The words Alzheimer’s and dementia have become commonplace across the U.S. and the globe, affecting families and caregivers far beyond just the physical costs. According to Alzheimer’s Disease International, the annual global cost of dementia is approximately $1.3 trillion dollars and is expected to more than double to $2.8 trillion dollars by 2030. Every three seconds, someone in the world develops dementia.

Costs accumulate for several reasons:

• Care provided informally by family and others
• Professional care costs associated with residential or in-patient care
• Direct medical care costs

The impact is staggering—if global dementia care was a country, it would be counted as the 14^th largest economy on the planet.  

While no cure exists for either disease, there are treatments available that may slow the progression of both. In this article, we’ll look closer at the causes, symptoms, treatments, and tips for caregivers and families.

Although the terms are often used interchangeably, Alzheimer’s and dementia are different. Dementia is an umbrella term, and Alzheimer’s is a type of dementia. They are similar in affecting memory and thinking, eventually leading to a decline in language, problem solving, and daily living.

Alzheimer’s is a disease that affects memory loss and thinking abilities. It’s the most common form of dementia, accounting for up to 80% of dementia cases, and eventually disrupts daily living. Here are some basic facts about Alzheimer’s:

• It’s not a normal part of the aging process.
• The disease largely affects people over 65
• It’s a progressive disease, ending in total loss of ability
• After diagnosis, the lifespan on average is 4 to 8 years.

Dementia is a general term that describes many types of neurological conditions that affect the brain over time. How those changes occur are as individual as the person. Some lose the ability to remember or reason; others can’t control their emotions or behaviors. Like Alzheimer’s, dementia isn’t part of the normal aging process and affects about one third of people 85 or older. Let’s look at the different kinds of dementia.

Alzheimer’s disease

The most common form of dementia, this disease typically occurs due to the buildup of proteins, known as amyloid plaques and tau tangles, that affect the nerve connections.

Frontotemporal dementia (FTD)

This is rare and tends to happen in those younger than 60. As the frontal lobe changes, this causes behavior changes.

Lewy body dementia (LBD)

Also caused by abnormal protein deposits, this type of dementia affects behavior, mood, movement, and thinking. Comedian and actor Robin Williams suffered from undiagnosed Lewy body dementia before his death.

Vascular dementia

This diagnosis is related to the vascular system, or small vessels, that carry blood to the brain. Stroke victims are at high risk for developing vascular dementia over time. White matter interferes with the brain’s connections, causing confusion.

Despite worldwide efforts to find new ways to slow the progression of dementia, the numbers paint a sobering reality.

• Every three seconds, someone across the planet develops dementia.
• In 2020, 55 million people were living with dementia, and this number is expected to double every 20 years.

Researchers are still trying to understand why some people develop dementia while others don’t. While one clear reason hasn’t been evident that genetics and lifestyle may play a role. Other risk factors include:

• Aging
• Smoking
• High blood pressure
• High alcohol consumption
• Diabetes

Scientists know that the brain’s nerve cells, called neurons, are greatly affected by dementia and Alzheimer’s. They can see damage or problems as cognitive symptoms appear, but they’re not certain how the diseases start. Two abnormalities are known to damage and kill nerve cells.

1. Protein fragments called plaques
2. Twisted fibers called tangles

Dementia can develop years before any recognizable symptoms appear. Even then, the behavioral or physical changes may be so subtle it may be difficult for family members or even the person suffering from the disease to recognize exactly what’s happening. If someone is experiencing memory issues, they may mask their symptoms or rely on family members to make excuses for any shortcomings.

Early dementia symptoms

Dementia differs from natural forgetfulness or normal memory challenges. Knowing how it differs and what to look for can be helpful towards diagnosing the disease.

Memory loss

A very common symptom, memory loss means more than just forgetting a name. Someone living with dementia may not remember a name but may also forget the context of a person or thing.

Difficulty with familiar tasks

Cooking, driving, or dressing may become a challenge for someone with dementia. The ability to know the sequence or steps involved in a task may be lost.

Isolation or withdrawal

If there’s too much activity, a person with dementia may feel overwhelmed. Maybe the room is too full, or the conversations are too fast. In either case, they may move to another room or simply withdraw more by not talking.

Confusion or disorientation

Someone who is normally good with directions may suddenly not be able to find their way home or feel increasingly agitated or frustrated doing a normal task.

Poor judgement

Making decisions, trusting strangers, and wearing inappropriate clothing are all signs of poor judgement. People with dementia may find it difficult to make decisions, solve problems, or keep up with paying their bills.

Misplacing items

Someone with dementia may place items in odd places. Milk may end up in a cabinet or dishes in the closet.

