Puzzled readers often ask why certain behaviors their elders exhibit seem to mirror classic Alzheimer’s disease, yet other behaviors don’t. Many are surprised when I suggest that the elder may have a “mixed diagnosis.”
Just as someone can have cancer and diabetes at the same time, a person can have Alzheimer’s and Parkinson’s disease, or vascular dementia and Alzheimer’s disease, or any number of other pathologies which can cause dementia.
A short article on Medical News Today, titled People Over 80 Often Have Mixed Pathologies In Their Brains That Account For Their Memory Loss, Confusion, points to recent studies that show, “…that elderly people over the age of 80 often have mixed pathologies in their brains that account for their memory loss and confusion. Very few senior citizens have ‘pure Alzheimer disease’, therefore, this terminology should be used with caution.”
For years, multitudes of people have asked on dementia forums and other question/answer formats, “What’s the difference between Alzheimer’s and dementia?” Doctors, nurses and lay people like me keep trying to explain that Alzheimer’s is just one form of dementia. It is the form that is in the news the most these days, since it is likely the most common and thus researchers are putting extra focus on solving the Alzheimer’s puzzle (whichever company wins this race wins the lottery).
However, there are many other types of dementia. The second most common seems to be vascular dementia. The Medical News Today article goes on to say that “…vascular problems such as high blood pressure and diabetes can shrink the parts of the brain that control memory…”
To me, this seems like important news. For one thing, families will need to learn that different dementias often affect different parts of the brain, thus they can expect changes in behavior associated with the aspects of personality that the affected part of the brain controls. For doctors, it’s important to start out with the knowledge that this patient they are trying to diagnose may have one or more types of dementia. This information may not only affect the diagnosis, but the treatment of the dementias.
In most cases, it’s good for a person with a dementia diagnosis to be checked by a neurologist or a geriatrician who is trained in dementia diagnosis. A second opinion doesn’t hurt, either. One very good doctor may know more about one type of dementia than another. The combined opinions may shed light on the best treatment for the behaviors exhibited by the patient.
Do remember that if a doctor hasn’t done a complete physical to rule out other causes of demented behavior, such as medication reactions, diabetes or infections, the whole process should likely back up to the point that an extensive physical is done. There are people who are treated for dementia when they actually have a B-12 deficiency, a urinary infection or a medication interaction problem. While I’m not a doctor, I’m a family member who has been through the mill with elders exhibiting different types of dementia. To me, a good physical should be number one, before anyone leaps to the conclusion that the elder has dementia.
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