Dementia & Alzheimer's - What's The Difference?
A correct diagnosis means the right medicines, remedies and support. For example, knowing that you have Alzheimer’s instead of another type of dementia might lead to a prescription for a cognition-enhancing drug instead of an antidepressant. Finally, you may be eligible to participate in a clinical trial for Alzheimer’s if you’ve been specifically diagnosed with the disease.
𝗪𝗛𝗔𝗧 𝗜𝗦 𝗗𝗘𝗠𝗘𝗡𝗧𝗜𝗔?
In the simplest terms, dementia is a decline in mental function that is usually irreversible. It’s a syndrome, not a disease, notes neurologist Ron Petersen, director of the Mayo Clinic Alzheimer’s Disease Research Center and the Mayo Clinic Study of Aging in Rochester, Minnesota.
The catchall phrase encompasses several disorders that cause chronic memory loss, personality changes or impaired reasoning, Alzheimer’s disease being just one of them, says Dan G. Blazer, a psychiatrist and professor at Duke University Medical Center.
To be called dementia, the disorder must be severe enough to interfere with your daily life, says psychiatrist Constantine George Lyketsos, director of the Johns Hopkins Memory and Alzheimer’s Treatment Center in Baltimore.
What it’s not? Typical forgetfulness caused by aging — say, having trouble remembering the name of an acquaintance who comes up to you on the street. In fact, the earliest stage of dementia, known as mild cognitive impairment, is considered “forgetfulness beyond what is expected from aging,” Petersen says. With mild cognitive impairment, a person is still functioning normally — paying her bills, driving well enough, doing his taxes — though performing some of those tasks may take longer than they used to. When someone starts to need regular assistance to do such daily activities, “that gets into the dementia range,” Petersen says.
𝗪𝗛𝗔𝗧 𝗜𝗦 𝗔𝗟𝗭𝗛𝗘𝗜𝗠𝗘𝗥’𝗦?
Alzheimer’s is a specific brain disease that progressively and irreversibly destroys memory and thinking skills. Age is the biggest risk factor for the disease. Eventually, Alzheimer’s disease takes away the ability to carry out even the simplest tasks.
To help determine whether patients have this particular brain disease, doctors talk to the patients and their close family members about any recent challenges or changes in behavior or memory. They also administer a mental status exam in an office setting, and possibly do a short neuro-psych evaluation.
A cure for Alzheimer’s remains elusive, although researchers have identified biological evidence of the disease: neuron-destroying plaques and tangles in the brain. You can see them microscopically in brain tissue or, more recently, on PET scans that employ a tracer that binds to the proteins they are made of, making them visible. You can also detect the presence of such plaques and tangles in spinal fluid, but that method isn’t used often in the United States.
𝗛𝗢𝗪 𝗜𝗦 𝗗𝗘𝗠𝗘𝗡𝗧𝗜𝗔 𝗗𝗜𝗔𝗚𝗡𝗢𝗦𝗘𝗗?
A doctor must find that you have two cognitive or behavioral areas in decline to diagnose dementia. These areas are disorientation, disorganization, language impairment, mood change, personality change and memory loss. To make an evaluation, a doctor (often a specialist such as a psychiatrist, neurologist or geriatric medicine physician) typically takes a patient history and administers several mental-skill challenges.
Thanks to growing medical consensus that irritability, depression and anxiety often flag dementia before memory issues do (and official changes to the diagnostic criteria to reflect this), doctors also ask more about changes in mood or personality, Lyketsos notes.
To check for cognitive decline, a doctor will ask whether a patient is experiencing just forgetfulness or, potentially more indicative of dementia, also having trouble figuring out calculations such as a restaurant tip, Petersen says. A physical exam can be important for flagging something like specific types of dementia caused by vascular disease (strokes) or Parkinson’s disease.
Next, a standard and fairly brief round of memory and thinking tests is given in the same office visit. In the Hopkins Verbal Learning Test, for example, you try to memorize and then recall a list of 12 words — and a few similar words may be thrown in to challenge you. Another test — also used to evaluate driving skills — has you draw lines to connect a series of numbers and letters in a complicated sequence.
