Stages of dementia, and the difference between Alzheimer's and dementia

Dementia is the general term for a group of symptoms. Alzheimer's is a specific disease that causes those symptoms.

A helpful comparison: "heart disease" covers many conditions, and a heart attack is one of them. In the same way, "dementia" covers many conditions, and Alzheimer's is the most common one.

No, but they're closely related. Everyone living with Alzheimer's has dementia, but not everyone with dementia has Alzheimer's.

"Dementia" tells you that someone's memory and thinking have changed. It doesn't tell you why. Finding the cause, whether it's Alzheimer's or something else, is the doctor's job.

Dementia is a decline in memory, thinking, behavior or communication that is serious enough to interfere with daily life. It isn't one illness. It's a collection of symptoms caused by different diseases and conditions that damage the brain.

Dementia is not a normal part of aging. If a doctor says "it's dementia" or "it's just old age", ask: which type? Knowing the cause helps you plan.

Alzheimer's disease is a form of dementia that affects brain function, including memory, behavior and reasoning. It is progressive, which means it gets more severe over time.

In Alzheimer's disease, abnormal proteins build up in the brain, forming plaques and tangles that damage and eventually kill nerve cells. The changes usually start in the parts of the brain that form new memories, which is why recent memory is often affected first.

Its effects range from mild memory loss in the early stages to being unable to care for oneself in the late stages.

Neither is "worse", because they aren't two separate things. Alzheimer's is one type of dementia.

How hard the journey is depends on the cause of the dementia, the stage, and the person's overall health and support.

Dementia doesn't turn into Alzheimer's. Alzheimer's is the disease, and dementia is the set of symptoms it causes as it progresses.

Changes in the brain from Alzheimer's begin before symptoms appear. Dementia describes the point when those changes start affecting daily life.

Many people think a mild memory problem is "dementia" and that it becomes "Alzheimer's" when it gets bad. That isn't correct. Alzheimer's can be the cause even in the very earliest, mildest stage.

Besides Alzheimer's, the most common types include:

• Vascular dementia: caused by reduced blood flow to the brain, for example after strokes.
• Lewy body dementia: caused by abnormal protein deposits in the brain. It can bring visual hallucinations, movement problems and alertness that changes from day to day.
• Frontotemporal dementia: damage to the front and side areas of the brain. It often changes personality, behavior or language first.
• Mixed dementia: more than one cause at the same time, such as Alzheimer's and vascular changes.

Read our guides to the types of dementia and Lewy body dementia.

Lewy body dementia is a type of dementia caused by abnormal protein deposits, called Lewy bodies, in the brain. These deposits affect thinking, movement, sleep, behavior and mood.

Common signs include visual hallucinations, alertness and attention that change from day to day, stiffness or shuffling like Parkinson's disease, and acting out dreams during sleep. It includes dementia with Lewy bodies and Parkinson's disease dementia.

Read our full Lewy body dementia guide, or read the National Institute on Aging's What is Lewy body dementia?

Vascular dementia is caused by reduced blood flow to the brain, which damages brain cells. It can follow a major stroke or a series of small strokes, or come from other damage to the brain's blood vessels.

Symptoms depend on which part of the brain is affected. Problems with planning, judgment, focus and slowed thinking are often more noticeable than memory loss at first, and changes can come in steps rather than slowly.

Managing blood pressure, cholesterol and diabetes may help lower the risk. Learn more from the National Institute on Aging's vascular dementia information.

Mild cognitive impairment, or MCI, is a small but noticeable change in memory or thinking. It's more than normal aging, but it isn't dementia, because the person can still manage everyday life on their own.

Some people with MCI go on to develop dementia. Others stay the same for years, and some get better, especially when the cause is treatable.

A diagnosis of MCI can be frightening. Regular check-ups help the doctor watch for changes. Learn more from the National Institute on Aging's What is mild cognitive impairment?

Usually not directly. Having a parent, brother or sister with Alzheimer's raises your risk somewhat, but it doesn't mean you will get it. Most people with a family history never develop the disease.

A few rare forms of Alzheimer's, which usually start before age 65, are caused by gene changes passed down in families. A more common gene, called APOE e4, raises the risk but doesn't decide whether someone gets the disease.

