Alzheimer’s vs. Dementia
Dr. Joseph Hoyle, MD, MPH
June is Alzheimer’s & Brain Awareness Month – and there’s no better time to discuss some of the most common questions.
First, what’s the difference between Alzheimer’s disease and dementia? Dementia is a catch-all term for diseases of brain function that make it difficult for a person to live alone. Alzheimer’s disease is a specific type of dementia that includes memory loss, difficulty learning, and other brain functions. It is known for being gradually progressive and starting subtly, and it is the most common cause of dementia.
What can be done to treat Alzheimer’s? While there are FDA-approved drugs that can have some effect on the symptoms of Alzheimer’s, there is not yet a cure or treatment that can significantly alter the disease progression. For those with “mild cognitive impairment” (memory loss that is not severe enough to keep someone from living independently), aerobic exercise seems to be beneficial.
What is being done to find better treatments? Because there is no cure or treatment, research on Alzheimer’s should be a priority in the United States. It is the most expensive disease in the nation, and most of its costs are borne by Medicare and Medicaid. Over the past few years, Congress has wisely invested additional funds in the National Institutes of Health to fund Alzheimer’s research, and it’s vital that they continue doing so. The Alzheimer’s Association also funds research directly and convenes scientists from around the world to share their ideas and results at the Alzheimer’s Association International Conference, which will be held in Chicago in mid-July.
If there is not a cure, why should I find out if the memory changes are due to Alzheimer’s disease? Many people rationalize that there is no benefit to knowing that one has the disease. However, according to surveys, 90 percent of people say they would want to know. I tell my patients they show symptoms of dementia or Alzheimer’s because of two reasons:
Empowerment: People with early-stage of the disease can still participate in their care decisions. As dementia progresses, care decisions become harder, but that’s all the more reason to consider long-term care options, discuss advance care planning preferences, make legal arrangements and assess finances as early as possible. Individuals may also choose to enroll in clinical trials, which can provide access to potential treatments and top-notch care, as well as contribute to the process of finding better treatments for others with the disease. The Alzheimer’s Association can help you learn about clinical trials that match your interests through its free Trial Match program.
Safety: When family members know the about the disease, they can make sure their loved one is safe from financial exploitation or highway dangers. They also have time to learn about common behaviors before they find themselves in a crisis.
What resources are available to help? As a physician, I tell every family about the Alzheimer’s Association 24-Hour Helpline at 1-800-272-3900. This is for anyone with dementia, not just Alzheimer’s. The trained counselors available through this number can provide support for situations even in the middle of the night, help identify clinical trials, and support families to prevent burnout. If you know families that are facing Alzheimer’s or another dementia, please get the word out about this wonderful resource!
Can dementia be prevented? While we can’t control our age or our genes, there are certainly steps that we can take to reduce our risk of cognitive decline. Science has shown that physical activity and educational attainment both promote brain health. In addition, avoiding traumatic brain injury (wearing a helmet when biking and stopping play if concussion is suspected), not smoking, and making nutritional changes (such as pursuing the Mediterranean diet) may help as well.
The good news is that rates of dementia and Alzheimer’s are falling. You are less likely to get dementia than your parents were 20 years ago. The reasons for this are not clear, but perhaps it has to do with improved rates of healthy lifestyles. It’s estimated that more than 1.5 million cases of dementia have already been prevented in the United States. However, even though rates of dementia are falling, there are more people with dementia than ever before due to the aging of our society. The total number of those with dementia is expected to triple by 2050.
Lastly, dear reader, consider this: “I’m Joseph Hoyle, a dementia patient.” If I were a patient with dementia or even Alzheimer’s disease, I wouldn’t introduce myself this way or want others to introduce me this way! I would want you to treat me like a person. Although there are other parts of brain function that are affected by dementia, usually social engagement is intact until later in the disease process – so keep treating your loved ones with dignity.