Alzheimer’s and Dementia

The Difference Between Alzheimer’s Disease and Dementia

Many people (including myself) use the terms Alzheimer’s and dementia interchangeably. Alzheimer’s is a disease, whereas dementia is a group of symptoms. Alzheimer’s is one of the most common causes of dementia, but there are some types of dementia that are completely unrelated to Alzheimer’s.

Alzheimer’s Disease

There are over 520,000 people in the UK with Alzheimer’s, and over 5 million in the US. It is a physical disease that affects the brain, during the course of which structures called ‘plaques’ and 'tangles’ form in the brain due to the build up of protein. Connections between nerve cells are lost, and eventually nerve cells die and brain tissue is lost.

Symptoms

Alzheimer’s is a progressive disease (as time goes on, more parts of the brain are damaged, more symptoms develop, and the symptoms are more severe). Alzheimer’s disease has common symptoms, but it is important to remember that everyone is unique: no two people are likely to experience Alzheimer’s the same way.

For most people, the earliest symptoms are memory lapses, particularly learning new information and recalling recent events. Long-term memory is often unaffected during the early stages of the disease.

Memory lapses can show itself in ways such as:

  • losing items around the house (keys, glasses, etc.)
  • forgetting people’s names
  • struggling to find the right word in a conversation
  • forgetting about recent conversations or events
  • forgetting appointments or anniversaries
  • getting lost in a familiar place or on a familiar journey

As the disease develops, the sufferer can go on to develop problems with other aspects of thinking, reasoning, communication, or perception:

  • language – struggling to follow a conversation or repeating themselves
  • visuospatial skills – problems judging distance or seeing objects in three dimensions; navigating stairs or parking the car becomes much harder
  • concentration, planning, organising – difficulties making decisions, solving problems, or carrying out a sequence of tasks (e.g. cooking a meal)
  • orientation – becoming confused or losing track of the day or date

In the earlier stages of Alzheimer’s, a person will often have changes in their mood. They may become anxious, irritable, or depressed. Many people become withdrawn and lose interest in activities and hobbies.

As the disease progresses, problems with memory loss, communication, reasoning, and orientation become more severe. The person will need more day-to-day support, either by someone moving in with them, or by moving into a nursing/care home.

Typical late stage symptoms include:

  • Delusions
  • Hallucinations
  • Agitation (restlessness, pacing, etc.)
  • Calling out
  • Disturbed sleep patterns
  • Repeating the same question
  • Reacting aggressively
  • Difficulties with everyday tasks (eating, walking, etc.)
  • Lack of awareness of what is happening around them
  • Increased fragility

These behaviours can be challenging for both the person and their carer. Eventually, the person will need help with all their daily activities.

The speed of progression of the disease, and the life expectancy of someone with it, varies. On average, life expectancy is eight to ten years after the first symptoms, though this varies, especially depending on the age of the person when they first developed Alzheimer’s.

Atypical Alzheimer’s

Sometimes, the earliest symptoms are not memory loss. This is called atypical Alzheimer’s, and occurs when a different part of the brain is attacked by the plaques and tangles than usual. It accounts for 5% of Alzheimer’s in those diagnosed over the age of 65, but is a far more common cause for those under the age of 65.

The atypical forms are:

  • Posterior cortical atrophy (PCA) – early symptoms include problems identifying objects or reading, even if the eyes are healthy, uncoordination (e.g. when dressing), or problems judging distances (e.g. when going downstairs)
  • Logopenic aphasia – the person’s speech may become laboured with long pauses
  • Frontal varient Alzheimer’s disease – symptoms include problems with planning and decision making, behaving in socially inappropriate ways, or not seeming to care about the feelings of others

Who Gets Alzheimer’s?

Age is the greatest risk factor for Alzheimer’s, with the disease mainly affecting people over the age of 65 (the risk of developing the disease doubles approximately every 5 years). However, early-onset Alzheimer’s disease affects about 40,000 people in the UK under the age of 65.

