Caring for a senior who is experiencing cognitive decline, or who is showing symptoms of cognitive decline, carries many questions. Will the elderly person remember loved ones as he or she gets worse? What changes will the family have to make in order to keep the elderly loved one safe? How will one know if the person is happy, in pain, or scared, if he or she has trouble communicating? Yet before a specific diagnosis is set in place, the biggest question is this: what is causing these symptoms of cognitive decline and how can whatever it is be prevented from getting worse?
Alzheimer's and dementia, while related, are not the same thing.
Unfortunately, dementia is a common experience for many aging people. Many caregivers get worried when they see symptoms of or hear the word dementia uttered by a physician or other caregiver, because they immediately flash to anecdotal and media evidence of what Alzheimer's is like. However, Alzheimer's and dementia, while related, are not the same thing. Alzheimer's is a specific disease that causes cognitive decline, and it is progressive, meaning that it will not "improve" over time. Dementia is also progressive, but it is not, in and of itself, a disease; it is a symptom, the way that a sneeze is a symptom of allergies. You can have Alzheimer's and dementia, but you can also have dementia without Alzheimer's or Alzheimer's without dementia. It is also true that the most common cause of dementia is Alzheimer's disease, but it is not the only cause--just as a sneeze might be provoked by allergies, a cold, or a deep sniff of pepper, dementia can also be caused by Parkinson's disease, vascular issues, or dementia with Lewy Bodies.
Symptoms of Dementia
Dementia varies considerably in the way the patient experiences it. According to the Mayo Clinic, dementia may include difficulty speaking, remembering, and making good decisions. Dementia can often be diagnosed properly only once symptoms begin, so as long as all other causes for changes in cognitive function are ruled out (such as a vitamin deficiency or medication reaction) dementia should be considered. The various causes of dementia often present slightly different symptoms, or they present similar symptoms on a slightly different timeline. For example, non-Alzheimer's dementia such as dementia with Lewy Bodies can include hallucinations and a fluctuation between lucid and confused moments in the early stages, which is not characteristic of Alzheimer's dementia.
Symptoms of Alzheimer's
Unlike dementia, Alzheimer's is itself a disease. Alzheimer's can also only be accurately diagnosed after death, when an autopsy can reveal the plaques and tangles in the brain's tissue that signal Alzheimer's progression. Many people receive a diagnosis of Alzheimer's before death because of a family history, or because their overall symptoms indicate it, but it still might not be definitively Alzheimer's.
Unlike dementia, Alzheimer's is itself a disease.
Alzheimer's disease attacks specific parts of the brain, causing the dementia experienced by patients afflicted by it to react in fairly specific ways, especially in thought, memory, and language. That may sound broad--and it is, when the vast ways in which such effects can manifest in behavior--but Alzheimer's targets a remarkably specific set of brain tissue. The plaque and tangles that are evident postmortem show doctors the exact places where the brain was attacked by the disease, which then tells them exactly what the cause of dementia was.
How to Spot the Difference
What is the key to spotting the difference between Alzheimer's and other dementia? It is important to consult an expert. Even primary care doctors cannot diagnose Alzheimer's alone and will suggest visiting with specialists before giving such a serious diagnosis. Consulting with multiple doctors who specialize in gerontology, neurology, and memory loss are all important ways to discover the difference, and how to create a plan for a seniors in one's care that will keep the person healthy for the longest period of time.
First, doctors will rule out other possible causes for dementia-like symptoms, some of which are temporary and have not truly caused dementia, just confusion or aphasia. Then doctors will use various brain scans, psychological tests, and behavioral evaluations to decide what is causing the symptoms of confusion, memory loss, questionable judgment, or difficulty speaking.
It is important to know that neither Alzheimer's nor dementia are reversible or curable today. While many seniors who have dementia and/or Alzheimer's will have days when their symptoms are worse and days when their symptoms are better, their brains cannot suddenly regrow healthy, normal connections and regain health.
Focusing on making life safe and happy for the sufferer is the priority until a cure can be found. It is also a good idea to place a senior in one's care in counseling to evaluate mental health. Dementia and its various causes can result in depression or anxiety, especially if communicating is difficult or if the person is in unmanaged pain. Having a trained counselor around to advise and to promote thoughtful reflection is a good step toward keeping a senior in one's care in a healthy place mentally, even as the person's brain struggles to cope with the disease and reality.
Alzheimer's Association. Know the 10 Signs. Available at http://www.alz.org/alzheimers_disease_know_the_10_signs.asp. Retrieved June 19, 2016.
Alzheimer's Association. Types of Dementia. Available at http://www.alz.org/dementia/types-of-dementia.asp. Retrieved June 19, 2016.
Alzheimers.Net. Difference Between Alzheimer's and Dementia. Available at http://www.alzheimers.net/difference-between-alzheimers-and-dementia/. Retrieved June 19, 2016.
Alzheimer Society Canada. Normal aging vs dementia. Available at http://www.alzheimer.ca/en/About-dementia/What-is-dementia/Normal-aging-vs-dementia. Retrieved June 19, 2016.
Fisher Center for Alzheimer's Research Foundation. What's the difference between dementia and Alzheimer's? Available at https://www.alzinfo.org/understand-alzheimers/dementia/. Retrieved June 19, 2016.
Lunde, A. (September 27, 2007). Alzheimer's disease and dementia are different. Mayo Clinic. Available at http://www.mayoclinic.org/alzheimers-disease-and-dementia/expert-blog/bgp-20055941. Retrieved June 19, 2016.