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Is It Dementia Or Alzheimer's Or Normal Aging? (Does It Matter?)

Millions of us never find out exactly what's causing Mom to start cursing or a diligent husband to forget to pay bills. Even after memory loss and cognitive glitches become impossible to ignore, families don't always seek (or receive) an official diagnosis. We just deal with the effects.
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Author, Surviving Alzheimer's

Author, Surviving Alzheimer's
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"What's the difference between Alzheimer's and dementia?" I hear that question constantly. Doctors see another version of this confusion: "It looks like dementia," they say. Then the patient (or a family member) replies with relief, "At least it's not Alzheimer's!"

Of course, Alzheimer's is dementia (though not all dementia is Alzheimer's). What's in a name, anyway? Does it matter what we call this brain-wreck of a disease?

Yes.

And no.

Millions of us never find out exactly what's causing Mom to start cursing or a diligent husband to forget to pay bills. Even after memory loss and cognitive glitches become impossible to ignore, families don't always seek (or receive) an official diagnosis. We just deal with the effects.

Besides, the name that doctors put in the chart is changing. This spring, the term "dementia" officially changed to major neurocognitive disorder, according to the DSM-5, the diagnostic bible used by psychiatrists. The new term had been announced in May 2013, with a one-year grace period for everyone to get used to the idea.

Major neurocognitive disorder -- catchy, isn't it? -- is not to be confused with mild cognitive impairment (MCI), a transitional stage between normal aging and major impairment that was introduced in 2011. MCI, which may or may not evolve into Alzheimer's, used to be called pre-dementia.

Adding to laypeople's understandable mixups about Alzheimer's & Co. are the many specific cognitive disorders lately in the news. Broadcaster Casey Kasem just died with the form of dementia called Lewy-Body disease, for example. Cookbook author Paula Wolfert has announced she has Benson's syndrome, a variant of Alzheimer's. Hockey great Gordie Howe is thought to have vascular dementia; his wife, Colleen, died of another brain-disease variant called Pick's. Meanwhile Alzheimer's is said to be the diagnosis for ex-model, restaurateur, and style maven B. Smith and singer Glen Campbell. As for the controversial Clipper Donald Sterling, one evaluation found him to have "mild global cognitive impairment...consistent with early Alzheimer's disease, but could reflect other forms of disease."

Got all that?

Here's what's really matters in the dementia name game:

DO distinguish between "normal aging" and "something's not quite right here."

When he was younger, my son misheard "Alzheimer's disease" as old timer's disease. It's true your odds of Alzheimer's increase with age. It's also true that thinking skills slow in some ways with age. But the biomarkers associated with Alzheimer's are thought to be distinct from normal brain aging.

Yet a new multinational survey from the Alzheimer's Association found that nearly 60% of people mistakenly think Alzheimer's is a natural result of aging.

DO explore the cause of worrisome symptoms.

You do want to find out what's wrong. In some ways, it's as important to know what the problem isn't, in order to rule out or treat possible causes that we know how to fix today. For examples, dementia symptoms that are caused by delirium or dehydration resolve when the underlying problem is addressed. Even if it's a progressive dementia caused by Parkinson's, alcoholism, or a brain injury, you want to treat that issue in all the known ways. When you know what you're dealing with, you can plan ahead.

DON'T get hung up on an exact name.

The importance of getting a diagnosis isn't to pin a label on a person, though. Whether your mom has Alzheimer's or vascular dementia or Lewy-Body, many of her symptoms and care needs are apt to remain the same. There are some differences. But in general, knowing the precise name isn't going to make Dad remember how to pull on his pants or keep your wife from wandering away from home and getting lost.

Too bad the number-one type of dementia such a weird name. Alzheimer's is neither descriptive (like, say, depression) nor simple (cancer). It's just a guy's name, after Dr. Alois Alzheimer, a German physician said to be the first identify it. And it's really hard to spell.

DO consider what's behind a name.

Part of the push behind more precise nameology has to do with sorting subjects for research purposes. By better identifying brain changes, researchers can gain more accurate insights into how drugs or other therapies work.

Some also say that a more accurate name like major neurocognitive disorder can help lessen stigma, because people so fear the words dementia (and its kin, demented) and Alzheimer's.

What's in a name? Plenty. Over in China, there's a push to change the character symbol name for dementia. The name is currently represented by two characters which translate to insane and idiotic. In 2004, Japan switched from characters that toughly stood for crazy person to those meaning brain disease. Net result: Less stigma, more openness to treatment and support.

DO find out what to do about it.

So what if you're left some kind of "major neurocognitive disorder"? Whether it's called Alzheimer's, dementia, MCI, old timers disease, or that-which-shall-not-be-named, the real question is, "What are we going to do about it?"

That's where you can't get enough practical information and emotional support -- also called Help.