For reasons that remain unclear, twice as many women as men over 65 have Alzheimer’s, possibly down to women living, on average, longer than men, or the lack of the hormone oestrogen after menopause.

A member of your family having Alzheimer’s disease does not necessarily mean you will also develop the disease. There are a number of genes that can increase or decrease your chances of getting the disease, but a healthy lifestyle can also lower the chances. Taking regular physical exercise, keeping to a healthy weight, not smoking, eating a healthy balanced diet, and drinking only in moderation, especially from mid-life onwards, can lower your chances of developing Alzheimer’s. Leading an active lifestyle that combines regular physical, social, and mental activity will help lower the risk.

Medical conditions such as diabetes, stroke and heart problems, high blood pressure, high cholesterol, depression, and obesity in mid-life are all known to increase the risk.

Treatment and Support

There is currently no cure for Alzheimer’s (although I know personally that the Physics department at the University of St Andrews has found a possible cure that has yet to be tested on humans), but a lot can be done via drug and non-drug care, support, and activities to enable someone to live well with the condition.

Talking with a professional about their diagnosis can help. Talking therapies can help someone who is depressed or anxious, as well as counselling. There are drug treatments that can alleviate temporarily some symptoms, or slow down the progression in some people.

Keeping up with activities that they enjoy is beneficial, as well as exercising their mind with reading/puzzles. Reminiscing about the past can also be beneficial as the symptoms worsen. Agitation and aggression is likely to be caused by the person being in pain, misunderstanding what is happening, or by being frustrated or under-stimulated. Listening to music or doing an activity that the person enjoys can help fight this.

Support for carers is also important, as they are likely to find these behaviours distressing, especially in the later stages. When writing a character with Alzheimer’s, make sure you don’t forget about the characters around them.

Dementia

Dementia affects about 800,000 people in the UK. There are many similarities between Alzheimer’s and dementia, as Alzheimer’s is a common cause of dementia. It is a syndrome (group of related symptoms) associated with the decline of the brain and its abilities, including:

  • memory loss
  • thinking speed
  • mental agility
  • language
  • understanding
  • judgement

People with dementia can become uninterested in their usual activities, and have problems controlling their emotions. Social situations can be challenging, losing interest in socialising, and aspects of their personality may change. They can lose empathy for others, experience hallucinations, or make false claims or statements. As dementia affects a person’s mental abilities, they may find planning and organising difficult. Maintaining their independence can also become a problem, leading to them often needing a carer.

Other symptoms may include:

  • increasing difficulties with tasks and activities that require concentration and planning
  • depression
  • changes in personality and mood
  • periods of mental confusion
  • difficulty finding the right words

Most types of dementia can’t be cured, but if it is detected early there are ways you can slow it down and maintain mental function.

Mixed Dementia

Roughly 10% of people with dementia have more than one type at the same time, and this is called mixed dementia. The most common mix is Alzheimer’s disease with vascular dementia (problems with blood supply to the brain). The symptoms of this kind of mixed dementia are a mixture of the symptoms of Alzheimer’s and vascular dementia.

Extra Stuff

For more information, please follow this link

'The Notebook’, starring Rachel McAdams and Ryan Gosling, has a major character who suffers from dementia. You will cry. I will judge you if you don’t.

~DP

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Video Gaming May Lead to Higher Risk of Neurological Disorders

A team of researchers report in the journalProceedings of the Royal Society B that while video game players exhibit more efficient visual attention abilities, they are also much more likely to use navigation strategies that rely on the brain’s reward system (the caudate nucleus) and not the brain’s spatial memory system (the hippocampus).

Past research has shown that people who use caudate nucleus-dependent navigation strategies have decreased grey matter and lower functional brain activity in the hippocampus. This, in turn, may lead to an increased risk of neurological disorders such as Alzheimer’s disease.

