The Doctor is in: Dementia: Alzheimer’s or something else? - Tucson Local Media: The Doctor Is In

The Doctor is in: Dementia: Alzheimer’s or something else?

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Moeen Din, M.D.

Posted: Wednesday, October 10, 2012 4:00 am

More than 5.4 million Americans suffer from Alzheimer’s disease – and the numbers are growing. While there is no known cure, research is revealing that a healthy lifestyle and early treatment can possibly delay the onset of major symptoms. 

Alzheimer’s is the most common form of dementia, accounting for 50 to 80 percent of all cases, according to the Alzheimer’s Association. Typically, Alzheimer’s develops after age 65 – 1 in 8 senior adults have Alzheimer’s disease – with an average age of 75 for the onset of the disease. However, up to 5 percent of patients have an early-onset form of the disease. 

Last year, the Alzheimer’s Association and the National Institute of Aging issued new guidelines for diagnosing Alzheimer’s disease, to improve diagnosis, identify brain changes associated with the disease, and promote research to support earlier detection, diagnosis and treatment. 

The guidelines identify three stages of the disease: pre-symptomatic (before outward symptoms are visible); mild cognitive impairment (MCI) (mild memory and thinking changes that are noticeable, but not debilitating); and dementia, or full-blown Alzheimer’s disease. The significance of the guidelines is the focus on early identification and symptoms management. 

MCI and Alzheimer’s disease are not the same condition, although some Alzheimer’s patients may first experience MCI in the early stages of the disease process. However, some people are diagnosed with MCI and never progress to Alzheimer’s. Research is underway to develop diagnostic tests, such as blood tests and screening methods, to identify the type of MCI that leads to Alzheimer’s disease. 

The new criteria expand the definition of Alzheimer’s to include some forms of MCI, and also distinguish MCI from Alzheimer’s disease, based on an individual’s level of successfully performing certain daily activities. Data show that the brain of a person affected with Alzheimer’s disease begins to change more than a decade before noticeable symptoms develop. Health experts are now exploring the benefit of early treatment, from lifestyle changes to drug therapy. 

Researchers stress that memory and thinking problems associated with MCI are not a normal part of aging. Recognizing the cognitive changes could be the key to early detection and intervention for those at risk of developing Alzheimer’s disease and other forms of dementia. Historically, MCI has been used to describe mild forgetfulness and decreased memory skills. It is now known that MCI affects other aspects of thought processing and can disrupt the ability to perform everyday tasks, such as shopping and bill paying. Early symptoms of Alzheimer’s, on the other hand, include memory loss, language problems, personality changes, disorientation and confusion, lack of hygiene, and odd behavior. 

While Alzheimer’s is a progressive disease with no known cure, certain lifestyle changes may delay the onset and severity of symptoms: regular exercise, a nutritious diet, quitting smoking and keeping blood pressure within healthy limits, and activities that stimulate the mind, such as crossword puzzles and word games. 

Medications have not demonstrated the capability to change the course of MCI or Alzheimer’s disease, but can serve as temporary treatment to stabilize patients for several years and delay the onset of more severe symptoms. 

Most importantly, early diagnosis can also help caregivers by providing education, counseling and support, enabling families to keep a loved one with Alzheimer’s at home longer, as well as make long-term decisions about healthcare and family activities.

If you are concerned about Alzheimer’s disease or MCI, talk with your doctor. Diagnosis involves a thorough medical evaluation, including a complete medical history, mental status testing, physical and neurological exam, and tests (such as blood tests and brain imaging) to rule out other causes of dementia-like symptoms.

(Editor’s Note: Moeen Din, M.D. is a neurologist practicing with Northwest Allied Physicians.  His office may be reached at 229-2578 or

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