Christine M. Valentin, LCSW, LLC
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Dementia vs. Alzheimer's Disease

2/15/2013

13 Comments

 
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Throughout my work with family caregivers, a common confusion that regularly arises regarding memory loss is the belief that Dementia and Alzheimer's disease are one in the same. While it is true some people, even health care professionals, will use the terms interchangeably it is important to understand the fundamental differences between the terms so that you can truly understand what you may/may not be up against and can properly plan ahead.
 
Dementia is an umbrella term that is used to describe the many symptoms associated with someone who is experiencing symptoms like confusion, disorientation, forgetfulness, language problems and/or visual impairments. It is also important  to know that medical conditions like a urinary tract infection, a stroke, a thyroid condition, etc. can cause dementia-like symptoms; Side effects of medication, or alcohol can also mimic dementia. There are currently at least 50 known causes for dementia. 

Alzheimer’s disease is one of the most common causes of dementia. It is defined as an irreversible, progressive neurodegenerative disease that initially affects a person’s short-term memory and eventually progresses to affect his/her long-term memory and physical capabilities. Alzheimer’s disease is a specific disease and according to one medical model consists of three stages - Early, Middle and Late. Below is a brief summary of some of the signs you may notice in an individual with Alzheimer's disease. 

         Early stage Alzheimer’s disease consists of intermittent memory loss which can make 

identifying a memory problem difficult especially if lack of sleep, exhaustion, depression or stress are "blamed" for the forgetfulness. Changes in personality and/or forgetting to attend a recently scheduled meeting/appointment are generally signs that something is wrong. 
      Middle stage Alzheimer’s disease is characterized by more forgetfulness and drastic changes in 
mood. Behavioral issues like wandering, paranoia, increased agitation and/or hallucinations are also common during this stage. This stage can be confusing because of the ability for an individual to remember specific details of past events while forgetting more recent occurrences. 
     Late stage Alzheimer’s disease is characterized by a more progressive decline. The ability to remember past events becomes harder and confusion regarding people and places can become prominent. Incontinence, slurred speech and difficulty walking can also be present during this stage. 

The essential thing to know about Dementia and Alzheimer’s disease is they are not the same. Someone who has dementia does not necessarily have Alzheimer’s disease. One of the best questions you can ask your loved one’s medical team should they issue a dementia diagnosis is, “What is causing the dementia?” While it may be hard for the medical team to give you a definitive answer, especially during an initial evaluation, an answer or even a speculation can at the very least help you begin the process of planning ahead.

Do you have any thoughts you would like to share or questions to ask? Please do so my commenting below. 

13 Comments
Melanie Santamaria link
2/18/2013 02:43:49 am

Thank you so much for posting this much needed information. Families are so confused by these diseases and the medical professionals (for the most part) do not take the time to really assess the cause of dementia, nor do the families know what to ask. I get asked this question a million times by family members wanting to place their loved ones and this information is so clear, and so appreciated.

Reply
Christine M. Valentin, LCSW link
2/19/2013 02:03:28 am

Hi Melanie,
I'm glad you find the information helpful and hope that many other readers will as well. There is definitely much confusion out there and by educating as many people as possible, we can help to ensure individuals and families have a better sense of how to prepare.

Reply
Laurie Mantz, OTR, CDP, CDCM
2/20/2013 04:32:58 am

Christine, Great job with the explanation. I would also include that Dementia is a syndrome of symptoms (decline in problem solving skills, motor skills, communication, memory, perceptual skills, calculations, executive function) that has a root cause. Just like the flu typically includes the symptoms of fevers, aches, cough. Absolutely determining the cause can determine if the dementia is reversible and how to address the individuals needs today and in the future.

The importance of early diagnosis is critical. As soon as one notices changes in cognitive function they should seek medical expertise. If the cause of the dementia is reversible it can easily be treated. An identification of dementia is not a death sentence. Do push for a definitive diagnosis for proper treatment!

Reply
Christine M. Valentin link
2/20/2013 04:35:51 am

Laurie,

Thank you for clarifying and making the analogy. I'm sure many people can relate to it. I also agree with early diagnosis being crucial. Thank you for pointing that out and contributing.