If you're worried, talk to your doctor before ordering a genetic test. Our free "Alzheimer's Disease Genetics Fact Sheet" and "Preventing Alzheimer's Disease: What Do We Know?" booklet are in the Caregiver Resource Library.

Only a doctor can tell, after a thorough evaluation. There is no single test for Alzheimer's.

Doctors work to rule out other conditions that can cause similar symptoms, such as infections, thyroid problems, vitamin deficiencies or medication side effects. Some of these can be treated.

A full evaluation usually includes a medical history, a mental status check, a physical exam, lab tests, and sometimes brain imaging and a neurological exam. Our free one-page guide, "Getting a Proper Diagnosis", walks you through each step. Find it in the Caregiver Resource Library.

Five common warning signs are memory loss that disrupts daily life, trouble with familiar tasks, confusion about time or place, problems with words and conversation, and changes in mood or personality.

Seeing one sign doesn't mean someone has dementia. It does mean it's time to talk to a doctor.

Occasional forgetfulness, like misplacing your keys or forgetting a name and remembering it later, is a normal part of aging. Dementia is different: the memory and thinking problems keep getting worse and start to get in the way of everyday life.

If you're unsure, a memory screening is a simple way to get a baseline.

Yes, this is very common. Dementia, especially Alzheimer's, usually affects new memories first. Memories from long ago are often stored more deeply and last longer.

So your person may tell a clear story from 50 years ago but not remember lunch or a conversation from an hour ago. It isn't on purpose, and it isn't a sign they're "not trying". As the disease progresses, older memories can fade too, and many people come to live mostly in the present moment.

No. Confusion that starts suddenly, over hours or days, may be delirium. Delirium is not a form of dementia. It's a medical problem that needs a doctor right away.

Delirium is often caused by something treatable, such as an infection (including a urinary tract infection), dehydration, a new medication or surgery. Dementia, by contrast, usually develops slowly over months or years.

A person living with dementia can also get delirium. If your person suddenly becomes much more confused, sleepy or agitated than usual, call their doctor the same day.

Start with their primary care physician. The doctor can rule out other conditions that can look like dementia.

At the same time, consider a free memory screening at a local research company. ADRC board member Dr. Malisa Agard of Conquest Research recommends a baseline memory screening after age 55, so changes can be spotted early.

Need help getting started? Call us at (407) 436-7750.

You're not alone. Denial is very common, for the person and for families. Sometimes a husband and wife are both in denial for a while, and many caregivers go through it before they reach out.

A few things often help:

• Call it a routine check-up or a medication review rather than a "memory test".
• Share what you've noticed with the doctor before the visit, in a short note or phone call.
• Go along to the appointment so you can fill in details your person may forget.
• Remind your person, and yourself, that some causes of memory problems are treatable.

If you're stuck, book a free Care Navigation session and we'll talk through your next step together.

A cognitive test is a short set of questions and tasks that checks memory, attention, language and problem-solving. Doctors use it to see whether thinking skills have changed and whether more testing is needed.

Common examples ask the person to remember a few words, draw a clock, name objects or answer questions about the date. Most take 5 to 15 minutes. A cognitive test is a screening tool. It can't diagnose dementia on its own, but it's a helpful first step and a baseline to compare against later.

The 3-word test is a quick memory screen. The person is asked to remember three unrelated words, does a short task such as drawing a clock, and then tries to recall the three words.

It's one of several short screening tools doctors use. It can flag a possible problem, but it can't diagnose dementia on its own.

The 2-finger test is a simple hand-gesture task. The person watches someone make a shape with their fingers and then tries to copy it.

Difficulty copying the gesture can be a sign of changes in the brain. Like other quick tests, it's a screening tool only, not a diagnosis.

Some newer blood tests can look for signs of Alzheimer's changes in the brain. Doctors may use them as one part of a full evaluation for someone who already has symptoms.

No blood test can diagnose dementia on its own. Before buying a test online, talk to your person's doctor about whether it would help and what the results would mean.

There is no cure for Alzheimer's disease yet. Medications are available that may slow the progression of the disease in some people for a period of time.

Researchers are constantly working toward a cure. Florida families can support that research through the State of Florida Brain Bank.