Memory-robbing Alzheimer's disease is the most common form of dementia. IV The condition affects more than five million Americans.
What you may not know: One-third to one-half of patients with dementia suffer from a nonAlzheimer's neurological disease that typically starts with symptoms other than memory loss.
In advanced stages, the symptoms of these other dementias resemble those of Alzheimer's disease. Besides suffering from memory loss, patients eventually have minimal ability to speak and/or limited ability to move.
Anyone who has problems with walking, planning activities or mood (such as apathy or depression) should be evaluated by a neurologist or geriatrician, who may suggest treatments that can help improve symptoms.
Non-Alzheimer's dementias…
Vascular Dementia
It's the second most common form of dementia in older adults, and the one that's potentially the most preventable.
Key symptoms: Difficulty performing mental tasks, such as balancing a checkbook or planning an activity, and problems with walking, bladder control and/or vision. Although memory loss is one of the first symptoms experienced by people with Alzheimer's disease, it typically occurs later in most patients with vascular dementia.
Vascular dementia can be caused by a single large stroke, multiple small strokes or narrowing of small blood vessels to the brain due to plaque formation atherosclerosis).
Some patients experience symptoms of vascular dementia abruptly-for example, immediately after a stroke. More often, damage to the brain occurs over a period of years. A magnetic resonance imaging (MRI) scan of the brain of ten shows abnormalities in people with vascular dementia.
The same conditions that increase the risk for stroke-elevated blood pressure, diabetes and high cholesterol-also increase the risk for vascular dementia. Treating these conditions won't reverse cognitive changes but can play a significant role in prevention.
Recent finding: European researchers followed a group of patients age 60 and older for four years. All had hypertension, but none had signs of dementia. Those who were given the drug nitrendipine-a calcium channel blocker similar to the US drug nifedipine (Procardia) to control hypertension were half as likely to develop vascular dementia over a four-year period as those who weren't given the drug.
Treatment: Alzheimer's drugs known as cholinesterase inhibitors, such as donepezil (Aricept) and rivastigmine(Exelon), may reduce symptoms of vascular dementia in some patients.
Lewy Body Dementia
Lewy body dementia, which typically occurs in adults age 65 and older, is named for Dr. Friederich H. Lewy, the scientist who discovered the disease's characteristic abnormal protein deposits that form inside nerve cells in the brain.
Key symptoms: Some are typical of Alzheimer's disease, such as memory loss and confusion...others resemble those caused by Parkinson's disease, such as muscle rigidity. Lewy body dementia also causes visual hallucinations (seeing objects or people that are not really there)...delusions la false belief that cannot be altered by a rational argument)...and fluctuations in alertness.
No one knows exactly what causes Lewy body dementia. The protein deposits are often present in patients with Alzheimer's and Parkinson's diseases, suggesting that the conditions may be linked in some way.
To diagnose Lewy body dementia, doctors look for a progressive decline in cognitive abilities, along with intermittent episodes of hallucinations, a lack of alertness and Parkinson's-like symptoms.
Treatment: Parkinson's disease drugs, such as carbidopa and levadopa (Sinemet), to improve motor symptoms.
Warning: In some Lewy body patients, Sinemet may worsen hallucinations.
For hallucinations and delusions, low doses of antipsychotics, such as quetiapine (Seroquel) or olanzapine (Zyprexa), if necessary.
Warning: The antipsychotic drugs haloperidol (Haldol) and risperidone (Risperdal) worsen Parkinson's-like symptoms in patients with Lewy body dementia.
Frontotemporal Dementia
This is a rare form of dementia in which portions of the brain shrink, causing extreme changes in personality. Unlike other forms of dementia, which are most common in older adults, frontotemporal dementia typically appears between ages 40 and 60.
Key symptoms: Inappropriate public behavior, such as getting undressed in public...rude comments...lack of inhibition...apathy or a loss of interest in everyday life...short-term memory loss.. and compulsive behavior, such as constantly shutting doors.
No one test can diagnose frontotemporal dementia. Imaging studies of the brain, such as MRI, will sometimes show shrinkage of the frontal or temporal lobes. There are no treatments that can stop frontotemporal dementia or slow its progression. Most patients die within two to 10 years after the initial diagnosis.
Treatment for symptoms: Antipsychotic drugs (preferably low-dose) may be used to reduce agitation or compulsive behavior. However, research shows that these drugs are not very effective for this purpose and may even hasten death in older dementia patients.
Is It Dementia?
Dementia potentially is reversible if it is caused by medication reactions, decreased thyroid function, a vitamin B-12 deficiency and/or depression.
True dementia typically progresses slowly over time-sometimes over decades—and current treatments are generally not very effective. Medication can sometimes improve cognitive function in people with Alzheimer's or vascular dementia, but it does not affect the outcome of these diseases.
Research shows that healthy lifestyle factors, such as not smoking, getting regular exercise and staying mentally active and socially engaged, can possibly delay the onset of dementia in some people by one to two years.
Eating Fish Improves Memory
In a recent study of men and women between the ages of 70 and 74, those who ate an average of more than 10 grams (0.35 ounces) of fish daily scored better on several tests that measure cognitive skills, including memory, visual conception, attention, orientation and verbal fluency.
The effect was stronger as fish consumption increased to as high as 80 grams (2.8 ounces) per day.
Caffeine Zaps Memory Problems
Caffeine may keep memory problems at bay in women, according to new research. Women age 65 and older who drank three cups of coffee per day had 30% less risk for memory decline than women who drank one cup or less.
Female coffee drinkers over age 80 had 70% less risk.
