As we grow older, all parts of our bodies experience changes, including our brains. Forgetfulness is a common part of aging, and everyone experiences mild memory lapses from time to time. For example, we forget where we left things, people’s names, or even appointments. These are typically a normal part of aging. However, if memory problems become more frequent or severe, a doctor should be consulted for evaluation. If symptoms progress to dementia, it can make it difficult to live independently and manage daily activities.
Signs that memory impairment may be more significant include:
- Asking the same questions over and over.
- Becoming increasingly confused about time, people, and places.
- Getting lost in places you used to know well.
- Having trouble following directions.
- Not caring for yourself properly—for example, not bathing regularly, eating poorly, and acting in an unsafe manner.
Everyone ages differently. How we age is affected by our genetic factors, which we cannot change, but also by things we have more control over, such as our lifestyle and the environment we live in. Eating a healthy diet, being physically active, and maintaining good social relationships can help us lead a healthy life and decrease our risk of developing conditions (including mental impairment) as we age. So, how do you distinguish between normal memory changes and dementia? And where does Alzheimer’s disease fit in?
MEMORY LOSS
Memory loss can progress through different stages, from age-related memory impairment and mild cognitive impairment to dementia. The chart below explains the differences between these distinctions.
Memory Impairment | |
| Age-associated memory impairment (considered a normal part of aging) | Memory difficulties:
|
| Mild cognitive impairment | Memory difficulties:
|
| Dementia | Memory difficulties:
|
WHAT IS DEMENTIA?
Dementia is not a single disease. It is a general term that describes a group of symptoms associated with various underlying conditions. These symptoms cause changes in thinking, memory, and reasoning skills that are serious enough to affect daily life, the ability to function independently, plus behaviours, feelings, and relationships. Some forms of dementia can be reversed; others are irreversible.
The brain is comprised of distinct regions, each of which is responsible for different functions (such as memory, judgment, and movements). When cells in a certain region are damaged, that region cannot carry out its functions properly.
WHAT IS ALZHEIMER’S DISEASE?
Although many people think dementia and Alzheimer’s disease are the same thing, they are not. Alzheimer’s disease is the most common form of dementia, accounting for 60% to 80% of all dementia cases. Increasing age is the greatest known risk factor for this type of dementia. When it affects people younger than 65 years of age, it is known as younger-onset Alzheimer’s or early-onset Alzheimer’s.
Alzheimer’s changes typically begin in the brain region that affects learning, and the most common early symptom is difficulty remembering newly-learned information. However, many people experience trouble remembering things sometimes, so having this symptom is does not confirm that a person has Alzheimer’s disease.
Important components of Alzheimer’s are two abnormal structures that can form in the brain, called plaques and tangles. Although most people develop some plaques and tangles as they age, people with Alzheimer’s develop far more and they develop in a predictable pattern. While scientists don’t know exactly how plaques and tangles play a role in Alzheimer’s disease, they do believe that they act by blocking communication among nerve cells.
SYMPTOMS OF DEMENTIA
The symptoms of dementia vary depending on the type of dementia a person has. The table below explains the symptoms associated with various types of dementia.
Dementia Symptoms | |
| Type of Dementia | Typical Symptoms |
| Alzheimer’s disease | Problems with short-term memory, paying bills, preparing meals, remembering appointments, getting lost in familiar places |
| Fronto-temporal dementia | Difficulty planning or organizing activities, having trouble communicating with others, acting inappropriately in social or work situations |
| Lewy body dementia | Memory loss, problems with movement or balance (such as stiffness or trembling), daytime sleepiness, confusion, sleep disturbances, staring spells, visual hallucinations |
| Mixed dementia | Several types of dementia can affect a person at the same time, and this can affect which symptoms the person will experience |
| Vascular dementia | Symptoms vary depending on the part of the brain that is affected, and they may overlap with symptoms of other types of dementia. |
TREATING DEMENTIA
Currently, there are no treatments that can reverse cognitive decline and cure irreversible types of dementia. However, there are treatments that can help manage challenging symptoms and help maintain the quality of life for individuals living with dementia. Medications that have been approved in Canada for the treatment of dementia include donepezil, rivastigmine, and galantamine, which improve communication between brain cells, and memantine which helps protect brain cells and improve their function. The medications selected for each patient will depend on the type of dementia the person has, how severe the symptoms are, and how quickly the disease is progressing.
Advances in the treatment of dementia and Alzheimer’s disease continue to evolve, offering reasons for optimism about the future of prevention and treatment. For instance, two newer biologic medicines, lecanemab and donanemab are currently under review by Health Canada with the goal of slowing cognitive decline in patients with Alzheimer’s disease. Additional treatments like these are expected to emerge in the coming years.
If you have any questions or concerns about any of the symptoms mentioned that you or a loved one may be experiencing, it is important to speak with your healthcare team. Early intervention may help reduce the progression of the disease and improve the person’s individual’s quality of life. If medications are prescribed, your pharmacist can provide guidance on how to take them and help you manage any potential side effects. They can also organize your medicines into blister packs to help with memory concerns and reduce your chances of missed doses or errors. Speak to your pharmacist to learn how we can help support your needs.
