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Alzheimer’s Awareness
Understanding the Signs for
Alzheimer’s Disease Means Decoding
Dementia, Delirium, and Depression
Today more than five million people
live with Alzheimer’s disease.
Alzheimer’s is
a progressive
and degenerative
disorder of the
brain and is
reported to be
the most
common cause
of dementia in
older adults.
Our brains age, so most of us notice some
slowed thinking and occasional problems
remembering certain things over time. However,
serious memory loss, confusion and other
major changes in the way our minds work
are not a normal part of aging.
Is it Alzheimer’s?
There are many causes for
memory problems. Some
are reversible through
treatment and some are
a cause for concern.
Dementia
Dementia
■ People with Alzheimer’s do suffer from dementia;
however, people with dementia don’t necessarily
have Alzheimer’s.
■ Dementia is characterized by mental decline and
impairment and is a term that describes disorders
that affect functioning of the brain: loss of memory,
judgment, language, complex motor skills, and other
intellectual functions.
Warning signs of dementia:
■ Trouble with new memories
■ Relying on memory helpers
■ Trouble finding words
■ Struggling to complete familiar
actions
■ Personality changes—such
as appearing anxious
■ Loss of interest in important
responsibilities
■ Withdrawing from social activities
■ Confusion about time, place
or people
■ Seeing or hearing things that are
not a part of reality
■ Misplacing familiar objects
■ Expressing false beliefs
■ Onset of new depression
or irritability
■ Inappropriate sexual behavior
in public
■ Making bad decisions
Causes of dementia:
■ Stroke
■ Malnourishment
■ Hospitalization
■ Trauma
People with a progressive dementia will most likely lose
the ability to perform everyday tasks necessary to live
independently.
Delirium
Delirium is a
cognitive or mental
disorder, not a
disease, which
appears suddenly,
often within hours
or days, and may
come and go
throughout the day.
Delirium is defined as a temporary confusion
caused by underlying medical problems, drug
toxicity, or environmental factors. Delirium
does not involve structural brain damage.
It is a very common, yet often unrecognized
condition in elderly individuals with dementia,
including Alzheimer’s disease.
Warning signs of delirium:
■ Confusion and
disorientation
■ Disorganized speech
■ Varying levels of
consciousness
■ Jerking motions
■ Disruption of sleep-wake
cycles
■ Hallucinations
■ Delusions and anxiety
■ Memory impairment
and altered speech
■ Intermittent agitated
behavior
■ Mood changes
■ Behavioral problems
such as aggression
and wandering
■ Changes in blood
pressure and pulse
Warning signs of delirium:
■ Delirium follows a time pattern. It has an
abrupt onset—less than one month; and a short
duration—not more than one month from the time
the symptoms are detected to intervention and
recovery.
Causes of delirium:
■ Infection
■ Trauma
■ Dehydration
■ Substance abuse
■ Physical illness
■ Reaction to medications
■ Head injury
Once the cause is identified and treatment begins
(changing medications, increasing fluids, or treating
infections), there is often a quick and complete
turn-around.
Depression
Depression is a mood disorder. It can and often
does affect both a person’s mind and body.
Experts estimate up to 40 percent of people
with Alzheimer’s disease suffer from significant
depression. Treatment of depression in
Alzheimer’s disease can improve a person’s
sense of well-being, quality of life, and
individual function.
It is normal to occasionally feel depressed or
sad; however, depression is characterized by
intense sadness lasting for a period of two
weeks or longer, and impacts a person’s ability
to lead a normal life. Depression can mask as
dementia in an older person and oftentimes a
depressed person will be inaccurately
diagnosed as having a dementia.
