The main differences between various forms of dementia and Alzheimer's disease

What is Alzheimer's type dementia?

Dementia is a syndrome of progressive or chronic brain damage during which higher cortical functions are impaired. These include memory, spatial orientation, thinking, understanding of the environment, learning ability, and speech. At the same time, the consciousness of the victims is not clouded.

To establish a diagnosis, the clinical picture of the disease must be observed for at least six months. A more progressive onset of the disease is also possible. The development of dementia in Alzheimer's disease is promoted by:

• long-term use of certain medications;
• lack of vitamins in the body;
• metabolic disorders due to pathologies of the liver and kidneys;
• hormonal imbalance;
• vascular diseases;
• damage by infectious agents of bacterial and viral etiology;
• frequent stress, depression;
• regular consumption of alcoholic beverages;
• traumatic brain injury with damage to brain structures;
• benign and malignant neoplasms.

What happens to personality, memory and “instrumental” functions of intelligence

Already at the beginning, Pick's disease causes serious personality changes. Patients become disinhibited, exhibit unmotivated behavior, and spontaneity becomes inaccessible. There is a combination of childishness and impoverishment of general activity.

Even the initial stage of Pick's disease makes patients capable of committing acts that worsen their financial situation and negatively affect their social condition. It happens that they leave home and quit their jobs. For such behavior to occur during Alzheimer's disease, the dementia must progress to a moderate stage. Only then will a person begin to resist leaving and begin to wander.

At the beginning of its occurrence, Pick's disease almost does not affect the basic, “working” functionality of the intellect. We can confidently talk about a slight change in attention, memory, and counting. The person still has good orientation and does not confuse places, times and events. But at the same time, the level of higher mental activity, which includes criticism, generalization, and abstraction, falls.

Deteriorating memory is the first sign of symptoms of Alzheimer's disease. People who are ill are unable to remember new information; they easily forget recent facts. Cognitive impairments occur. Their manifestations are mild or moderate. The initial stages of the disease do not cause destruction of the personality; it remains almost at the same level.

Difference between vascular dementia and Alzheimer's disease

It is important to know the difference between dementia and Alzheimer's disease. If a person has vascular dementia, the ability to normally perceive and analyze information is impaired. Among the causes of pathology, peripheral vascular diseases, myocardial diseases, hypertension, and elevated cholesterol levels are most often observed.

Alzheimer's disease is a severe neurological brain disease that causes dementia. The etiology of the development of Alzheimer's disease is associated with a person's age, genetic predisposition, and general poor health. In addition, the disease is characterized by a slow course, due to which pathological processes develop over many years.

What is Alzheimer's disease?

Alzheimer's disease

is a condition that affects the brain. The disease is named after Dr. Alois Alzheimer, who first described the condition in 1906. Common symptoms of Alzheimer's disease include memory loss, language problems, and impulsive or unpredictable behavior. One of the main features of this condition is the presence of plaques and tangles in the brain. Another feature is the loss of communication between nerve cells, or neurons, in the brain. These features mean that information cannot easily pass between different areas of the brain or between the brain and muscles or organs. As symptoms worsen, patients find it increasingly difficult to remember recent events, reason, and recognize people they know. Ultimately, a patient with Alzheimer's disease may require ongoing care.

Alzheimer's disease is the sixth leading cause of death, but other estimates suggest it may be the third leading cause of death, just behind heart disease and cancer.

Difference between dementia and Pick's disease

Patients who suffer from dementia combined with Pick's disease are able to continue to learn and remember events from their lives. In patients with Alzheimer's dementia, loss of cognitive function is one of the first symptoms. During Pick's disease, short episodic hallucinations are possible, which go away on their own. Patients also experience outbreaks of nervousness and agitation.

In the early stages of development, both diseases have similar symptoms. Patients behave confusedly, forget the way, words, and the ability to make decisions. They have disorders of speech and perception of the environment, and their vocabulary is significantly reduced.

What is the difference between dementia and Alzheimer's disease?

Dementia and Alzheimer's disease are similar concepts, but not the same. Dementia is a general term and has many different types, one of which is Alzheimer's disease. Sometimes there is confusion between the two because people often use these terms interchangeably.

Dementia is an umbrella term used to describe a range of symptoms that significantly affect cognitive function, including:

• Memory
• Ability to think and concentrate
• Problem solving ability
• Connected speech
• Adequate visual perception

Alzheimer's disease is a specific type of dementia that causes a gradual decline in memory and thinking.