Changes in mood or behavior

Mood swings, irritability for no reason, and showing less emotion are just a few of the ways dementia may affect behavior.

Early detection can benefit patients and families in several ways:

• Healthcare providers can provide an honest assessment and create a plan.
• Certain medicines or interventions may help manage symptoms.
• Participation in a clinical trial may be an option.
• Families who accept the reality have more time to plan and gain more knowledge.
• Planning for the future and making important decisions
• Finding more resources and services through your doctor or healthcare providers

Technology has given doctors and healthcare providers better tools to see what’s happening in the brain. Researchers continue to work to develop easy, non-invasive tests for early detection. Current options include:

• Brain neuroimaging to detect Alzheimer’s
• Functional imaging like a positron emission tomography (PET) scan tests for dementia
• Molecular imaging pinpoints any clues about brain changes
• Cerebrospinal fluid (CSF) tests like a spinal tap analyzes certain markers in the brain

Diagnosing dementia requires time and help from a doctor or neurologist. Generally, they will review current health and family history. More specifically, a doctor or healthcare provider will look at any impaired memory or thinking skills, changes in personality, or if a person’s daily routine is interrupted due to memory loss or function.

Mental status testing

This test focuses on thinking skills, known as cognitive skills, and memory.

Neuropsychological tests

A specialist can conduct extensive tests to help doctors and patients understand if someone can still complete daily tests as well as advise if medications may help with current brain function loss.

Interviews with family

Families are ideal for sharing observations about someone’s behavior or symptoms. By asking for feedback, doctors can establish a baseline for past and current behavior.

Treatment with medications

A class of drugs called cholinesterase inhibitors focuses on raising a chemical in the brain called acetylcholine. Drugs like donepezil and rivastigmine work to raise the levels of this chemical which helps nerves to talk to each other.

Once diagnosed, a person with dementia and the family faces a new way of living and managing. No one is immune to the resulting emotional, mental, physical, and financial drain that comes with these diseases. Often, patients can live for years, draining reserves and energy from those around them. Finding resources and support helps families and caregivers navigate the daily challenges and future unknowns.

1. Keep a routine — Probably the most important single thing anyone can do for a dementia patient is to keep a strict routine. Without routine, patients face the unexpected and feel insecure about the most common tasks.
2. Establish a system of reminders, especially for daily medications.
3. Respect loved ones who have dementia, practicing patience and acceptance.
4. Recognize the disease drives the person’s behavior, especially anger and frustration.

Keeping caregivers healthy and strong is just as critical as helping the person living with dementia, if not more so. Caregivers often work themselves to the point of exhaustion. How can you recognize if a caregiver needs more help? Here are a few warning signs.

• Increased anger, especially at the loved one
• Denying the disease is causing problems and blaming the loved one
• Increased anxiety and worry about the future
• Depression or feeling like “I don’t care anymore.”
• Exhaustion

Tips for managing caregiving stress

Besides finding outside help or seeking professional guidance, caregivers can practice certain techniques or wellness exercises to regain perspective.

1. Practice relaxation techniques like deep breathing, meditation and yoga.
   
2. Get moving. Exercise or any physical activity helps improve overall well-being.
3. Claim time for yourself. Unplug and share the burden regularly.
4. Continue to find answers, resources, programs, and education to find new coping strategies.
5. Be sure to take care of your own appointments, however inconvenient. Hair appointments, massages, doctor’s appointments, and lunches with friends are all equally valuable.
6. Remember to make time for recreation and fun. Laughing with friends can make all the difference.

Across the globe, dementia causes significant financial, physical, and societal impact for families. Even with the best technology and research, no cure has been found. While the exact cause is still a mystery, scientists know that certain brain changes due to proteins or vascular issues contribute to the disease's progression.

Learning more about dementia and Alzheimer’s can help families provide better support for loved ones suffering from the disease. Knowing the risk factors and the importance of early detection can help when managing the disease or creating care plans. Many resources and practical support are available to educate families and caregivers, offering hope for an uncertain future.

Content contained on this page is for informational purposes only and does not constitute medical advice. Consult your health care provider before beginning any new fitness or dietary plan. References provided are for informational purposes only and do not constitute endorsement of any websites or other sources. Should you have any health-related questions, you should contact your health care provider.

Related articles:

• 5 Ways to Care for Caregivers
• 10 Early Signs of Dementia
• Brain Games For Seniors

Sources:

• What is Alzheimer's Disease? Symptoms & Causes
• Dementia statistics
• What Is Dementia?
• Diagnosing Alzheimer's: How Alzheimer's is diagnosed
• Medication for dementia symptoms
• Dementia
• Caregiver Stress