𝗛𝗢𝗪 𝗜𝗦 𝗔𝗟𝗭𝗛𝗘𝗜𝗠𝗘𝗥’𝗦 𝗗𝗜𝗔𝗚𝗡𝗢𝗦𝗘𝗗?
For decades, diagnosing Alzheimer’s disease has been a process of elimination based on looking at a person’s symptoms and mental-test scores, then ruling out other types of dementia, such as Parkinson’s dementia or vascular dementia.
With Alzheimer’s in particular, the progression and timing of symptoms is also important. To identify this degenerative brain disease, doctors are looking for “a gradual, insidious onset that is slowly getting worse,” Petersen says.
Until fairly recently, a conclusive diagnosis was not possible until an autopsy was performed and the brain examined for the physical hallmarks of the disease — beta-amyloid and tau, proteins that look like plaques and tangles in the brain.
Now, a patient can immediately request a PET scan or cerebrospinal fluid sampling that can show, with 95 percent accuracy, whether such plaques or tangles are present. But a high percentage of patients never get such a test, doctors say. PET scans aren’t normally covered by insurance, and treatments based on specifics such as whether you have more amyloid plaques or more tau tangles in your brain aren’t yet available.
What’s more, doctors say they are often confident, based on evidence such as memory tests, a patient’s age and the progression of symptoms, that a patient suffers from Alzheimer’s in particular. Having a PET scan done also doesn’t change the available treatment, which so far consists of only a handful of drugs used to briefly control symptoms of the disease. Without conclusive imaging, doctors will still act on what they call the strong assumption someone has “probable” Alzheimer’s.(1)
𝟳 𝗕𝗘𝗦𝗧 𝗛𝗘𝗥𝗕𝗦 & 𝗦𝗣𝗜𝗖𝗘𝗦 𝗙𝗢𝗥 𝗕𝗥𝗔𝗜𝗡 𝗛𝗘𝗔𝗟𝗧𝗛
A number of herbs and spices may help improve your brain health, and some of them may be already sitting in your fridge or pantry. Several of these herbs and spices have been studied for their effects on Alzheimer's disease, while others have been tested for their overall effects on cognition (i.e. the mental action or process involved in thinking, understanding, learning, and remembering).
Here's a look at some of the herbs and spices found to benefit the brain in scientific studies.
A spice known for its pungent scent, sage might also improve cognition and aid in the treatment of Alzheimer's disease. In fact, a research review published in 2017, suggests sage contains compounds that may be beneficial for cognitive and neurological function.
Try adding sage to butternut squash, roasted chicken, turkey, tomato sauce, or in a white bean soup. Sage can also be consumed in tea form.
Turmeric is a spice long used in Ayurveda. It contains a compound called curcumin, which has antioxidant and anti-inflammatory effects (two factors that may benefit brain health and overall health).
According to a review published in 2010, preliminary research suggests that turmeric may boost brain health and stave off Alzheimer's disease by clearing the brain of beta-amyloid (a protein fragment). The buildup of beta-amyloid is known to form Alzheimer's-related brain plaques. In addition, turmeric may shield brain health by inhibiting the breakdown of nerve cells in the brain.
Turmeric is a key ingredient in curry powder, which typically also includes such spices as coriander and cumin. To increase your intake of turmeric, try adding curry powder or turmeric to stir-fries, soups, and vegetable dishes. Include a couple of dashes of black pepper to enhance the absorption of turmeric.
3. Ginkgo biloba
Long used as a treatment for dementia, ginkgo biloba is a commonly taken remedy in traditional Chinese medicine (TCM) and well known for its benefits. It's thought that ginkgo biloba might help improve cognitive function in part by stimulating circulation and promoting blood flow to the brain.
Although research on ginkgo biloba has yielded mixed results, there's some evidence that this herb may enhance cognitive function in people with Alzheimer's disease or mild cognitive impairment.