What is dementia?

Dementia is a syndrome, a term that describes a set of symptoms without any specific cause. A syndrome is different from a disease, which has specific symptoms and a common cause.

Dementia can affect a wide range of mental functions. As a result, many different diseases and conditions are types of dementia.

Alzheimer's disease is the most common type of dementia, but there are several other types, including:

• vascular dementia, which occurs as a result of strokes or other conditions that block blood flow to the brain
• dementia with Lewy bodies, which results from abnormal protein deposits in the brain
• frontotemporal disorders, which are types of dementia that result from damage to the frontal and temporal lobes of the brain

It is possible to have multiple types of dementia at the same time. The term used for this is mixed dementia.

Causes and risk factors

Causes vary by type, but the exact causes of many forms of dementia are currently unclear.

One of the main risk factors for developing dementia is age. In fact, up to 50 percent of people aged 85 and older may have some type of dementia. About 32 percent of people over 85 currently have Alzheimer's disease.

Symptoms tend to worsen with age, but it is important to remember that dementia is an optional part of old age.

It is possible to develop dementia at a younger age, but it is more common among older people.

Warning signs and symptoms

Some people find it difficult to detect symptoms of dementia because they may be mild. However, in other cases they can be severe enough to have a significant impact on daily life.

Symptoms vary depending on the area of ​​the brain affected by dementia, but the most common signs are:

• anxiety and suffering
• Bad mood
• detachment and disinterest
• repeating the same questions
• psychosis
• sleep disorders
• walking around the house for no apparent reason
• inappropriate social behavior

Symptoms of dementia may appear many years after the onset of the disease. This can be a challenge when it comes to diagnosing and treating the syndrome. Significant damage may already be present in a person before visiting a doctor, which can make treatment more difficult.

What is Alzheimer's disease?

Alzheimer's disease has a specific set of symptoms that have a common cause.

Researchers believe that the accumulation of abnormal proteins forms plaques and tangles in the brain, causing Alzheimer's disease. These abnormal proteins surround brain cells and can damage their ability to transmit and receive information. This ultimately leads to cell death.

Accumulations of protein tangles occur in certain areas of the brain, including the hippocampus. This area of ​​the brain plays a critical role in long-term memory.

Warning Signs and Symptoms

Alzheimer's disease affects certain mental functions because it affects specific areas of the brain. This causes some symptoms that are common in other forms of dementia, such as:

• confusion
• disorientation
• memory problems
• sudden mood changes

Other symptoms more specific to Alzheimer's disease:

• difficulty remembering past events
• difficulty remembering new information
• personality changes such as aggression or paranoia
• persistent bad mood
• difficulty swallowing, speaking, or walking

Treatment of dementia and Alzheimer's disease

There is no cure for dementia and current treatments cannot reverse the disease. Treatment options may vary depending on the type of dementia.

For example, treatment for Alzheimer's disease aims to relieve symptoms and may include:

• medications for memory loss
• medications to correct behavioral changes or depression
• cognitive training
• hypnotic

Positive lifestyle changes are an important part of overall health, and they can help prevent or slow the progression of Alzheimer's disease and other forms of dementia.

Some lifestyle changes may include following a Mediterranean diet and regular physical activity. However, confirming the benefits of these changes requires additional research.

Treating people with Alzheimer's disease or other forms of dementia is very challenging. It is important to help people stay productive for as long as possible and provide support when needed.

Forecast

The outlook for people with dementia depends on how early a professional diagnoses and treats the condition. Depending on the type of dementia, symptoms may be detected early enough so that the person can live many more years and maintain the highest possible quality of life.

Dementia in general, and Alzheimer's disease in particular, are progressive disorders that have no cure. Treatment can help slow degeneration, but cannot prevent it.

The rate of cognitive decline varies widely and can have a serious impact on quality of life.

Stages of Alzheimer's type dementia

The initial stage of the disease is accompanied by minor clinical symptoms. Patients experience memory impairment, in which they forget the meanings of some words, as well as certain life events. They find it difficult to analyze the situation and think abstractly. The patient realizes that his condition is worsening, as a result of which he experiences psychological disorders. They are accompanied by irritability, agitation, cravings for alcohol and insomnia.

At an early stage of development of pathology, a person’s facial expressions are subject to dramatic changes; he is characterized by a surprised facial expression, an open mouth, raised eyebrows and rounded eyes. Patients forget about hygiene procedures; they have poor spatial orientation, even in familiar places. They find it difficult to write and count, and motor activity slows down significantly.

