The Many Faces of Dementia: Memory loss versus Alzheimer’s
Submitted to The Union
As America’s population ages, Alzheimer’s disease and other dementia are becoming increasingly prevalent and troublesome problems. Everyone fears the onset of dementia and frequently jumps to the conclusion: “ I just can’t remember anything. I must be getting Alzheimer’s.”
Correct diagnosis is critical. When you can’t remember where you left the keys to your car, it may not be dementia. As we age, particularly after the mid-60s, we tend to loose brain mass — actual volume at the rate of about 1 percent per year. So some memory loss can be normal.
When we had the Alzheimer’s care home, we generally only had residents who were diagnosed as mid-stage dementia, predominately Alzheimer’s disease. But on several occasions, we had applications from family members saying that “Mom” needed to have full-time care because she was forgetting everything.
As part of admission procedures, we always asked for a health care professional’s diagnosis. On one occasion, the adult child brought Mom in so we could meet with her. We talked for about a half hour with Mom and her daughter. During the conversation, Mom was reasonably conversant and able to remember most things — both recent and long term. Mom might have been diagnosed with “MCI” or mild cognitive impairment. Maybe.
When Mom left, we had a conversation with the daughter later that day and asked when Mom had last seen a doctor, as there were no records presented to us along with the visit. The daughter explained that she didn’t know the dates but was sure it was more than a year earlier and was having Mom relocate from Southern California. We strongly recommended that she establish a relationship with a local health care professional and have a complete physical, including blood testing. The result of that exam and subsequent treatment for vitamin B-12 deficiency was that Mom moved into the daughter’s home and had amazingly regained much of her memory loss.
There are a number of systemic body conditions that can mimic Alzheimer’s disease. These mimicking symptoms can be memory loss, confusion, slowness, paranoid depression and, in extreme stages, hallucinations. Don’t rule out that nutritional causes may be the problem and, in most cases, are preventable and treatable.
Let’s briefly look at some of the possible culprits that mimic dementia, vitamin deficiency, hypercalcemia, hypothyroidism and depression.
A Vitamin B-12 deficiency (and to a much lesser degree, B-1 and B-6) can cause memory loss, irritability, depression, confusion, delirium and paranoia. These symptoms can be difficult to distinguish from age-related dementia. If someone has a severe lack of certain B vitamins, folic acid or niacin, that person may be at risk for having his or her condition misdiagnosed unless the doctor knows to check for these deficiencies.
Hypercalcemia is an electrolyte imbalance caused by too much calcium in the blood. When the level of calcium in the bloodstream gets too high, it may produce an altered mental status and memory problems that are similar to Alzheimer’s disease.
Hypothyroidism. A small gland in your neck known as the thyroid gland can be another culprit. Severe hypothyroidism, a deficiency of the thyroid, can cause symptoms similar to Alzheimer’s disease: memory loss, confusion, slowness, paranoid depression and, in some cases, hallucinations. Thyroid disease is one of the many treatable diseases that must be ruled out before arriving at the diagnosis of Alzheimer’s, which is incurable.
While hypothyroidism increases with age and only represents a small percentage of cases when evaluating for possible dementia, it nevertheless should be part of a thorough health evaluation.
Depression. Severe clinical depression may be mistaken for Alzheimer’s Disease. People who are severely depressed can experience problems in thinking or memory, including difficulty concentrating, recalling information and keeping track of dates or time, or they may complain that they can’t stay focused on a task. They may report difficulty making decisions or starting or completing projects, and they may appear apathetic. A person can have both depression and Alzheimer’s disease at the same time. So one diagnosis does not, in this case, eliminate the other.
Because so many different conditions can produce symptoms typically associated with Alzheimer’s disease, your health care professional must rule out all other potential causes and ensure that symptoms fit the criteria for Alzheimer’s before he or she arrives at a diagnosis. A complete physical, including family history, blood testing, alcohol use, polypharmacy (too many medications) and a host of other issues, can be and should be determined before diagnosing Alzheimer’s or another dementia.
If all mimicking symptoms and other possibilities have been ruled out, then go forward with a specialty health care professional’s diagnosis.
Tor Eckert has been involved all facets of Alzheimer’s disease since the 2005, including owning an Alzheimer’s Care Home. His public speaking forums — The Many Faces of Dementia — have provided health care professionals, adult children, caregivers and families with an understanding of Alzheimer’s and the other dementias. For information, please call Eckert at (530) 432-8308 or email email@example.com.
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