Is the Diagnosis Dementia, Senility, Old Age, or Alzheimer's Disease?

“Mrs. Doe”, the doctor said to his patient sitting across from him, “I have some good news and some bad news. The bad news is that I am not completely sure of what is causing your symptoms of memory loss and confusion. You told me that you have been forgetting a lot of things recently and that you are worried that you may have Alzheimer’s disease. So the first thing we did was have some tests done that could help us get to the bottom of your trouble.”

“We completed a urinalysis to rule out the possibility of a urinary tract infection since that can cause temporary confusion and memory loss in some older people. We also did a number of blood tests to see if something there could explain your symptoms. Sometimes low levels of Vitamin B-12 or iron deficiency can reduce a person’s ability to think clearly and sharply. All of your test results were normal.”

“As you probably already know, he went on, the older we get the more forgetful we become. I’m younger than you and I already notice it! But when you told me that you’ve noticed some pretty big changes lately and that you are worried about this, I don’t want to make the mistake of blaming everything to the fact that you are 75 years old. Since there is a possibility that something else is going on, I’m going to refer you to a doctor whose specialty is the diagnosis and treatment of neurological disorders. I’m sorry that I can’t give you the answer you were looking for today. I don’t want you to worry too much, but you’ve told me about some unusual symptoms and I believe that further tests will help determine what could be causing your problems.”

“The good news is that once we find the correct diagnosis, there are medications and treatments that can slow down, or even stop, the progression of certain types of dementia. I’ll have my nurse check with you on the best time to set up this appointment so we can get this started as soon as possible.”

Oh! My! the patient is thinking after the shock has begun to settle. Don’t worry? Is he crazy? What am I going to tell my family? What am I going to do if I do have dementia? Doesn’t every person forget things when he-she gets older? What if I do have Alzheimer’s disease! Who’s going to pay for my treatment? Will my insurance cover the costs? I have so much to live for! This is not fair! What am I going to do? Please help me, God!!

Most of us have on occasion misplaced our car keys or our glasses, or have forgotten where we parked the car in the huge parking lot. We’ve also forgotten someone’s name when we meet for the first time in eight years! Does this mean we have dementia or Alzheimer’s? Could be, but probably not. There are a lot of reasons why people forget things. Having too many issues on our minds is one reason a healthy person can be forgetful. But there is a difference between losing one’s keys and not knowing what the key is used for (i.e., operating the car).

We can certainly sympathize with Mrs. Doe. These words by her doctor, along with the prospect of facing any serious neurological diagnosis can strike fear in anyone’s heart. Why?

1. There is no known cure for Alzheimer’s disease at the present time.
    
2. Because many people still believe that life is a progressively downhill run from the moment of diagnosis to the end of life.

So, let’s go back to what the doctor told Mrs. Doe, because we can learn a lot about why he chose the tests he did and what the test results have told him so far. Several simple laboratory tests, along with a urinalysis, helped the doctor sort out whether Mrs. Doe’s mental confusion and memory loss may be caused by a correctable problem. Most of the causes listed under the heading, Delirium (see below), are treatable and correctable. Once treated, symptoms often disappear and the patient once again functions at the level seen before the medical problem arose. That’s why it was wise of Mrs. Doe to talk to her doctor about her symptoms, even though she was afraid of what she may hear.

Now that the doctor ruled out the possibility of delirium, what’s next? The next step is to try to find out which disease may be causing the dementia, since the prognosis and treatment will depend on which disease it is. You see, the diagnoses of Dementia and of Alzheimer’s disease are not one and the same; Mrs. Doe need not jump to the conclusion that she has Alzheimer’s disease and start planning her funeral. Not all dementia patients have Alzheimer’s Disease, however all Alzheimer’s patients have dementia. Confusing? Read on.

Dementia can be caused by:

• Alzheimer’s disease
   
• Vascular disease
   
• Parkinson’s disease
   
• Lewy body disease
   
• AIDS
   
• Etc.

Delirium can be caused by:

• Medication reaction
   
• Metabolic abnormality
   
• Infection (e.g., bladder)
   
• Pressure in the brain
   
• Psychological problems
   
• Etc.

Dementia, according to the Mayo Clinic, is a neurological disorder that can affect one’s ability to think, speak, reason, remember, or move. Alzheimer’s is just one form of dementia. Dementia describes a group of symptoms that can be caused by a number of diseases and conditions (i.e., Alzheimer’s disease, Huntington’s disease, Parkinson’s disease, Vascular diseases and AIDS, to name a few).

Reactions to certain medications, metabolic abnormalities, untreated emotional problems, infections, and a build up of brain fluids can lead to dementia-like symptoms that medical people refer to as delirium. If left untreated, these conditions can cause permanent damage leading to dementia. But fortunately, most of the aforementioned conditions that lead to delirium can be successfully treated, and if treated promptly, the dementia-like symptoms usually disappear.