Written by Aaron Khew Kok How, AA Pharmacist.

Is dementia the same as Alzheimer’s?

No, they are not the same. Dementia is not a disease in itself. It is a term to define a set of clinical symptoms manifested when the brain cells malfunction. Alzheimer’s, on the other hand, is one of the diseases causing dementia.

Dementia

Dementia describes a group of symptoms including memory loss, difficulties with thinking, problem solving or language, and often changes in mood, perception or behavior. The specific symptoms that individual with dementia experiences will depend on the parts of the brain being damaged and the disease that is causing the dementia. The different types of dementia include:

  • Dementia of the Alzheimer type
  • Vascular dementia (stroke)
  • Fontotemporal dementia (personality and mood changes, disinhibition and language)
  • Dementia with Lewy Bodies
  • Mixed Dementia

Knowing the type of dementia enables appropriate treatment, advice and support to be offered. There is no specific test for dementia. Diagnosis is usually based on history taking, physical examinations and tests (to rule out other possibilities), test of mental abilities or a brain scan when necessary. Dementia is usually diagnosed by a psychiatrist, geriatrician or a neurologist.

Alzheimer’s

Alzheimer’s is a type of dementia that causes problems with memory, thinking and behavior . It is progressive and it worsens gradually over time. Alzheimer’s disease typically progresses slowly in 3 general stages:

1. Early Stage (Mild)
In this early stage, a person may still function independently but they may start to have memory lapses such as forgetting familiar words or the location of everyday objects.
2. Middle Stage (Moderate)
It is the longest stage of Alzheimer’s disease. We may notice them with confusing words, getting frustrated or angry, or acting in unexpected ways, such as refusing to bathe. Damage to nerve cells in the brain makes them difficult to express their thought and perform routine tasks.
3. Late Stage (Severe)
At this stage, they lose their ability to respond to their environment, to carry on a conversation and eventually to control movement.

Risk Factors

  1. Age- 65 years and older.
  2. Family history
  3. Genetics- (Alzheimer’s):
    Risk Gene (Apolipoprotein E-e4)- increase the likelihood of developing a disease but do not guarantee it will happen.
    Deterministic genes (Amyloid precursor protein (APP), Presenilin-1, Presenilin-2)- directly cause a disease.
  4. High blood pressure
  5. Lack of exercise
  6. Smoking
  7. Head injuries

Management

There is no cure for Alzheimer’s disease but there are medications to help with the symptoms.

Pharmacological Treatment:

  • Cholinesterase inhibitors (Donepezil, Rivastigmine, Galantamine):
         Prevent the breakdown of acetylcholine, a chemical messenger important for memory and learning. By keeping levels of acetylcholine high, thissdrugs support communication among nerve cells.
  • Glutamate regulator (Memantine):
    A messenger chemical involved in information processing.

Non Pharmacological Approach:

  • Vitamin E
    It may slow functional decline in Alzheimer’s disease.
  • Gingko biloba
    A 240mg/day of gingko stabilized and slowed decline in cognition, function, behavior and global change in cognitive impairment and dementia.
  • Cognitive behavior therapy 
    Offered if the person develops depression and anxiety.
  • Cognitive stimulation therapy
    A way to keep their mind active (themed activity sessions).
  • Cognitive rehabilitation therapy
    Help them to retain skills and cope better.
  • Maintain healthy lifestyle
    Exercise, healthy balanced diet, stop smoking, well controlled of blood pressure, blood glucose and cholesterol level.
  • Coconut oil
    Provide alternative fuel source to keep the brain nourished.
    (Read more: The wonder oil – Coconut oil)
  • Fish Oil Omega-3
    May provide benefit for parts of the brain critical for memory and thinking skills.
  • Vitamin B6 (pyridoxine), B9 (folate) and B12 (cobalamin)
    Intake of these Vitamin B may lower blood level of homocysteine which subsequently reduce the rate of brain shrinkage and memory loss.

Reference:

  1. Alzheimer, S. o. (2018). Coconut oil- an answer for Alzheimer’s disease. Retrieved from alzheimer.ca/en/Home/About-dementia/Alzheimer-s-disease/Risk-factors/Coconut-oil.
  2. Alzheimer’s, A. (2016). Basic of Alzheimer’s disease. What it is and what you can do? Retrieved from www.alz.org.
  3. Alzheimer’s, A. (2018). Alzheimer’s Disease. Retrieved from https://www.alz.org/alzheimers_disease_1973.asp.
  4. Alzheimer’s, R. U. (2015). All about dementia. Retrieved from https://www.alzheimersresearchuk.org/wp-content/uploads/2015/01/All-about-dementia.pdf.
  5. Alzheimer’s, S. U. (2018). Talking Therapies. Retrieved from https://www.alzheimers.org.uk/info/20009/treatments/109/talking_therapies/2.
  6. Australia, N. D. (2017). What is dementia? Retrieved from www.dementia.org.au.
  7. Food, f. t. (2013). ALzheimer’s Prevention step. Retrieved from https://www.foodforthebrain.org/media/342447/alzheimers_6steps_rgb.pdf.
  8. Morris, M. C. (2006). Thoughts on B-vitamins and dementia. Journal Alzheimer’s Disease, 429-433.
  9. National, I. o. (2017). Dietary Supplements and Cognitive Function, Dementia, and Alzheimer’s Disease:What the Science Says. National Center for Complementary and Integrative Health.
  10. William, J. N. (2018). FISH OIL SUPPLEMENTS MAY BOOST BRAIN HEALTH. Fisher Center for Alzheimer’s Research Foundation.
  11. Winslow, B. T. (2011). Treatment of Alzheimer Disease. American Family Physician, 1403-1412.