Aging in Place with Alzheimer’s and Other Dementias

It may surprise many people to know that dementia is not a normal part of aging. Dementia is a syndrome caused by a variety of brain illnesses that affect memory, thinking, behavior and the ability to perform everyday activities. It is true that memory declines in older adults, but normal memory problems should not affect everyday life. For example, misplacing a pen is very different from forgetting what a pen is used for.

Types of Dementias

Alzheimer’s

Alzheimer’s, a degenerative brain disease, is the most common form of dementia. Dementia itself is not a specific disease. The word is a general term for loss of memory and other mental abilities that are significant enough to interfere with everyday life. While Alzheimer’s represents 60 to 80% of diagnosed cases, there are many types of dementia–and all result from physical changes in the brain.

Dementia With Lewy Bodies

Dementia with Lewy bodies (DLB) involves abnormal microscopic deposits called Lewy bodies that damage brain cells over time. This type of progressive dementia affects thinking, reasoning, and independent function. Lewy bodies appear in other brain disorders, including Alzheimer’s and Parkinson’s disease dementia, although memory loss generally occurs later in DLB.

Vascular Dementia

Vascular dementia sometimes takes place after a stroke that has blocked blood vessels. But in all cases, blocked or reduced blood flow to the brain deprives brain cells of vital oxygen and nutrients. This leads to a decline in thinking skills. Vascular brain changes often coexist with changes linked to Alzheimer’s, DLB, and other dementia forms. Several studies have found that vascular changes and other brain abnormalities may interact in ways that increase the likelihood of dementia diagnosis. But because these changes range broadly from mild to severe, some professionals choose to this condition vascular cognitive impairment (VCI).

Parkinson’s Disease

Parkinson’s disease dementia is an impairment in thinking and reasoning that eventually affects many people with Parkinson’s disease. The brain changes caused by Parkinson’s disease begin in a region that plays a key role in movement. As these brain changes gradually spread, they often begin to affect mental functions like memory, judgment, and attention span. The key brain changes linked to Parkinson’s disease and Parkinson’s disease dementia are abnormal microscopic deposits composed chiefly of Lewy bodies, which are also found in DLB and other brain disorders.

With more than one million Americans living with Parkinson’s and the disease affecting nearly 2% of those over the age 65, researchers estimate that 50 to 80% of them will eventually show signs of Parkinson’s disease dementia over a 10-year period. Along with memory and judgment changes, this type of dementia often results in muffled speech, visual hallucinations, depression, delusion, sleep disturbances, irritability, and anxiety.

Posterior Cortical Atrophy

Posterior cortical atrophy (PCA) refers to gradual and progressive degeneration of the brain’s cortex and posterior. But researchers do not yet know whether this a unique disease or a variant form of Alzheimer’s. Some PCA-affected brains have amyloid plaques and neurofibrillary tangles, which are similar to what happens in Alzheimer’s. Yet other PCA patients exhibit brain changes similar to DLB or CJD, which is Creutzfeldt-Jakob disease. PCA onset usually occurs in a patient’s 50s or 60s, 15 years before Alzheimer’s symptoms begin to show.

Creutzfeldt-Jakob Disease

Creutzfeldt-Jakob disease (CJD) is the most common human form of a group of rare, fatal brain disorders known as prion diseases. CJD occurs when prion protein begins folding into an abnormal three-dimensional shape. This gradually triggers prion protein in the brain to fold into the same abnormal shape. CJD causes a type of dementia that worsens unusually fast.

Frontotemporal Dementia

Frontotemporal dementia (FTD), or frontotemporal degenerations, comes from progressive nerve cell loss in the brain’s frontal and temporal lobes. This affects nerve cells and causes language disturbances, changes in muscle or motor functions, and affects the individual’s behavior and personality.

