welcome to the organic green doctor blog

i am a family physician who was diagnosed with
early mild cognitive impairment(mci) amnestic type on december 21, 2010
this is a precursor to alzheimers disease
because of this diagnosis i have opted to stop practicing medicine
this blog will be about my journey with this disease
please feel free to follow me along this path
i will continue blogging on organic gardening, green living,
solar power, rainwater collection, and healthy living
i will blog on these plus other things noted to be interesting

Friday, April 16, 2021

alzheimers news-the five most common dementias


i have been asked frequently over the years
are alzheimers and dementia the same

dementia is an umbrella term that means any of the dementias that cause memory loss

i also am asked or am told that someones family member had dementia
i ask 
what kind
i dont know they said
they just had dementia

in 2021 during an evaluation usually you can find out which dementia a person has
why is that important
most people and their families want to know

the management of the different dementias can be different

the five most common dementias are
alzheimers disease
vascular disease
lewy body disease
frontotemporal dementia
mixed dementia

alzheimers disease 
we all know about alzheimers disease 
it is associated with amyloid protein accumulation and tau protein accumulation and inflammation in the brain

early onset alzheimers is caused by rare genes that if you inherit them you will most likely get the disease at an early age usually in the 50s and early 60s

late onset alzheimers is associated with the apoe 4 gene
about 25% or less of us have that gene
if you get the gene you are at risk for developing late onset alzheimers disease
how you live your life determines if you get it if you have apoe 4 gene

not all alzheimers is gene related

like the other dementias there is no treatment or cure

vascular dementia
the vascular system gets affected
strokes are a common cause of vascular dementia
my mother probably had a mixture of vascular dementia and alzheimers disease
my younger brother probably had alzheimers disease only
so far that is the case with me

lewy body dementia
this is the one robin williams had
if your read about the last months of his life you get an idea how bad this one is
these patients have an accumulation of lewy body proteins in the brain
its an unpleasant one to have in your loved one

frontotemporal dementia
there is accumulation of proteins in the frontal and temporal parts of the brain
these areas control behavior and emotion and language
it tends to occur under the age of 60 
it also can be an unpleasant dementia for loved ones to experience
unpleasant reactions can occur in these patients

mixed dementia
its a combination of two of these
alzheimers disease and mixed dementia are the most common one

none of these are treatable or curable
medications are used to help control some of the symptoms but eventually the dementias all win in the end

if i had to choose one
i would i guess choose alzheimers disease or vascular disease 

these is not a good choice though amongst the dementias
i would not want lewy body or frontotemporal dementia

there is more work being done on alzheimers than the other dementias
my guess is a treatment will be available probably for alzheimers disease before one for the other dementias

my drug biogen aducanumab may end up helping slow down alzheimers disease but probably will not help with these other dementias

here is a good review of these dementias from alzheimers.gov

here is a review from the alzheimers associations website with links to more information 

when you or someone you know is being evaluated for memory loss be sure they have had a good thorough workup

sometimes memory loss can be reversed in some cases such as

side effect of medications
issues such as depression anxiety stress 
certain vitamin deficiencies like vitamin b12 eg
drinking too much alcohol
blood clots tumors or infections in the brain
delirium a sudden state of confusion and disorientation 
head injury such as a concussion from a fall or accident
thyroid kidney liver problems
normal pressure hydrocephalus  an increased accumulation of spinal fluid in the brain

then if you or they have dementia it needs to be defined accurately since the management of them are different

the patient should have a medical exam and medical history labs memory testing in house and maybe a more complete neuropsychological exam if indicated and maybe a mri

if needed to make the diagnosis an amyloid pet scan can be done to help solidify or rule out  an alzheimers diagnosis

a blood test will be available to be used to help diagnose alzheimers also

once an accurate diagnosis is made then a treatment to help control the symptoms can be done
if it is a reversible cause then treatment can be started 
if the thyroid is low thyroid replacement can be started
if the vitamin b12 is low vitamin b12 replacement can be started
stopping alcohol intake if abuse is a problem
adjusting offending medications
treating depression anxiety or stress

hopefully this is helpful to those who inquired about the difference between dementia and alzheimers

the organicgreen doctor

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