, massages, and meditation have also proved helpful in patients with vascular dementia.

 

Another type of dementia is known as Dementia with Lewy Bodies – or DLB. DLB is sort of a hybrid of Alzheimer’s and Parkinson’s, a disease that heavily affects mental and physical abilities in a diagnosed person. About 10-15% of dementia cases are DLB.

 

DLB is so similar to Alzheimer’s, that it is often misdiagnosed for the latter – but there are key differences that are worth looking out for. The right diagnosis means the right care for your loved one. Of course, DLB and Alzheimer’s require much the same care, so a misdiagnosis likely won’t make a great impact on your loved one’s treatment. Still, understanding the difference between DLB and Alzheimer’s can mean little changes in treatment and care that go a long way.

 

Lewy bodies refer to deposits of protein that emerge in nerve cells within the brain. While it is unknown why these deposits show up, their impact on the brain is clearer. Lewy bodies lead to low levels of chemicals that are important for brain function – especially acetylcholine and dopamine, which are essential for carrying messages through the nerve cells. A lack of connections in the cells leads to nerve cell death.

 

Lewy bodies also affect the areas of the brain that control movement and mental disease. Because of this, many people with DLB are also diagnosed with Parkinson’s disease.

 

Treatment for DLB is used to keep a patient’s quality of life as high as possible, for as long as possible. As with other forms of dementia, a healthy diet will help to keep your loved one feeling strong and energized. A psychotherapist can help your loved one to feel supported and learn how to manage emotional and behavioral difficulties.

 

Talk to your loved one about joining a support group or taking on one on one therapy. Even in the age of COVID-19, therapies and support groups are taking place over Zoom. You might even find that your loved one is more willing to share their experiences through a camera than in person, which might make them feel overwhelmed.

 

Another form of dementia is Frontotemporal Dementia – or FTD. This is a rarer form of the disease, but it does affect about 50,000 to 60,000 people in the United States each year. FTB takes place when the nerve cells in the frontal and temporal lobes of the brain are damaged or dying. This causes connections to break down and chemical messengers to decrease significantly.

 

For a person with FTD, behavioral and personality changes are common. Because the frontal lobe plays a huge role in personality, this can mean drastic changes in the people we love. Their emotions, behaviors, and focus will be greatly impacted, to the point where they may not be recognizable to us.

 

At the same time, the temporal lobes are involved with language. Someone with FTD might struggle with the meanings of words or using the correct words to describe an object. If you notice that your parent is having trouble with language and their personality and behavior have significantly changed, they might be suffering from FTD. Unlike other forms of dementia, where the first symptoms are typically memory loss, personality changes and language problems occur early on in a patient with FTD.

 

Establishing a care plan for a loved one with FTD is important. Choosing a type of care that can help them to stay as independent as possible, for as long as possible, can make the transition to long term care helps a little bit easier.

 

Therapies like physiotherapy, occupational therapy, and speech and language therapy can be enormously helpful for anyone with FTD. Physiotherapy will assist your loved one with mobility problems, while occupational therapy will help them with other problems – like dressing and problem solving. Speech and language therapy will help with communication, memory, and even issues swallowing.

 

The more stimulating, active assistance your loved one can receive, the longer they can hopefully remain relatively independent. Of course, nothing is guaranteed, but therapies have been proven to make every day living easier for patients with FTD.

 

Your loved one may also be struggling with mixed dementia. Mixed dementia is when a person has more than one type of dementia. Most commonly, a person will have Alzheimer’s disease and vascular dementia at the same time. Another common combination is Alzheimer’s disease and LBD.

 

About one in ten people with dementia has more than one type – this is especially common for people over the age of 75. Even though that’s a high number, it is not commonly diagnosed. According to Alzheimers.org.uk, doctors usually only diagnose mixed dementia when a person struggles deeply with more than one type that are both contributing equally to their symptoms.

 

Unsurprisingly, symptoms of mixed dementia vary greatly, depending on the combination of diseases. In most cases, one type of dementia is considered the “predominant” disease in a person and impacts more of the brain than the other. If a person has Alzheimer’s and Vascular Dementia, for instance, they will probably have more symptoms of Alzheimer’s if the blood supply blockage is only in one part of the brain.

 

Dementia is not reserved for the elderly. Early onset dementia in younger people, a common form of young-onset dementia affects about 200,000 Americans every year, according to Alzheimers.org. This is usually difficult to diagnose, just because doctors don’t tend to think of dementia when meeting with younger patients.

 

If you are under the age of 65 and have been experiencing symptoms related to memory loss or personality changes, it might be smart to meet with a doctor who specializes in Dementia, rather than your regular physician.

 

Early onset dementia is often hereditary, but it can also be caused by over consumption of alcohol. In that case, it’s known as alcohol related dementia, or ARBD. 

 

Alcohol-related dementia affects about one in eight people with dementia under the age of 65. Usually, a person with ARBD is about 40-50 years old. This occurs when a person drinks or binge drinks regularly, leading alcohol to damage the brain’s nerve cells, blood vessels, or ability to process VitaminB1. A person with ARBD might struggle with day-to-day tasks and memory loss, balance, and mood swings.

 

There are many other types of dementia, that can affect people of all ages. These include Huntington’s Disease, Parkinson’s Disease Dementia, Creutzfeldt-Jakob Disease, and more.  

 

Regardless of the type of dementia your loved one is struggling with, they will need constant care and support from their family, friends, and caregivers. This includes constant care as the disease progresses, brain stimulating activities, and a whole lot of patience, gentleness, and love.

 

Remember that these diseases are greatly impacting your loved one’s brains, so your loved one is not at all in control of her behavior, mood, or thinking. Because of that, it’s essential not to blame your loved one for their behavior, no matter how frustrated you might feel. Always keep in mind that this is as hard for your loved one, if not harder, than it is for you.

 

If you are worried that your parent might be suffering from dementia or Alzheimer’s, but aren’t entirely sure, make sure to schedule a doctor appointment where all of their symptoms can be addressed.

 

The earlier you can pin down a diagnosis, the sooner you can provide your parent with the treatment and support they need. While there is no cure for dementia, treatment plans can help delay the progression of the disease. To learn more about that, listen to our episode on supporting a loved one with dementia.

 

We know how devastating it can be when a loved one is struggling with a cognitive disease. We hope that through a better understanding of these diseases, you can better prepare yourself to understand what your loved one is going through. 

 

We want to thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone is who could benefit from this episode, please share it with them.

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https://www.healthline.com/health/types-dementia

 

https://www.healthline.com/health/alzheimers-disease/difference-dementia-alzheimers

 

https://www.seniorlifestyle.com/resources/blog/understanding-different-types-dementia/

 

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https://www.alz.org/alzheimers-dementia/what-is-alzheimers/brain_tour_part_2

 

https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/vascular-dementia#:~:text=Vascular%20dementia%20is%20widely%20considered,%25%20to%2010%25%20of%20cases.

 

https://www.alz.org/alzheimers-dementia/difference-between-dementia-and-alzheimer-s#:~:text=Dementia%20is%20a%20general%20term,Dementia%20is%20not.

 

https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia

 

https://www.alz.org/media/documents/understanding-alzheimers-dementia-b.pdf