Warning signs of depression:
■ Sadness
■ Changes in sleep patterns
■ Lack of energy
■ Constant aches and pains
■ Feeling of hopelessness
and worthlessness
■ Change in appetite
■ Social isolation or
withdrawal
■ Recurrent thoughts of
death, suicide plans or
a suicide attempt
■ Irritability
■ Inappropriate or
excessive guilt
■ Difficulty concentrating
Causes of depression:
■ Hereditary predisposition
■ Physical limitations
■ Diagnosis of a medical
condition
■ Grief or loss of a spouse
or loved one
■ Substance abuse
■ Conflict
■ Reaction to medication
■ Abuse
■ Significant change
in one’s life
■ Loneliness
Delirium and depression are also sometimes
mistaken for Alzheimer’s or dementia.
Understanding these two will also be helpful
in understanding options when one is confused
or having problems associated with memory.
Alzheimer’s
Disease
Alzheimer’s disease is a common and serious
brain disease. Although symptoms can vary
widely, the first problem many people notice
is forgetfulness severe enough to affect their
work, lifelong hobbies, or social life.
Alzheimer’s disease is not a normal part of
aging. It is a disease.
Warning signs of Alzheimer’s disease:
■ Memory loss, especially of recent events, names,
placement of objects, and other new information
■ Confusion about time and place
■ Struggling to complete familiar actions, such as
brushing teeth or getting dressed
■ Trouble finding the appropriate words, completing
sentences, and following directions and conversations
Warning signs of Alzheimer’s disease:
■ Poor judgment when making decisions
■ Changes in mood and personality, such as increased
suspicion, rapid and persistent mood swings,
withdrawal, and disinterest in usual activities
■ Difficulty with complex mental assignments, such
as balancing a checkbook or other tasks involving
numbers
Facts about Alzheimer’s disease:
■ Advancing age. The Alzheimer’s Association reports:
“As many as 13% of all people 65 years of age and
older have Alzheimer’s and as many as 43 percent of
all people 85 and older have the disease.” However,
Alzheimer’s is certainly not an inevitable part of aging.
Additionally, there is an early-onset form of the
disease that can strike people as early as their
30’s, although this form of the disease is rare.
Facts about Alzheimer’s disease:
■ Genetic factors. Just because someone in the family
has the disease, it does not necessarily mean others
in the family will have the disease; however there has
been a familial link shown with some forms of the
disease.
■ Other risk factors that increase one’s chances of
getting Alzheimer’s disease include a serious head
injury, high blood pressure, heart disease, high
cholesterol, type 2 diabetes and glaucoma.
Seek medical attention if you notice a change in
a loved one’s behavior. Diagnosing Alzheimer’s
disease involves a battery of tests and ruling
out several other conditions. People who
receive treatment often experience improvement
in their overall medical condition and realize a
better quality of life.
Helpful Suggestions for Care
Partners of Those with Alzheimer’s
■ Get educated about the disease. Read books, attend
workshops, and consult with healthcare professionals.
■ Learn caregiving techniques. Key areas are
communication skills, safety concerns, and managing
behavioral challenges and activities of daily living.
■ If a friend or loved one has Alzheimer’s, try
to understand the experience. Adjust your
expectations.
► Be patient and kind.
Helpful Suggestions for Care
Partners of Those with Alzheimer’s
■ As a care partner to a person with Alzheimer’s:
► Avoid care partner burnout. Make time for yourself. Join
care partner support groups. Pursue interests beyond your
caregiving role, such as exercise, hobbies, journaling, and
art.
► Maintain your own physical and mental health. Exercise,
respite, and other activities can reduce stress. Seek medical
help if there are signs of depression.
Helpful Suggestions for Care
Partners of Those with Alzheimer’s
► Discuss the situation with family and friends. Support
systems are critical.
► Do cognitive stimulation activities with your loved one.
Listening to music, solving word puzzles, and playing
memory games can easily be done at home.
► Foster communication with physicians. Be involved in
your loved one’s medical care. Ask questions about the
progression of the disease, express concerns, and discuss
treatment options.
Helpful Suggestions for Care
Partners of Those with Alzheimer’s
► Take care of financial, legal, and long-term care
planning issues. Try to involve your loved one in
decision-making, if he or she is still capable of providing
input, and consider his or her wishes related to future care
and end-of-life issues.