The moderate form of the disease is characterized by speech, writing and reading disorders. Coordination of movements is significantly impaired. Patients do not recognize their loved ones and relatives, and practically do not remember any events in their lives. Most of them experience irritability, which gives way to apathy. Patients cannot find the right words or are completely silent.

The severe course of the disease is accompanied by changes in the patient's personality. He does not remember who he is, and is also not aware of what is happening around him. Such people are sedentary and silent. They often experience tremors and delusional disorders.

Patients suffering from moderate to severe forms of the disease are completely dependent on the help of others. They must not be left alone to prevent them from harming themselves or other people.

Symptoms of Alzheimer's disease

Alzheimer's disease

is a progressive condition, meaning that symptoms get worse over time. Memory loss is a key feature and one of the first symptoms to develop. Symptoms appear gradually over several months or years. If they develop over a period of hours or days, the person may need medical attention as it may indicate a stroke.

Symptoms of Alzheimer's disease include:

1. Memory loss
   : The patient has difficulty perceiving new information and remembering information. This may be accompanied by: repetition of questions or conversations
2. forgetting about events and meetings
3. a person can get lost

In 2021, researchers published findings suggesting that a change in a person's sense of humor may also be an early symptom of Alzheimer's disease.

Diagnostics

To establish a preliminary diagnosis of dementia due to Alzheimer's disease, the patient must visit a neurologist. After collecting a general and family history, the doctor proceeds to examine the patient, as well as conduct a series of neuropsychological tests.

In order to confirm the diagnosis, the doctor prescribes instrumental and laboratory diagnostic methods. Among them, the most effective are:

• general and biochemical blood test;
• blood test for glucose and B vitamin levels;
• biochemical analysis of cerebrospinal fluid;
• electroencephalography;

• computed and magnetic resonance imaging.

As an additional diagnostic method, the study of genetic material for the presence of mutated genes is used. The functionality of the endocrine organs is also checked.

Examination methods, differential diagnosis

Differentiating various pathologies is the task of a neurologist, psychotherapist or psychiatrist. The assistance of a neurosurgeon or vascular surgeon may be required. Standard events:

1. Oral interview with the patient and his relatives. To detect typical complaints, symptomatic complex.
2. Anamnesis collection. It is necessary to find out what was the probable cause of the development of the condition.
3. Research in cardiology. ECG, ECHO, and, if necessary, daily monitoring. The involvement of a specialized specialist will be required.
4. Neurological examination. Checking reflexes.
5. Psychological testing. In order to determine the state of the emotional-volitional and cognitive spheres. It involves questionnaires, passing special tests, and conversations with a psychologist or psychotherapist.
6. Complete psychopathological examination.
7. Assessment of hormone levels in the blood.
8. MRI of the brain, also computed tomography if necessary. Both examinations are contrast-enhanced.
9. Angiography.
10. Electroencephalography. To evaluate the electrical activity of the brain.
11. Dopplerography of neck and brain vessels, duplex scanning.

If it is not possible to make an accurate diagnosis, dynamic observation with repetition of diagnostic measures is indicated. The same applies to a confirmed diagnosis. In this case, diagnostics are indicated to assess the quality of therapy.

Differential diagnosis of dementia and Alzheimer's is difficult and requires the efforts of several doctors at once. It may take more than one week or even more than one month just to determine the cause of cognitive impairment.

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Treatment

The principles and methods of treatment are selected individually, taking into account the patient’s age, stage of the disease and the presence of concomitant pathologies. They are aimed at treating Alzheimer's dementia, as well as eliminating the consequences of degenerative changes in nerve tissues.

Complex treatment is carried out by taking medications that stimulate blood circulation and metabolism in the structures of the brain. In parallel, this is supplemented by physiotherapy, exercise therapy and a special diet.

Helpful information

In combination with basic treatment, doctors carry out prevention and treatment of diseases that develop against the background of dementia. These include hypertension, atherosclerosis, obesity, diabetes mellitus, and depression.

To strengthen the body overall, antioxidants and vitamins are prescribed. For moderate and severe stages of the disease, drugs with pathogenetic effects are used.

Dementia due to Alzheimer's disease cannot be completely cured. Timely initiation of therapy will improve the patient’s quality of life, increase its duration, and also ease the responsibilities of loved ones in caring for him. At a certain stage, even these actions cease to have the desired effect, as a result of which the patient’s personality is completely amenable to change. He literally stops being himself.