Reply
George Wolf
2/22/2013 12:58:45 am

Enjoyed your exhaustive and thoroughly professional explanation. Besides irreversibility, Alzheimer's is really only finally diagnosable post mortem, although researchers are working on earlier diagnosis possibilities. Dementia on the other hand, stands for as you mention 50 different possibilities, many of which can be diagnosed and some of which can be reversed or at least ameliorated. All create a burden on family and caregivers, Alzheimer's of course the worst and eventually unmanageable in the home.

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Christine M. Valentin link
2/22/2013 01:09:02 am

Hi George,
Thank you for commenting and pointing out how Alzheimer's disease, at this time, is only truly diagnosable after death. It is hard fact for many family caregivers to accept, epsecially when the scientific community has tools to diagnose so many other terminal illnesses. Thank you again.

Reply
Dr. Chris Johnson
2/22/2013 01:24:52 am

I have a helpful article that was published in the American Journal of Alzheimer's Disease and Related Disorders. Its called, Alzheimer's Disease as a 'Trip back in Time.' I would be happy to send it to anyone who emails me a request. There are over 80 diseases that cause this condition called, Dementia. This article, however, describes the unique course of AD takes that changes the perspective of caregivers. The British Alzheimer's Society asked my wife (co-author) and I to publish a one page version of this article for their electronic newsletter that went out to their caregivers.

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Juliane Brenner Vieira Haragushiku
2/23/2013 11:21:50 am

Olá. Gostei muito do seu texto sobre esta doença Christine. Sou enfermeira e professora de graduação e pós-graduação e este assunto é muito importante em minhas aulas. Li o comentário do dr. Chris Johnson e queria solicitar a ele uma cópia do artigo dele para leitura. Grata.

Reply
Susan Krancer link
3/5/2013 10:31:39 pm

Dr. Johnson, I would love a copy of your article. I'm not happy with the medical support Mom is getting. She as dementia, but we don't know what kind. She was diagnosed last summer with thyroid cancer. Her thyroid was removed in October. Lot's of other issues this past year. She was rear ended in April. Had several backing out spells in July - Sept. Hard defibrillator implanted in Sept. Went through paranoia and depression in Dec and Jan... wasn't sleeping. Moved her in with me Xmas eve. Inpatient treatment for paranoia and depression (the place was awful). She's much better now physically and emotionally, but memory is continuing to be an issue.

We are considering assisted living but have not made a decision yet.

Reply
Marsha Watt link
2/22/2013 10:22:30 am

My mother had vascular dementia back in 93 - 99 and when she passed the Physician signed her death certificate reason for death - Alzheimer's, congestive heart failure.
I thought it was very wrong of him - she had had a stroke that enabled her to eat - and she refused a feeding tube - and she only weighed 113 # and her pace maker was still working! What do you think she passed from? I thought it was illegal for them to lie on a death certificate? Does this happen all the time with Dementia v. Alzheimer's?

Reply
Christine M. Valentin link
2/25/2013 02:01:39 am

Hi Marsha,

Thank you for sharing your situation with us. As for your questions, unfortunately, I'm unable to answer them since I'm not a physician and not familiar with the intricacies of her case. What I can say is that Alzheimer's disease is not 100% diagnosable until an autopsy is done.

Reply
Karen Cornwell
2/25/2013 06:55:40 am

What is it that they find in an autopsy that makes it diagnosable? Thanks.

Christine M. Valentin link
2/25/2013 08:36:21 am

Hi Karen,

That is a good question. While I'm not sure of the specifics, here is some information on getting an Alzheimer's disease diagnosis. This particular page does not go into explicit detail but it can serve as a gateway to getting more information to your question. Hope it helps. http://www.nia.nih.gov/alzheimers/topics/diagnosis#how

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    Christine M. Valentin 

    As a licensed clinical social worker, I help individuals caring for a loved one reduce feelings of anxiety, depression and stress.  This blog is meant to share with you, many of the suggestions I recommend to many family caregivers. Sign up to receive them directly.

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The Site does not provide psychotherapy advice. The Site is intended only for use by individuals in search of general information of interest pertaining to caregiving, stress and related topics. Content is not intended to replace or serve as substitute for professional consultation or service. Contained observations and opinions should not be misconstrued as specific counseling advice.
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