Earlier on Huff/Post50:

11 Easy Ways To Shorten Your Life
1. Make Bad Dietary Choices(01 of11)
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Over the years, there's been a lot of debate related to diet and longevity. But most experts agree that a diet low in sugar and refined carbohydrates is best. And some studies show that eating a traditional Mediterranean diet can add years to your life. (credit:Shutterstock)
2. Never Check Your Cholesterol(02 of11)
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Just like high blood pressure, high cholesterol can also increase your risk of heart disease and stroke. Therefore it's a good idea to have your cholesterol checked to see whether you need to undergo certain lifestyle changes or even possibly take some kind of cholesterol-lowering medication. For more information about cholesterol and saturated fats, go here.Eating certain foods, such as beans, which are rich in fiber and antioxidants, can help lower cholesterol. (credit:Getty Images)
3. Mix Alcohol And Prescription Or Illicit Drugs(03 of11)
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Even drinking wine with dinner and then taking prescription sleep aides can be a lethal combination. A U.S. Department of Health and Human Services study found 5.8 percent of people age 50 to 59 used illicit drugs in 2010, up from 2.7 percent in 2002. (credit:Alamy)
4. Never Check For Diabetes(04 of11)
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The number of Americans with Type 2 diabetes is expected to rise from 30 million today to 46 million by 2030, when one of every four boomers -- 14 million -- will be living with this chronic disease, according to the National Center for Chronic Disease Prevention and Health Promotion.

Untreated diabetes can lead to blindness, amputations and clogged arteries that can cause heart attacks and strokes. The test to determine whether you are diabetic is a simple blood test; you should remind your doctor to include it in your annual physical. (credit:Alamy)
5. Pack On The Pounds(05 of11)
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More than one out of every three boomers -- more than 21 million -- will be considered obese by 2030. Already, we are the demographic with the highest and fastest-growing rate of obesity. As we age, our metabolism slows down and we burn fewer calories -- if we don't alter our eating and exercise patterns, weight gain is inevitable. Obesity can lead to high blood pressure, heart disease, and a host of other life-threatening ailments. Losing just 10 percent of your body weight has health benefits, so consider that as a goal. (credit:Alamy)
6. Ignore The Signs Of A Heart Attack(06 of11)
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No chest pain doesn't mean no heart attack. Women having heart attacks frequently report experiencing a feeling of indigestion and extreme fatigue, while some men say they feel a fullness or a squeezing pain in the center of the chest, which may spread to the neck, shoulder or jaw. When a diabetic has a heart attack, the pain is often displaced to other areas such as the lower back. (credit:Alamy)
7. Get Little Sleep(07 of11)
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Try as you might, you just can't stay asleep, right? You pass out before "60 Minutes" is over, but then wake up around midnight and count sheep until the alarm goes off. If that sounds like you, you aren't alone. The U.S. Centers for Disease Control and Prevention says that boomers report not getting enough sleep between one and 13 nights each month.Is it life-threatening? In itself, no. But as soon as you slip behind the wheel bleary-eyed, you are putting yourself and others at risk. Your reflexes are slower, you pay less attention and you could become one of the more than 100,000 Americans who fall asleep at the wheel and crash each year. And the National Highway Traffic Safety Administration says that's a conservative estimate, by the way. Driver fatigue results in an estimated 1,550 deaths, 71,000 injuries and $12.5 billion in monetary losses. (credit:Alamy)
8. Avoid Exercise(08 of11)
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AARP says the minimum you need to stay healthy are muscle-strengthening exercises twice a week, plus 2.5 hours a week of moderate activity like walking or 75 minutes a week of a more intense activity like jogging. Exercise is also good for your memory: Just one year of walking three times a week can increase the size of the hippocampus, the part of the brain that's key to memory. (credit:Alamy)
9. Carry The World's Burdens On Your Shoulders(09 of11)
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We're talking about stress with a capital S. Boomers are the sandwich generation, caught in the middle of caring for our parents and our children. We were deeply affected by the recession and boomers have the highest rates of depression by age demographic. Unless we unload, we are going to implode. (credit:Alamy)
10. Carry A Beer Belly And A Caboose(10 of11)
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It isn't just our extra weight; it's where we carry it. An excess of visceral fat causes our abdomens to protrude excessively. We call it a "pot belly" or "beer belly" or if the visceral fat is on our hips and buttocks, we say we are "apple shaped." Cute names aside, scientists now say that body fat, instead of body weight, is the key to evaluating obesity. And guess what? It's all bad. (credit:Alamy)
11. Continue To Smoke(11 of11)
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Gallup found that baby boomers between the ages of 44 and 54 reported higher levels of smoking than those immediately younger or those who are older. Hard to imagine that they haven't gotten the word yet about the risks cigarettes carry. (credit:Alamy)

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