Dementia 101

Summary

This script addresses the complexity of diagnosing dementia, emphasizing the importance of distinguishing it from normal aging. It highlights the necessity to identify changes and consider reversible causes like depression or medication issues. The speaker clarifies that dementia is an umbrella term for various conditions, not just Alzheimer's, and stresses the progressive, terminal nature of the syndrome. The message encourages support for those affected and the adaptation to living with the condition, offering hope for a meaningful life under the 'umbrella' of dementia.

Takeaways

• 🤔 The first step in addressing cognitive decline is to differentiate between normal aging and dementia to determine if there's a change that could be reversible.
• 🏥 It's crucial to rule out treatable conditions such as depression, hypothyroidism, medication side effects, or sensory issues like hearing or vision problems before assuming dementia.
• 🔍 Observing changes in cognitive function is essential, and assumptions should be avoided; a thorough evaluation is necessary to understand the situation.
• 🧠 Dementia is an umbrella term for approximately 85 to 90 different conditions, with Alzheimer's being one of the major types but not the only one.
• 🚫 Dementia is not a diagnosis in itself but a syndrome characterized by a collection of symptoms indicating brain changes.
• 🔑 The presence of dementia typically involves at least two parts of the brain being affected, one of which may be related to memory but not always in the conventional sense.
• 💊 Currently, there is no cure or treatment to stop the progression of dementia, which requires focusing on how to support individuals living with it.
• ⏳ The average duration of dementia symptoms is 8 to 12 years, though this can vary, emphasizing the long-term nature of the condition.
• 🔄 Dementia is a progressive and neurodegenerative illness, meaning it will continue to evolve and cannot be halted.
• 💔 All forms of dementia are terminal, but the speaker encourages a shift in perspective from fear to understanding and adaptation.
• 👫 Dementia affects not only the individual diagnosed but also their support network, who must decide how to respond and adapt to the changes.

Q & A

What is the first step in determining if someone's cognitive changes are due to dementia?

The first step is to determine if the changes are normal for that person or if something is changing that could be addressed, such as depression, hypothyroidism, medication issues, hearing or vision problems, or a new medical condition.

Why is it important not to immediately assume cognitive changes are due to dementia?

It's important because cognitive changes can be due to various treatable conditions, and making assumptions can lead to overlooking these potentially reversible causes.

What is the significance of the term 'umbrella term' in the context of dementia?

The term 'umbrella term' signifies that dementia is not a single condition but a collection of symptoms that can be caused by approximately 85 to 90 different conditions, each with its own form and cause.

What is the misconception about dementia and Alzheimer's disease?

The misconception is that dementia and Alzheimer's are the same, when in fact Alzheimer's is just one of the many conditions that fall under the umbrella of dementia.

Why is it incorrect to diagnose someone with 'dementia' alone?

It's incorrect because dementia is not a diagnosis but a syndrome—a collection of symptoms. A specific underlying condition should be identified to provide accurate treatment and care.

What are the four typical characteristics of dementia?

The four characteristics are: 1) At least two parts of the brain are changing, 2) There is currently no cure or way to stop the progression, 3) The condition is constantly changing due to its progressive nature, and 4) All forms of dementia are terminal.

How long do symptoms of dementia typically last on average?

On average, symptoms of dementia can last for 8 to 12 years, though this can vary in duration.

How does dementia affect not just the individual but also those around them?

Dementia affects everyone around the individual because it requires support, understanding, and adjustments from family and caregivers, impacting their lives as they cope with the changes.

What is the role of a caregiver or supporter in the context of dementia?

The role of a caregiver or supporter is to help the person with dementia live with their condition by adapting to their abilities, acknowledging what's missing, and utilizing what they still have left.

What is the key message of the speaker regarding the approach to dementia?

The key message is to avoid making assumptions, to seek a proper workup to identify the specific cause of cognitive changes, and to support the person with dementia by adapting and making positive changes in response to their condition.

How can one make a positive difference in the life of someone with dementia?

One can make a positive difference by pulling together support, understanding the condition, and helping the person with dementia to maintain their quality of life and engage in activities that they are still capable of.

Outlines

00:00

🤔 Understanding Dementia: Beyond Assumptions

The first paragraph emphasizes the importance of distinguishing between normal aging and dementia. It encourages not jumping to conclusions but to consider whether there's a change in the individual's condition that could be due to treatable causes like depression, hypothyroidism, or medication issues. The speaker clarifies that dementia is not a single condition but an umbrella term for approximately 85 to 90 different conditions, including Alzheimer's. Dementia is characterized by changes in at least two parts of the brain, with memory often affected in various ways. The paragraph also points out that dementia is a syndrome of symptoms, not a diagnosis, and that it's a progressive, neurodegenerative illness with no cure, typically lasting 8 to 12 years. The speaker stresses the terminal nature of dementia and the need to support those living with it, as it affects not only the individual but also their circle of care.