► Smile. Kindness, humor and creativity are essential parts of
caregiving. Hugs, hand massage, and other gentle physical
contact will help your loved one feel connected and loved.
► Think positively. Focus on your loved one’s remaining
strengths and enjoy your relationship while you are still able.
Stages of Alzheimer’s
■ While not everyone
experiences the same
symptoms in the same
order or with the same
time schedule, Alzheimer’s
disease can generally be
categorized into seven
stages of brain
deterioration.
Stages of Alzheimer’s
1. No impairment (normal function)
► The person does not experience any memory problems.
An interview with a medical professional does not show
any evidence of symptoms of dementia.
Alzheimer’s Association, 2011.
Stages of Alzheimer’s
2. Very mild cognitive decline
► The person may feel as if he or she is having memory
lapses—forgetting familiar words or the location of everyday
objects. But no symptoms of dementia can be detected
during a medical examination or by friends, family or
co-workers.
Alzheimer’s Association, 2011.
Stages of Alzheimer’s
3. Mild cognitive decline
► Friends, family or co-workers begin to notice difficulties.
During a detailed medical interview, doctors may be able
to detect problems in memory or concentration.
Alzheimer’s Association, 2011.
Stages of Alzheimer’s
4. Moderate cognitive decline
► At this point, a careful medical interview should be
able to detect clear-cut problems in several areas:
● Forgetfulness of recent events
● Impaired ability to perform challenging mental arithmetic
● Greater difficulty performing complex tasks
● Forgetfulness about one’s own personal history
● Becoming moody or withdrawn, especially in socially
or mentally challenging situations
Alzheimer’s Association, 2011.
Stages of Alzheimer’s
5. Moderately severe cognitive decline
► Gaps in memory and thinking are noticeable, and
individuals begin to need help with day-to-day activities.
Alzheimer’s Association, 2011.
Stages of Alzheimer’s
6. Severe cognitive decline
► Memory continues to worsen, personality changes may
take place and individuals need extensive help with daily
activities.
Alzheimer’s Association, 2011.
Stages of Alzheimer’s
7. Very severe cognitive decline
► In the final stage of this disease, individuals lose the ability
to respond to their environment, to carry on a conversation
and, eventually, to control movement. They may still say
words or phrases.
► At this stage, individuals need help with much of their daily
personal care, including eating or using the toilet. They may
lose their ability to smile, to sit without support, and to hold
their head up. Reflexes become abnormal. Muscles grow
rigid. Swallowing is impaired.
Alzheimer’s Association, 2011.
So is it Alzheimer’s?
Some of the many causes for memory problems
have been presented here. Some are reversible
through treatment and some are a cause for
concern.
Awareness is the first step towards getting help.
Alzheimer’s disease strips the mind of
its memories, but it doesn’t have to strip
people from their familiar surroundings.
Many people with loved ones suffering from
Alzheimer’s or dementia are unaware of the
options available to them—like in-home care.
Mayo Clinic reports that people with Alzheimer’s
do better when they have a routine and maintain
familiar surroundings. It allows them to refresh
and reinforce their pattern of behavior every
day. People have choices when it comes to
Alzheimer’s care. Loved ones can remain safe,
active, and comfortable—at home. Call
Sovereign Home Health for more information.
For more information…
■ Sovereign Home Health
► (888) 978-5234
► [email protected]
► www.SovereignHomeHealth.com
Sources: The Alzheimer's Foundation of America, Alzheimer’s Association,
D.P. Devanand, M.D., a professor of clinical psychiatry and neurology at the
College of Physicians and Surgeons at Columbia University in New York.,
and B. Reisberg’s Clinical Presentation, Diagnosis, and Symptomatology
of Age-Associated Cognitive Decline and Alzheimer’s disease (Alzheimer’s
Disease: the Standard Reference, New York Free Press, 1983).