Understanding Dementia & Alzheimer’s Disease

Are you caring for a loved one with dementia? You don't have to figure this out all on your own. Welcome to Truth, Lies Alzheimer's, the show that helps you reimagine a new relationship with your loved one, a relationship a little more free of stress and anxiety. Join host Lisa Skinner and her 30+ years of experience as she guides you on a new path to a better relationship with those you care for. Here's Lisa.

Hi everybody, welcome to another new episode of The Truth, Lies Alzheimer's Show. I'm Lisa Skinner, your host, and I am going to be talking about the most common types of of dementia. I'm not sure if you're aware of this, but there actually are over 100 known brain diseases that cause dementia, and I'm going to be sharing with you the 4 most common types. You know, as we age, it's normal to lose some neurons in the brain. People living with dementia, however, experience far greater loss. Many neurons stop working, lose connections with other brain cells, and eventually die. At first, the symptoms can be mild, but they do get worse over time. So today I'm going to talk about 4 of the over 100 different types of known brain diseases. So currently, these are the most common types of dementia. Alzheimer's disease is number 1, and then there's frontotemporal dementia, there's Lewy body dementia, and vascular dementia. Remember, dementia is used as an umbrella term that includes a range of neurological conditions affecting the brain that continue to progress over time and refers to the symptoms that present with these conditions. What is happening with the brain when these diseases strike? With Alzheimer's disease, abnormal deposits of proteins form amyloid plaques and tau tangles throughout the brain. With frontotemporal dementia, abnormal amounts or forms of tau and TDP-43 proteins accumulate inside neurons in the frontal and temporal lobes. Lewy body dementia. This is where abnormal deposits of the alpha-synuclein protein called Lewy bodies affect the brain's chemical messengers. With vascular dementia, conditions such as blood clots disrupt blood flow in the brain. Now, I want to note that these changes are just one piece of a complex puzzle that scientists are studying to understand the underlying causes of these forms of dementia and others. So I'm going to describe the different symptomology of the 4 different types of brain disease that we're discussing. So some of the common symptoms of Alzheimer's disease in the mild stage include wandering and getting lost, repeating questions. Then as it progresses to the moderate stage, People start having problems recognizing friends and family, and you might see impulsive behaviors. And then as they progress to the severe stage, most people cannot communicate. Now, these are just a few of the many, many symptoms that we see. So some of the symptoms that you can expect to see of frontotemporal dementia would be behavioral and emotional, such as difficulty planning or organizing, impulsive behaviors, emotional flatness, or executive excessive emotions. People who are experiencing frontotemporal dementia can have movement problems like shaky hands, problems with their balance and walking. They can have language problems such as difficulty making or understanding speech. Now, there are several types of frontotemporal disorders, so the symptoms can vary by type. Lewy body dementia People will suffer cognitive decline. For example, the inability to concentrate, to pay attention, or to stay alert. They may have disorganized or illogical ideas. You'll see sometimes movement problems such as muscle rigidity, loss of coordination, and reduced facial expression. You might see sleep disorders such as insomnia or excessive daytime sleepiness and visual hallucinations with Lewy body dementia. Symptoms of vascular dementia could include forgetting current or past events, misplacing items, trouble following instructions and/or learning new information, hallucination or delusions, and poor judgment. The typical age of diagnosis for these types of dementia are: for Alzheimer's disease, typically shows up in the mid-60s and above, with some cases in the mid-30s to 60s., and we call that early onset Alzheimer's disease. For frontotemporal dementia, it can typically show up between the age of 45 and 64. Lewy body dementia, 50 and older. And vascular dementia typically shows up after the age of 65. Diagnosis for these 4 types of dementia are that symptoms can be similar among different types of dementia, and some people have more than one form of dementia happening at the same time. We call that mixed dementia, and that can obviously make an accurate diagnosis extremely difficult. Symptoms can also vary from person to person. The doctors may ask for a medical history complete a physical exam and/or neurological and laboratory tests to help diagnose dementia. There's currently no cure for any of these types of dementia, but some treatments are available, so you want to speak with your doctor to find out what might work best for you. Living with dementia can be challenging, but there are ways to manage it. So the information that I am sharing with you today was last updated by the National Institutes of Health on June 5th, 2025. So it is very current and very recent. As we know, Alzheimer's disease is a brain disorder that slowly destroys memory and thinking skills and eventually the ability to carry out the simple tasks. In most people with Alzheimer's, symptoms first appear later in life. Estimates vary, but experts suggest that more than 6 million Americans, most of them age 65 or older, may have Alzheimer's disease. It is currently ranked as the 7th leading cause of death in the United States and is the most common cause of dementia among older adults. It's the number one leading cause of death in the UK, in the Netherlands, and in Finland. Oh, and they just added Australia. Dementia is the loss of cognitive functioning— thinking, remembering, and reasoning— and behavioral abilities to such an extent to the extent that it interferes with a person's daily life and activities. Dementia ranges in severity from the mildest stage, when it's just beginning to affect