(Photo : © iriska / Fotolia) 

Deconstructing Brain Systems Involved in Memory and Spatial Skills

In work that reconciles two competing views of brain structures involved in memory and spatial perception, researchers at University of California, San Diego School of Medicine have conducted experiments that suggest the hippocampus – a small region in the brain’s limbic system –  is dedicated largely to memory formation and not to spatial skills, such as navigation. The study is published in this week’s issue of the Proceedings of the National Academy of Sciences.

“The role of the hippocampus in spatial cognition versus memory formation is a major debating point in our understanding of how the human brain processes its exterior environment,” said senior author Larry Squire, PhD, Distinguished Professor of Psychiatry, Neurosciences, and Psychology. “This study shows that the hippocampus is primarily associated with memory. It’s an adjudication on two perspectives that span more than 60 years of research.”

In one of these perspectives, developed in the 1950s, the hippocampus is viewed as being the critical structure enabling the formation of declarative, long-term memories, such as the ability to remember one’s high-school prom. That view shifted in the 1970s when experiments conducted largely with rats showed that the hippocampus plays a major role in spatial skills, such as those needed to navigate through a maze. The experiments led some researchers to speculate that the human hippocampus might also be active in spatial cognition and mapmaking skills.

“We have not found evidence that this is the case,” said Squire, who is also a research career scientist at the Veterans Affairs San Diego Healthcare System. “Patients with hippocampal lesions can perform spatial tasks as long as these tasks don’t depend on long-term memory. We think they can do these spatial tasks because these tasks can be managed within short-term memory functions, supported by the frontal lobe of the neocortex. The discrepancy we see with rats may reflect the fact that rodents don’t have a well-developed frontal cortex or the associated short-term memory processing skills. The spatial tasks that we can do with our neocortex using short-term memory must be performed by the hippocampus in rats.”

The results are based on experiments with six adults with hippocampal lesions, one adult with damage to the medial temporal lobe, which includes the hippocampus, and 12 control subjects. For the experiments, participants were asked to study a simple scene, such as a pair of boots, and to draw the scene from memory. The drawings were scored for detail and accuracy on a 1-5 scale. Participants were also evaluated for a normal tendency, known as boundary extension, in which people tend to recall an image as having a larger background and smaller foreground than is present in reality. In the boot example, this means people tend to draw the boots smaller than they were in the original photograph. The background consequently takes up a larger fraction of the image, hence the term boundary extension.

In a second set of experiments, participants were asked to look at a scene, such as a slide in a park, and describe what might come into view if the image were enlarged. The participants’ narratives were scored for details, spatial references, thoughts and emotions.

All participants with hippocampal damage demonstrated an impaired ability to accurately recall details about the boots. Their average score was 2, compared with 3 for the control group. However, the patients displayed normal boundary extension. Both patients and control subjects shrunk the size of the boots relative to the background by about 60 percent. Both groups were also equally skilled in imagining and constructing detailed narratives about what might come into view if the scenes were expanded.

“The value of this type of research is that we are building an understanding of how the brain works,” Squire said. “We know Alzheimer’s disease usually begins in the medial temporal lobe and this study reminds us that it’s not the patients’ spatial skills that are immediately at risk, it is their memory. This is consistent with clinical experiences. Patients don’t complain about loss of spatial skills, they complain about memory loss.”

Pictured: (Left to right) Image shown to study participants; image drawn by memory by a control subject; and image drawn by patient with hippocampal damage. Image courtesy of PNAS

dailydot.com
Celebrated fantasy author Terry Pratchett dies at 66

Beloved fantasy author Terry Pratchett has passed away aged 66, after a long struggle with Alzheimer’s disease.

The author is best known for his world-famous Discworld series, as well as numerous other science fiction, fantasy, and children’s books. Among his many collaborations is the cult fantasy novel Good Omens, which was cowritten with Neil Gaiman. Over the past 30 years, Pratchett became an icon in the fantasy fiction community, respected both for his humor as a satirist and for the rich creativity of the Discworld books.