Treatment of dementia due to Alzheimer's disease

• Drug therapy (nootropics, cholinesterase inhibitors, vitamin therapy, antiparkinsonian drugs, vascular drugs, neurometabolites; limited use of tranquilizers and antipsychotics).
• Instructing relatives.

Treatment is prescribed only after confirmation of the diagnosis by a medical specialist.

Essential drugs

There are contraindications. Specialist consultation is required.

• Ipidacrine (anticholinesterase agent). Dosage regimen: orally, at an initial dose of 20 mg/day. (in two doses), then it is increased over 2-4 weeks. before therapeutic (40-80 mg/day in two doses). The duration of treatment is at least 3 months.
• Galantamine (anticholinesterase agent). Dosage regimen: orally, at an initial dose of 8 mg/day. (4 mg morning and evening) for 4 weeks. With good tolerance from the 5th week. the daily dose is increased to 16 mg (8 mg in the morning and evening). With insufficient effectiveness and good tolerability from the 9th week. treatment, the daily dose can be increased to 24 mg (12 mg in the morning and evening). Duration of treatment is at least 3-6 months.
• Memantine (neuroprotective agent). Dosage regimen: orally, at an initial dose of 5 mg (once in the morning), every 5 days the daily dosage is increased by 5 mg (in two doses) until the therapeutic dose is reached. The course of treatment is at least 3 months.
• Piracetam (nootropic drug). Dosage regimen: orally, with liquid at a dose of 400-800 mg in 3 divided doses.
• Cerebrolysin (nootropic drug). Dosage regimen: intravenously, at a dose of 20-30 ml of the drug in 100 ml of 0.9% sodium chloride solution, 20 infusions per course. A course of treatment with Cerebrolysin 1-2 times a year is recommended.

“By following the recommendations of doctors, you can extend the active phase.” Vladimir, 57 years old

“We noticed symptoms in March 2011, but in hindsight we realized that dementia had started to develop earlier. Six months before, she was bad at sewing, knitting, and cooking. But we didn't attach any importance to this. Then she began to get confused more than usual, making mistakes in the simplest things. Mom, of course, is an elderly person, but it became obvious to both me and my sister that something was wrong.

We didn't understand what was happening and took her to a neurologist. The doctor immediately said that my mother had dementia, possibly Alzheimer’s disease. She prescribed medications, injections and suggested specialists who deal with this problem in Moscow. The Scientific Center for Mental Health of the Russian Academy of Medical Sciences sounded. Department for the Study of Alzheimer's Disease and Associated Disorders. I found it. In the first months we managed to get an appointment. For the first five or six years we visited there regularly. They told me how to behave with my mother in everyday life, what to do with her.

The first years we lived actively. We did Nordic walking and played chess. We did everything together: shopping, eating, cleaning, even doing laundry together. We tried to communicate: we went to visit, we invited friends.

But this time quickly passed. Three years ago, my mother began to fall into delusional states, sleep poorly, and behave aggressively. She has required continuous monitoring for the last two years. We had to put locks on all the doors and windows and remove the handles from the stove. If I’m doing something, I look back at her every two or three minutes. Now my mother is bedridden. He speaks poorly and doesn't understand anything.

All the concern lies with me. At first I went to work, but then I had to leave everything. The situation was depressing. But over time, we got used to each other and managed. My sister is a visitor and comes when she can. I can do some things at this time. But since my sister, unlike me, is not constantly looming before my eyes, my mother does not perceive her well: she does not listen, she contradicts her.

My mother’s character changed a lot during her illness. She doesn't react well to all people, so we haven't thought about a caregiver. We did not consider boarding houses either. She is very restless, energetic, and difficult to keep track of. And a change of scenery wouldn't do any good.

Mom, of course, doesn’t realize much, but her native walls work better on her. Even when we first went to a relative’s dacha, she always asked to come back home. As we were told at the “School of Caring” and as I myself understood through experience, caring for such patients is still the business of relatives. Nothing can replace their help and care.

On the recommendation of the center’s specialists, we registered at the neuropsychiatric dispensary at our place of residence. The doctors sent me, saying that they could give me free medicine. But the necessary drugs were not available. We buy everything ourselves. We spend 5-7 thousand a month.

In my opinion, the most important thing is to notice in time, give importance to the changes and turn to specialists. Nothing good will happen if you leave things to chance. By following doctors’ recommendations, you can extend the active phase.”