05:03

💪 Adapting to Life with Dementia

The second paragraph focuses on the speaker's role in helping individuals and their caregivers adapt to living with dementia. It acknowledges the inability to change or stop the condition but offers strategies to better align with the capabilities of the person affected. The speaker motivates the audience to embrace change and support each other, as dementia impacts everyone involved. The paragraph concludes with a call to action, encouraging unity and proactive support for those living under the 'umbrella' of dementia, highlighting the collective responsibility to make a positive difference in the face of this challenge.

Keywords

💡Dementia

Dementia refers to a group of symptoms that affect cognitive function severe enough to interfere with daily life. In the video's context, it is emphasized that dementia is not a single condition but an 'umbrella term' encompassing various conditions, with Alzheimer's being one of the most common but not the only type. The script highlights the importance of not hastily assuming dementia without considering other treatable causes such as depression or hypothyroidism.

💡Normal Aging

Normal aging is a natural process that can lead to mild cognitive decline but does not equate to dementia. The script suggests distinguishing between changes due to normal aging and those indicative of a potential cognitive disorder. It prompts viewers to question whether observed changes are typical for the individual or if they signal a deviation that might be addressed.

💡Depression

Depression is a mood disorder that can cause symptoms overlapping with dementia, such as memory problems and cognitive decline. The script uses depression as an example of a condition that is treatable and should be considered before attributing symptoms to dementia.

💡Hypothyroidism

Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones, which can lead to symptoms similar to dementia. The script mentions it as another potentially reversible cause of cognitive issues that should be ruled out before concluding dementia.

💡Alzheimer's

Alzheimer's disease is the most common form of dementia, characterized by progressive cognitive decline and memory loss. The video clarifies that while Alzheimer's is a significant part of the dementia spectrum, it is not the only cause, and assumptions should not be made that all memory problems are Alzheimer's.

💡Lewy Body Dementia

Lewy Body dementia is a type of dementia characterized by the presence of Lewy bodies (abnormal protein deposits) in the brain. The script mentions it as one of the 'mixed pictures' that can fall under the dementia umbrella, indicating the diversity of conditions that can present with dementia-like symptoms.

💡Frontotemporal Dementia

Frontotemporal dementia is a group of disorders that affect the frontal and temporal lobes of the brain, leading to personality and behavioral changes. The video script uses it as an example to illustrate the variety of dementia types and their distinct impacts on memory and cognition.

💡Vascular Dementia

Vascular dementia occurs due to problems with blood supply to the brain, often linked to conditions like stroke. The script includes vascular dementia to show that dementia can have various causes, not just neurodegenerative processes.

💡Neurodegenerative

Neurodegenerative refers to the progressive degeneration of the structure or function of neurons, often leading to conditions like dementia. The script describes dementia as a neurodegenerative illness, emphasizing the progressive and irreversible nature of the disease.

💡Terminal

Terminal describes a disease or condition that is not curable and will ultimately lead to death. The video script points out that all forms of dementia are terminal, urging a shift in perspective from fear to understanding and adaptation.

💡Cognitive Decline

Cognitive decline refers to a decrease in cognitive abilities such as memory, attention, and problem-solving skills. The script discusses cognitive decline in the context of aging and dementia, highlighting the need to differentiate between expected age-related changes and more significant issues that may require intervention.

Highlights

The importance of distinguishing between normal aging and dementia before making assumptions.

The necessity to identify changes in a person's cognitive state to determine if it's a normal part of aging or a symptom of a treatable condition.

Examples of treatable conditions that can mimic dementia, such as depression, hypothyroidism, medication issues, and hearing or vision problems.

The emphasis on not making assumptions and conducting a thorough workup to understand the root cause of cognitive changes.

The clarification that dementia is not a single condition but an umbrella term for approximately 85 to 90 different conditions.

The misconception that Alzheimer's is the only form of dementia, when in fact there are various types with mixed causes.

The current understanding that dementia is not a diagnosis but a syndrome, a collection of symptoms.

The typical characteristics of dementia, including the involvement of at least two parts of the brain, one often related to memory.

The acknowledgment that there is currently no cure or treatment to stop the progression of dementia.

The average duration of dementia symptoms, which is 8 to 12 years, with variations in individual cases.

The progressive nature of dementia, being a neurodegenerative illness that continues to change over time.

The terminal nature of all forms of dementia, with the understanding that life itself is terminal.

The impact of dementia on not just the individual but also on everyone around them, emphasizing the need for support.

