DEMENTIA Dementia is an umbrella term used to describe conditions that exhibit memory loss and confusion. There are dozens of causes of dementia aside from Alzheimer’s, including many that may be correctable, such as hypo-thyroidism, normal pressure hydro-cephalus, and vitamin deficiencies. Sometimes it’s hard to distinguish dementia from what doctors call delirium, or severe confusion due to illness. Delirium is reversible and may be caused by dehydration, pneumonia, drug reactions, or a severe exacerbation of many pre-existing conditions. Rarely are personality changes found to be due to brain tumors. Alzheimer’s disease is the most common irreversible dementia. The other two most prevalent dementias are Lewy body disease and vascular or multi-infarct dementia. Lewy body disease is closely related to Parkinsons disease and may co-exist with that. Rigidity and difficulty initiating movement along with severe hallucinations, delusions and aggressive outbursts usually show up before real memory loss is apparent. It’s quite difficult to distinguish from Alzheimer’s and may benefit from some of the same therapy. Vascular dementia is the broad term for dementia associated with problems with the circulation of blood to the brain. It can be caused by high blood pressure, high cholesterol and strokes. Multi-infarct dementia is caused by repeated strokes sometimes mini-strokes or Transient Ischaemic Attacks (TIA,) but it also may occur if several larger strokes have happened. Frontal lobe dementia is the name given to any dementia caused by damage to this part of the brain. It includes Pick’s disease, but can also be caused by genetic predisposition and other diseases. The frontal lobe governs mood, behavior, and self-control.  Damage leads to changes in the way a person feels and expresses emotion, and loss of judgment. Alcohol related dementia is caused by excessive use of alcohol. It’s usually also a deficiency in thiamine and vitamin B1. Initial symptoms are similar to those of early Alzheimer’s disease, but may be improved or reversed with vitamin therapy. *** It’s important to distinguish between normal "senior moments" like forgetting your grandchild’s name and more seriously forgetting that you have a family. Periodic memory lapses are normal. Our brains will retain and regurgitate facts quickly as long as there’s a natural connection to something else current in a thought train. In other words, it’s harder for any of us to remember something completely unrelated. As we get older our brains have so much more to sort through to recollect a specific thought, that recall may be much slower, but this is not Alzheimer’s disease. Mom always kept track of everyone’s birthday and anniversary, calling the rest of you to remind you to send a card or a bouquet of flowers. She used to be sure of herself, outgoing, and quick to break into a smile. Lately things have been so different. This woman, who was known as an impeccable dresser, now often dresses in inappropriate outfits and has even shown up disheveled at family gatherings. She is becoming withdrawn and anxious and will break into tears at the smallest upset. Mom, who was the keeper of the family archives, now has trouble remembering the names of her own children and sometimes even denies furiously that she has any grandchildren. You fear that she may be developing Alzheimer’s disease. But before you jump to this conclusion, keep in mind that many people develop dementia from disorders that may be reversible. It’s important for her to see a doctor for thorough physical and mental testing. After all else has been eliminated the probable diagnosis may in fact Alzheimer’s. There’s a real advantage to knowing this as early as possible. Mom can get started on one of the Alzheimer’s medications and she can participate in planning for her future. If Mom’s dementia has come on suddenly, you’ll want her to see her doctor immediately. It could be a reaction to an infection or nutritional deficiency. Bring with you a complete list of her food and drug intake, including prescriptions, over-the-counter medications, vitamins, and alternative supplements. Mom should have thorough physical examinations, including MRIs and CAT scans, which are particularly good for detecting brain tumors, fluid on the brain, and blood clots. Request extensive blood tests and discuss tests for possible food allergies. ALZHEIMER’S DISEASE Alzheimer’s disease is named after Dr. Alois Alzheimer, a German neuropathologist, who identified the disease in 1906. A patient at a local mental institution had exhibited severe dementia for ten years before her death at age 55. During the autopsy on her brain, Dr. Alzheimer found tangled nerve cells and plaque deposits that he believed to be the cause of her dementia. Alzheimer’s disease is the term for a specific deterioration of nerve clusters in the brain. These clusters become calcified and tangled, causing many cells to die. There are between four and six million people with Alzheimer’s disease in this country. With the aging of our population, these numbers are expected to increase dramatically. Research has been stepped up dramatically in the past twenty years, but we continue to have many more questions than answers. Some medications on the market can ease or delay symptoms for some folks. There are some promising developments in the search for a vaccine, but it will probably be years before these are ready to use on people. Diagnosis Early diagnosis is very important, to allow the person to be involved in decisions about the future and to start Alzheimer’s