Many signs and symptoms of dementia often mimic the natural process of aging, so if you’re concerned about yourself or a loved one, doctors urge you to err on the side of caution and get screened.
The good news is that with more attention on dementia, more people are being screened at younger ages, said Chad Yucus, MD, a neurologist who specializes in memory disorders and dementia.
Forms of dementia
There are many different forms of dementia; there are neurodegenerative diseases and non-degenerative diseases. “When we think of dementia, we primarily think of neurodegenerative diseases. Those include Alzheimer's disease, frontotemporal dementia, Lewy body dementia,” Dr. Yucus said.
There are many types of neurodegenerative diseases that people often don’t hear about because Alzheimer's disease is the most common, he said.
“Vascular dementia is not so much neurodegenerative, but it is a primary brain disease.”
Even other medical conditions can lead to or even mimic dementia, which we don’t think of as degenerative, he said. “For example, hypothyroidism can mimic dementia because of cognitive changes.”
“So when someone has memory changes, it is very important to have a medical evaluation to fully determine if they are related to something medical or if they are related to something primarily with the brain,” Dr. Yucus said.
Warning signs
The Alzheimer's Association has a comprehensive list of 10 early warning signs of Alzheimer's and dementia that doctors follow.
“That being said, some of these symptoms can happen even with normal aging,” he said. “For example, forgetting where you place objects or forgetting words. These by themselves aren’t always signs of a clinical disease. It’s really the frequency and severity of the symptoms.”
The 10 warning signs published by the Alzheimer's Association are very good signs to monitor, but having a physician evaluate these symptoms and do an examination provides more clarity on whether a symptom represents a disease or whether it represents normal aging, Dr. Yucus said.
Early intervention
If you notice yourself or a loved one exhibiting these signs, like losing things or forgetting words, it’s important to see a doctor, Dr. Yucus urged. “Unfortunately, it is often the case that people tend to ignore symptoms and we don’t see people until there is a disruption in managing their daily routines.”
“Generally speaking, we don’t want people waiting until they start having significant problems with their activities of daily living — driving, forgetting to take medicines — we would like to evaluate someone before there are significant problems in their daily lives.”
Recently Dr. Yucus has noticed patients coming to him early when exhibiting symptoms, thanks to the attention and exposure that dementia and Alzheimer's disease have received.
“Now, I think people are starting to be more proactive in evaluating symptoms, and I’m seeing people earlier in the course of intervention,” he said.
This early intervention is excellent for patients because the FDA recently approved two intravenous medicines for Alzheimer's, with the caveat that these medications only be given early in the course of the disease, Dr. Yucus said.
Stages
In general, the stages for all types of dementia are mild, moderate and severe, he said.
“With Alzheimer's disease, there’s a specific scale called the functional assessment staging test. That particular scale is subdivided into seven stages … that is primarily based on the person’s ability to manage their medications and finances, to be able to dress appropriately, and to maintain all other basic activities of living independently.”
Other types of dementia don’t necessarily follow the same course as Alzheimer's, he added.
Treatments to slow the disease, improve daily life
“There is still a stigma attached to having dementia involving lack of treatment and lack of hope,” Dr. Yucus said. He wants patients with dementia to know that there is hope of making their condition manageable and improving their daily lives as much as possible.
While there are no medications that can stop or cure dementia, there are oral medications that can help stabilize or slow the progression of dementia, he said. “These medications help stabilize cognitive function so people can maintain their activities of daily living.”
“The whole point of being evaluated early is to maintain daily functional abilities for as long as possible, and even apart from pharmacological options, it is always helpful for people to know that physical exercise, mental exercise and social activities can be helpful in maintaining some functions of the brain.”
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