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New Link Between Alzheimer’s and Diabetes Discovered

Full article .

Researchers have uncovered a unique connection between diabetes and Alzheimer’s disease, providing further evidence that a disease that robs people of their memories may be affected by elevated blood sugar, according to scientists at Washington University School of Medicine in St. Louis.

The research is in Journal of Clinical Investigation. (full open access)

Research: “Hyperglycemia modulates extracellular amyloid-β concentrations and neuronal activity in vivo” by Shannon L. Macauley, Molly Stanley, Emily E. Caesar, Steven A. Yamada, Marcus E. Raichle, Ronaldo Perez, Thomas E. Mahan, Courtney L. Sutphen, and David M. Holtzman in Journal of Clinical Investigation doi:10.1172/JCI79742

Image: The researchers showed that spikes in blood glucose increased the activity of neurons in the brain, which promoted production of amyloid beta. This image is for illustrative purposes only.

Alzheimer Amyloid Clumps Found in Young Adult Brains

Amyloid – an abnormal protein whose accumulation in the brain is a hallmark of Alzheimer’s disease – starts accumulating inside neurons of people as young as 20, a much younger age than scientists ever imagined, reports a surprising new Northwestern Medicine study.

Scientists believe this is the first time amyloid accumulation has been shown in such young human brains. It’s long been known that amyloid accumulates and forms clumps of plaque outside neurons in aging adults and in Alzheimer’s.  

“Discovering that amyloid begins to accumulate so early in life is unprecedented,” said lead investigator Changiz Geula, PhD, research professor in the Cognitive Neurology and Alzheimer’s Disease Center. “This is very significant. We know that amyloid, when present for long periods of time, is bad for you.”

The study was published March 2 in the journal Brain.

Read more >>

This work was supported in part by a Zenith Fellows Award from the Alzheimer’s Association, and by grants from the National Institute on Aging (AG014706, AG027141, AG20506 T32) of the National Institutes of Health. 

Hi! So I made a post like this last summer and I hate doing this again but me and my family are participating in the Walk to End Alzheimer’s for the second year in a row. We just recently lost my Nana to Alzheimer’s a year ago and it’s still been really hard. 

Alzheimers disease can effect you and your entire family from literally out of nowhere, I feel like one day my Nana was fine and the next she barely knew who I was or where she was. It doesn’t just effect the memory of the person diagnosed, but it turns them into a whole different person. I don’t even know how to explain it, everything you know and love about a person basically just disappears and there is nothing you can do to help them. There is no cure and no real working treatments that help slow the process down. 

I know it’s a lot of me to ask you to donate because I know you guys have your own things to pay for and what not but you never know if one of your loved ones could be diagnosed with this awful disease, but even if you just reblog this post it would mean so much, I never know who it could reach. I love yall so so much thank you for even just reading this.

And if anyone else has lost someone to Alzheimers or is going through the really hard time of caring for someone with it, I am always here to talk to if you need because I know exactly what you are going through.

Sleep Deficit Linked to Accumulation of Alzheimer’s Protein and Memory Loss

Full article at NeuroscienceNews.com.

Berkeley neuroscientists connect a deficit of restorative slumber to an accumulation of beta-amyloid.

The research is in Nature Neuroscience. (full access paywall)

Research: “β-amyloid disrupts human NREM slow waves and related hippocampus-dependent memory consolidation” by Bryce A Mander, Shawn M Marks, Jacob W Vogel, Vikram Rao, Brandon Lu, Jared M Saletin, Sonia Ancoli-Israel, William J Jagust and Matthew P Walker in Nature Neuroscience doi:10.1038/nn.4035

Image: Heavy deposits of the toxic protein, beta-amyloid, shown in red in the brain on the right, are linked to poor sleep and may be paving the way for Alzheimer’s disease. A brain benefiting from deep sleep brain waves and an absence of beta-amyloid is shown on the left. Image courtesy of Bryce Mander and Matthew Walker.