Huntington’s Disease

Huntington’s disease (HD) is a by-product of a single defective gene on chromosome 4—one of the 23 human chromosomes that carry a person’s entire genetic code. This progressive brain disorder is passed down from parent to child. This defective gene codes the blueprint for a protein called huntingtin. Defective huntingtin protein causes changes in the brain that cause abnormal involuntary movements, a severe decline in thinking and reasoning skills, and mood changes.

Mixed Dementia

Mixed dementia shows abnormalities associated with characteristics of more than one type of dementia. In its most common form, the abnormal protein deposits associated with Alzheimer’s disease coexist with blood vessel problems linked to vascular dementia. Alzheimer’s brain changes also often coexist with Lewy bodies. Some patients may have brain changes linked Alzheimer’s, DLB, and vascular dementia.

Autopsy studies play a key role in shedding light on mixed dementia and DLB. It is not currently possible to quantify all of a living patient’s dementia-related brain changes. But depending on the individual, symptoms may resemble or even match those of Alzheimer’s or another type of dementia. Some researchers have concluded that since vascular changes are the most common coexisting brain change in mixed dementia, minimizing risk of heart or vascular diseases may also protect the brain from vascular changes associated with dementia.

Normal Pressure Hydrocephalus

Normal pressure hydrocephalus (NPH) is a brain disorder in which excess cerebrospinal fluid accumulates in the brain’s ventricle, causing thinking and reasoning problems, difficulty walking, and loss of bladder control. Despite the excess fluid, any cerebrospinal fluid pressure measured during a spinal tap is often normal. As brain ventricles enlarge with the excess cerebrospinal fluid, they can disrupt and damage nearby brain tissue. This results in symptoms like difficulty walking, difficulty thinking and planning, and loss of bladder control. While NPH primarily affects older adults, researchers don’t yet know how many seniors have it because it shares so many symptoms with other common brain disorders. While doctors may trace some patients’ NPH to hemorrhages or inflammation in the brain, the reason for the fluid buildup is not usually known.

Korsakoff Syndrome

Korsakoff syndrome stems from severe deficiency of thiamine (vitamin B-1), which helps brain cells convert sugar into energy. This common memory disorder may occur when there is not enough energy to function property. Most commonly caused by alcohol abuse, Korsakoff’s is sometimes linked to poor nutrition, chronic infections, AIDS, and other conditions.

The Root of Alzheimer’s

Experts concur that Alzheimer’s, like other common chronic conditions, is most likely an effect of complex interactions of factors like genetics, age, lifestyle, environment, and other medical conditions. Factors that can’t be controlled–like age and genetics–can be balanced with lifestyle changes to combat factors like high blood pressure, high cholesterol, and diabetes. Research in these areas suggests that the risk of Alzheimer’s can be identified and reduced. Some autopsy studies have even revealed that as many as 80% of Alzheimer’s patients also have cardiovascular disease.

Researchers do not yet know why some people develop hallmark Alzheimer’s plaques and tangles but not any of the disease’s symptoms. Hopefully, more research can clarify the link between and Alzheimer’s and vascular health.

Improving the Odds

While experts cannot pinpoint why some patients get dementia, the benefits of a heart-healthy wellness plan should not be ignored. This means regular exercise, reducing sugar and saturated fats. and filling your diet with fruits, vegetables, and whole grains. Many studies suggest that keeping your brain and social life active may reduce the risk of cognitive decline. Social and mental stimulation is thought to strengthen connections between the brain’s nerve cells in the brain, as do consistent sleep patterns.

Still other studies show a strong link between Alzheimer’s and significant head trauma, particularly when the patient has lost consciousness. Wearing helmets and seat belts when appropriate, as well as making changes on your property to reduce the risk of falls, are easy steps to manage risk.

While you can’t absolutely know your degree of risk for Alzheimer’s or other dementias, anything you do to promote both brain health and overall health go a long way in improving your quality of life and maintaining normalcy. You may not be able to cure the problem, but arming yourself with information can be the best way of living the life you want in the home where you want to stay.