Dementia and Alzheimer’s disease, to the casual observer, may seem different. But according to Dr. Bruce Naughton, Excellus BlueCross BlueShield vice president and chief medical officer for Medicare, they’re actually related.
Naughton is an internist in Buffalo and an expert in the field. Alzheimer’s, he says, is actually a form of dementia. It’s easy to get the two confused.
The word “dementia” is derived from the Greek term for no memory or impaired memory, but there are many forms of dementia.
“I like to think of it as a form of brain injury, and there are many types of brain injury,” Naughton says.
This includes trauma, toxins (the most common is alcohol) and diseases like Alzheimer’s. “In the United States, Alzheimer’s accounts for about half of the dementia cases,” Naughton says.
Dementia is more common the older we get and accelerates after age 75. “But it’s not an inherent part of aging,” he says. “It’s a separate disease.”
Comparing the two, Naughton says experienced clinicians can easily diagnose the pattern of memory loss associated with Alzheimer’s. And the disease takes less of a physical toll on the body, while dementia can affect both the body and brain.
“Other types of dementia have distinct patterns,” he says. Most do not have patterns associated with Alzheimer’s.
Alzheimer’s usually begins with recent memory loss and “can be progressive in a fairly predictable manner, extending out seven to 10 years,” Naughton says. Having a stroke will “complicate the course” and may result in more problems with speech and motor skills.
“Generally, Alzheimer’s affects the higher functions of the brain, not the motor functions,” he says. “It’s a tragic disease in the sense that it affects the person’s personality and memory, their identity declines.”
Alcohol and certain medications can worsen the effects of either. Be sure to check the Beers Criteria Medication List for medications you or a loved one might be taking.
Naughton recalls giving medicine to a woman, a native of Italy, who had lost her ability to speak English. “The next time, she spoke in English, but we had made her more aware of her disease and she was less tolerant of the care,” he says. “We were better off not giving her the medicine.”
Naughton urges a thorough medical evaluation if someone exhibits signs of dementia or Alzheimer’s. He notes that low thyroid levels can make dementia worse.
“The hallmark of Alzheimer’s is early manifestation of memory loss, misplacing items, forgetting things, trouble remembering names of people or items,” he says.
However, we’ve all experienced walking into a room and forgetting what we intended to do. Don’t worry.
“If they tell me they are forgetting things, they probably do not have Alzheimer’s,” he says.
Fortunately, there are plenty of resources out there for family members. Naughton suggests visiting the Alzheimer’s Associate website for starters.
“There are many support groups out there in cities and towns that help you try to understand the diseases,” he says.
However, he advises avoiding reminding a person the simple things like what day it is. “That can be embarrassing, it’s learning to accept the person as they are,” he says. “You can’t interact with them as you always did because they may not understand what you are talking about and that can be stressful.”
A strong support system is important for spouses who suddenly find themselves as caregivers.
For some patients, depression sets in after they are told they’re in the early onset of dementia or Alzheimer’s. “The caregiver needs a lot of support, and we are trying to get better at that,” he says.
Look to your local hospital or universities such as those in Rochester, Syracuse and Buffalo for information about Alzheimer’s disease and dementia and about their respective support groups.
This article was originally published in Community Health for Finger Lakes Area School Health Plan.