The call to action for individuals to make a choice in how they respond to dementia, whether to support or walk away.

The role of the speaker in offering ways to adapt and support individuals living with dementia, focusing on their remaining abilities.

The message of unity and the collective effort required to make positive changes in the face of dementia.

The final thought on embracing the challenge of living with dementia and the importance of making informed choices.

Transcripts

So the first question is, is it or is it not dementia?

But we actually have a question before that.

Normal aging, not normal aging.

Because before we start assuming it's dementia, what we need to figure out is,

is this normal for this person?

Or is something changing?

If it's changing, is it necessarily permanent

or could it be something that we could fix, we could address, we could modify?

A couple of examples to keep in mind would be something like depression,

which is treatable, hypothyroid,

treatable, medication problems,

treatable or even a problem with hearing that nobody's picked up on.

Or a problem with vision

or a problem with a new medical condition, maybe like diabetes or something.

So what you want to notice first is, is there a change?

Is something changing?

And don't make assumptions.

We want to check things out.

People deserve a good workup.

We don't want to think, Oh, yeah, look, it's not normal, it’s dementia.

We want to think, hmm.

I don't know that this is normal for this person.

Something seems to be changing.

And if we notice the change we want to find out, can we do something?

And if we do that and we're still going, ooh, something's going on here.

We don't want to make the next leap, which is oh, it's got to be Alzheimer’s.

It’s bound to be Alzheimer's.

Not necessarily.

This is where there's a lot of misunderstanding about what's dementia

and what's Alzheimer's, and what does it mean?

It doesn't mean memory problems.

When we talk about dementia, we need to be thinking about a great big

umbrella term.

A great, big umbrella.

As a matter of fact, that we find underneath that umbrella

approximately 85 to 90 different conditions, forms, causes of this thing

called dementia and dementia is not maybe what you think it is.

It's more and it's different.

Alzheimer's is under there.

It's certainly one of the big boxes under there.

But it's not the only box.

And what we used to think, you know, 80 to 90% of all dementias are Alzheimer's.

Now we know they may be mixed pictures, a couple, or a different one entirely.

Things like Lewy Body or frontotemporal dementia

or maybe vascular dementia or dementia that comes with a health condition

And we think now that dementia actually isn't a diagnosis.

So if somebody has been diagnosed as having dementia, something's

not right already because you don't get a diagnosis of dementia.

When you have dementia, you have a syndrome, a collection of symptoms.

So what do we want to do?

Well, we want to know we're under the umbrella.

Well, what does it mean to be under the umbrella to have dementia?

Well, it means four things typically.

Number one, at least two parts of your brain are dying

they're changing and we can't fix them right now.

So your brain is changing on you, at least two parts.

One of them

will typically be related to memory, but not always in the way we think about.

It's not always the can't remember new things, but do remember old things.

For alcohol related dementia, I have blackouts,

but they might be a variety of blacked out or missing pieces.

For vascular, I again could have a whole bunch

of different memory issues and for frontotemporal

I may think something happened that you don't remember happening.

So with memory, it's important to recognize it's

not just the standard thing.

Now, the second thing that's true about all dementias is that right now

we currently have nothing that's going to fix it, cure it,

make it go away, or even stop it in its tracks.

So what we have to realize is

we're going to have to figure out how to help somebody live with it.

And on average, for all the dementias if we considered

all of them, we'd be talking about 8 to 12 years of symptoms

now could be shorter, could be longer,

but 8 to 12 years is a long time to endorse something

that the third thing that's true about all dementias is constantly changing.

And it's constantly changing because this is a neurodegenerative

or a progressive illness.

It's not going to stop until it's over.

And now we get to the fourth thing that's true about all dementias.

They're all terminal, but frankly, so is life.

So what we've got to stop thinking is, oh, no, and start going, Oh, huh,

I'm going to have to make some changes.

I'm going to have to do something

because I am living with someone who's living under the umbrella.

Now, let me say that again.

When one person gets dementia, it doesn't just affect that one person.

Everyone around them is going to be living with dementia one way or the other.

So this one person got chosen,

but it's not a choice they would have ever made.

You choose.

And the question is, will you pull together

and support that person or will you fall apart and walk away?

Will you wear yourself out and not make a positive difference?

The purpose and the reason I do what I do is to help you do what you do.

And that's where we can make the change happen.

I can't change the condition.

I can't make the changes stop.

But what I can do is offer you ways to start changing to better match

what they're able to do, to acknowledge

what's missing and use what they still have left.

There's life under the umbrella for all of us.

Life under the umbrella is a challenge when it's in you, but

it's also a challenge when you're living with the person who's experiencing it.

The choice is yours with dementia.

Let's pull together.

Let's change because the change is happening.