Furthermore, a research review published in the Journal of Alzheimer's Disease in 2015 suggests that a ginkgo biloba extract called EGb761 may be especially helpful in slowing decline in cognition among patients experiencing neuropsychiatric symptoms in addition to cognitive impairment and dementia.
A core feature of Alzheimer's disease and dementia, neuropsychiatric symptoms include depression and other non-cognitive disturbances.
Another Ayurvedic herb, ashwagandha has been found to inhibit the formation of beta-amyloid plaques in preliminary research, according to a review study published in 2010.
What's more, the review says preliminary studies have indicated that ashwagandha may benefit the brain by reducing oxidative stress (a factor that may contribute to the development and progression of Alzheimer's disease).
One of the most popular plants in herbal medicine, ginseng contains anti-inflammatory chemicals called ginsenosides. According to a review published in 2018, scientists have observed that ginsenosides may help reduce brain levels of beta-amyloid in preliminary lab studies.
6. Gotu Kola
In alternative medicine systems such as Ayurveda and TCM, Gotu kola has long been used to improve mental clarity. Findings from animal-based research suggest that this herb may also help the brain by fighting oxidative stress.
In a preliminary study published in Clinical and Experimental Pharmacology & Physiology in 2003, for instance, tests on rats demonstrated that gotu kola may inhibit Alzheimer's-associated oxidative stress and improve cognitive function.
7. Lemon Balm
An herb often taken in tea form and frequently used to ease anxiety and insomnia, lemon balm may help improve cognitive function.
For a study published in the Journal of Neurology, Neurosurgery, and Psychiatry in 2003, 42 patients with mild to moderate Alzheimer's disease took either a placebo or lemon balm extract for four months. At the end of the study, those given lemon balm showed a significantly greater improvement in cognitive function (compared to those given the placebo).(2)
𝗧𝗛𝗘 𝗧𝗥𝗨𝗦𝗧 𝗢𝗥𝗚𝗔𝗡𝗜𝗫 𝗗𝗬𝗡𝗔𝗠𝗜𝗖 𝗗𝗨𝗢 𝗙𝗢𝗥 𝗕𝗥𝗔𝗜𝗡 𝗛𝗘𝗔𝗟𝗧𝗛
As listed above, studies have shown that certain herbs and spices can help prevent the onset of dementia and Alzheimer’s. It’s believed the best time to start using these natural remedies is during midlife, well before the signs of memory loss surface.
𝗠𝗼𝗿𝗲 𝗧𝗵𝗮𝗻 𝗚𝗿𝗲𝗲𝗻𝘀 and 𝗠𝗼𝗿𝗲 𝗧𝗵𝗮𝗻 𝗧𝘂𝗿𝗺𝗲𝗿𝗶𝗰, used individually or, better yet, taken together, contain 4 of the 7 herbs listed above to reduce inflammation, slow the buildup of amyloid plaque which causes memory loss, and flood the body with antioxidants to combat free-radicals that damage cells.
𝗩𝗶𝘀𝗶𝘁 TrustOrganix.com 𝗮𝗻𝗱 𝗹𝗲𝗮𝗿𝗻 𝗮𝗯𝗼𝘂𝘁 𝗠𝗼𝗿𝗲 𝗧𝗵𝗮𝗻 𝗚𝗿𝗲𝗲𝗻𝘀 𝗮𝗻𝗱 𝗠𝗼𝗿𝗲 𝗧𝗵𝗮𝗻 𝗧𝘂𝗿𝗺𝗲𝗿𝗶𝗰 — 𝗬𝗼𝘂𝗿 𝗯𝗿𝗮𝗶𝗻’𝘀 𝗶𝗻𝘀𝘂𝗿𝗮𝗻𝗰𝗲 𝗽𝗼𝗹𝗶𝗰𝘆 𝗮𝗴𝗮𝗶𝗻𝘀𝘁 𝗱𝗲𝗺𝗲𝗻𝘁𝗶𝗮 𝗮𝗻𝗱 𝗔𝗹𝘇𝗵𝗲𝗶𝗺𝗲𝗿’𝘀.
(2) VeryWellMind. Cathy Wong. Medically reviewed by Caitilin Kelly, MD.
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