Sutton's Place

The young man was adamant. “My mother doesn’t have Alzheimer’s”, he said. “She has dementia.”

That would be like saying his mother doesn’t have leukaemia, she has cancer.

Just as cancer is the umbrella word for a host of different types of disease, so is dementia the umbrella word for many types of disorders.

Dementia is the generic term for the loss of thinking, remembering, and reasoning skills that interfere with daily life and activities.

MCI – Medium Cognitive Impairment is not dementia. Instead, it is a stage in between the decline of normal aging and the more serious decline of dementia.

There are several different types of dementia, the most common being Alzheimer’s Disease. The next is Vascular and Mixed Dementia, followed by Frontotemporal Degeneration, and LewyBody Dementia. Each of these share symptoms but each is different and within each, there may be variations.

Alzheimer’s disease is a progressive neurogenerative disease. According to the Alzheimer’s Drug Discovery Foundation, (ADDF) “It begins slowly from a clinical point of view. The first symptom will likely be short term memory loss. As it develops, cognitive and functional impairment will become increasingly noticeable and severe. Aging is the highest risk factor, but Alzheimer’s is not a normal part of aging”. The ADDF website lists several causes: inflammation, misfolded proteins, mitochondrial dysfunction, vascular disease, synaptic loss, and loss of brain cells.

Early onset Alzheimer’s affects people under the age of 65. Although the symptoms may be the same, this type of dementia has a different genetic base than that of Alzheimer’s disease. In that it may pose great stress on family life, the ability to earn an income, and the stigma that comes with misunderstanding, this can be an especially cruel type of dementia.

Vascular and mixed dementia are the result of reduced blood flow to various regions of the brain. They commonly follow a stroke, or series of ministokes. Symptoms may include disorientation, confusion, balance, and/or numbness on one side of the face.

There are two types of Dementia with LewyBodies– Dementia with LewyBodies and Parkinson’s Dementia. They are associated with deposits of a protein called alpha-synuclein in the brain and they affect thinking, movement, behaviour and mood. The symptoms are more movement-based than Alzheimer’s and memory loss tends to come later, as the disease progresses. Lewy Body Dementia symptoms include REM sleep disorders, vision and spatial issues, and changes in movement. The second type has the symptoms of Parkinson’s disease, stiffness of muscles, tremors, a shuffling walk. In the first, cognitive and movement decline occur about the same time. With Parkinson’s Dementia, the movement disorders come first, with cognitive decline occurring about a year later.

Frontotemporal Dementiais an umbrella word for uncommon disorders that are the result of progressive nerve cell loss in the frontal (behind the forehead) or temporal (behind the ears) areas of the brain. Symptoms include changes in behaviour, personality, and language loss. It affects a younger group – typically between 40 and 45 — and may result in socially inappropriate behaviour and impulsiveness. Frontotemporal dementia is sometimes misdiagnosed as a psychiatric issue.

There is no cure for any of these types of dementia, nor are there any drugs that will alter or reverse their course.  There are some drugs that may alleviate some of the symptoms.  Most importantly, there are now over 120 drug trials underway, as well as research into the use of existing drugs, that offer possibilities.

In July 2018, philanthropist Bill Gates and the Alzheimer’s Drug Discovery Foundation (ADDF) co-founder Leonard Lauder announced a new initiative, Diagnostics Accelerator, to develop novel biomarkers for the early detection of Alzheimer’s disease and related dementias. Other philanthropists have joined Gates and Lauder in funding and, as a result, $30million has been dedicated to this initiative.

To learn more about these types of dementia, I recommend the following websites: The National Institute of Health, the National Institute on Aging, the Mayo Clinic, The Alzheimer’s Association, and The Alzheimer’s Drug Discovery Foundation.  The latter’s site, CognitiveVitality.org is an excellent source of information about lifestyle changes that may slow progression of the disease, as well as diet and nutrition.