Medications. Alzheimer’s disease is identified by the plaques and tangles found in the brain at autopsy. Doctors use a combination of medical history and verbal tests to ascertain cognition, memory and reasoning. Brain scans usually detect changes in the brain. These changes are non-specific at early stages and may even be present in normal elderly individuals. After all physical tests eliminate other possible causes for the dementia, the diagnosis will be “probable” or “possible” Alzheimer’s disease. The combination of these tests by experienced diagnosticians have shown to be about 90% accurate. Sometimes for subtle or early symptoms detailed neuropsychiatric tests performed by trained psychologists can help determine if the memory loss is Alzheimer’s or another problem such as depression. Other common dementias are Parkinsons Disease and Lewy Body Syndrome, the latter exhibits hallucinations. Progression Alzheimer’s disease begins with a loss of short-term memory, progressing through confusion, difficulty communicating and loss of cognitive function to a complete loss of all bodily functions. These disorders usually progress very slowly, so nothing is going to change drastically in Mom’s condition anytime soon. In the meantime the best approach is to work on a change in lifestyle. Above all, don’t panic. Following the ideas in this book can help improve life for both of you. Causes Researchers have identified multiple factors associated with Alzheimer’s disease, among them genetic connections, biochemical changes, and environmental factors, such as head trauma in the patient’s past, alcohol abuse, and toxins. However the basic cause, if there is just one, remains elusive. The Heart Connection. Studies are showing that people with heart disease, high blood pressure and elevated cholesterol are at a considerably greater risk for developing Alzheimer’s disease. The Stroke Connection. Ministrokes, also known as TIAs, damage the blood vessels in the brain and often lead to multi-infarct dementia, which mimics and may eventually lead to Alzheimer’s disease. The Genetic Connection. Three chromosomes have been identified as being responsible for early onset Alzheimer’s (people in their 30s to 50s.) Together these three chromosomes account for only about 5% of all Alzheimer’s cases. A fourth, apoE4, shows up in 65% of all Alzheimer’s patients studied. This particular gene helps carry cholesterol in the blood. It comes in different forms. One appears to prevent a person from Alzheimer’s, while another seems to make a person more susceptible to developing the disease. However many people with apoE4 don’t develop Alzheimer’s disease. At this point, there are no explanations for why some people develop the disease and others don’t. Even if your parent has Alzheimer’s disease linked to genetic causes there’s no guarantee that you’ll get it. The Protein Connection. Numerous studies show an unusually high accumulation of amyloid beta protein in Alzheimer’s brains as well as another protein named Tau. Researchers point out that amyloid beta protein occurs naturally in large quantities in the brain. It enters the cell plasma and decomposes. When this protein doesn’t break down properly it accumulates, destroys the cells, and causes neurological damage. The greater the degree of dementia, the higher the levels of these proteins. These are important discoveries in the search for more accurate tests, vaccines, and antidotes for the disease once it has set in. The Folate and Choline Connections. There is a correlation between a deficiency in folic acid (folate) and Alzheimer’s disease. It’s often found in connection with a deficiency of vitamin B12. Unfortunately this condition is not reversible once the disease has developed. Folate is found in legumes, salmon, tuna, citrus fruit, and root vegetables. (Cooking destroys folate.) Vitamin B12 is found only in animal foods such as milk, eggs, and most meat, especially liver. Dementia can also develop due to a vitamin B12 deficiency, but this is different from Alzheimer’s dementia. Choline is crucial to the health of nerve transmitters in the brain and other organs. Some research is showing that serious choline deficiency is common in Alzheimer’s victims. Choline deficiency impairs the nervous system and brain function as well as the digestive system and blood pressure. Choline is found in meat, egg yolks, legumes, soybeans, and whole grain cereals. The Aluminum Connection. Four times the normal amount of aluminum deposits is found in Alzheimer’s brains upon autopsy. There’s disagreement among researchers as to the significance of this. You may want to take precautions anyway and avoid excessive exposure to the metal. Avoid storing foods in aluminum containers, especially acidic juices. Environmental Toxins. There appears to be correlation between the use of herbicides (weed killers) and insecticides (bug sprays) and the development of Alzheimer’s. Another study shows that Alzheimer’s is more prevalent among persons who have been exposed excessively to household cleaners. Tests A person showing symptoms of dementia should undergo a thorough physical, including basic blood tests to detect possible deficient levels of folate, B12 and thyroid secretions. Once it has been ascertained that the dementia is not caused by a reversible condition, the next step is tests by a neurologist or psychologist, who will use verbal memory tests and likely order an MRI or a CAT scan. Researchers are working on simple skin and urine tests. Excerpted from Alzheimer’s A to Z, A Quick Reference Guide, ©New Harbinger Publications