a person's functioning, to the most severe stage, when the person must depend completely on others for help with even the basic activities of daily living. The causes of dementia can vary depending on the types of brain changes that may be taking place. Other forms of dementia do include Lewy body dementia, the frontotemporal disorder, and vascular dementia. And again, it is common— more common than most of us realize— for people to have mixed dementia, a combination of two or more types. Of dementia. For example, some people can be experiencing both Alzheimer's disease and vascular dementia simultaneously. Alzheimer's disease has been around for a long time. It was named after Dr. Alois Alzheimer, and way back in 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior. So after she died, Dr. Alzheimer examined her brain and found many abnormal clumps that we now refer to as amyloid plaques. And tangled bundles of fibers in her brain. Those fibers are now called neurofibrillary or tau tangles. Now, these plaques and tangles in her brain, in the brain, are still considered some of the main features of Alzheimer's disease. Another feature is the loss of connections between neurons. In our brains. The neurons transmit messages between different parts of our brain and from the brain to muscles and organs in our bodies. So exactly how does Alzheimer's affect the brain? Well, scientists are continuing to unravel the complex brain changes involved in Alzheimer's disease. Changes in the brain may begin a decade or more before symptoms actually appear. During this very early stage of Alzheimer's, toxic changes are taking place in the brain, including abnormal buildups of protein that form amyloid plaques and tau tangles. Previously healthy neurons stop functioning. They lose connections with other neurons and eventually die. Many other complex brain changes are thought to play a role in Alzheimer's as well. The damage initially appears to take place in the hippocampus and entorhinal cortex, which are parts of the brain that are essential in forming memories. As more neurons die, Additional parts of the brain are affected and begin to shrink. By the final stages of Alzheimer's, damage is widespread and brain tissue has shrunk significantly. I'm going to discuss more common signs and symptoms of Alzheimer's disease. Memory problems are typically one of the first signs of cognitive impairment related to Alzheimer's. Some people with memory problems have a condition called mild cognitive impairment, or MCI as it's more commonly referred to. With MCI, people have more memory problems than normal for their age, but their symptoms still do not interfere with everyday life, with their everyday lives. Movement difficulties and problems with sense of smell have also been linked to MCI. Older people with MCI are at greater risk of developing Alzheimer's, but not all of them do so. Some may even revert to normal cognition. But I want to emphasize that it really depends on what's causing the symptomology. If the root cause is one of the over 100 brain diseases that we know of, then it will progress to full-blown dementia. If there's another medical condition that's causing the symptoms that we see that are similar to full-blown dementia, then it can be treated, like a thyroid condition, for example. The first symptoms of Alzheimer's do vary from person to person. For many, decline in non-memory aspects of cognition, such as word finding, visual and spatial issues, and impaired reasoning or judgment may signal the very early stages of the disease. Researchers are studying biomarkers, which we talked about in a very recent episode. And biomarkers are the biological signs of disease found in brain images, in cerebrospinal fluid, and in blood tests to detect early changes in the brains of people with mild cognitive impairment and in cognitively normal people who may be at greater risk for developing Alzheimer's disease. However, more research is needed before these techniques can be used broadly and routinely to diagnose Alzheimer's disease in a healthcare provider's office. A little bit more about the stages of Alzheimer's disease. Since it is the number one most common type of brain disease that causes dementia. So usually, and of course these vary from person to person, but typical for mild Alzheimer's disease, as it worsens, people experience greater memory loss and other cognitive difficulties. Problems can include wandering and getting lost, trouble handling money and paying bills, repeating questions or stories in the same conversation, taking longer to complete normal tasks, and we'll see personality and behavioral changes. People are often diagnosed in this stage. Moderate Alzheimer's disease. In this stage, damage occurs in the areas of the brain that control language, reasoning, conscious thought, and sensory processing, such as the ability to correctly detect sounds and smells. Memory loss and confusion grow worse, and people begin to have problems recognizing family and friends. They may be unable to learn new things, carry out multi-step tasks such as getting dressed, or cope with new situations. In addition, people at this stage may have hallucinations, delusions, and paranoia, and may behave impulsively. When we get to the severe stage of Alzheimer's disease, this is when plaques and tangles are spreading throughout the brain, and brain tissue shrinks significantly. We call this atrophy. People with severe Alzheimer's disease cannot communicate and are completely dependent on on others for their care. Near the end of life, the person may be in bed most or all of the time as their body is shutting down. In recent years, scientists have made tremendous progress in better understanding Alzheimer's, and the momentum continues to grow. But unfortunately, scientists still do not yet we don't fully understand what causes Alzheimer's disease in most people. The causes probably include a combination of age-related changes in the brain along with genetic, environmental, and lifestyle factors. The importance of any one of these factors in increasing or decreasing the risk of developing Alzheimer's may differ from person to person. Scientists are conducting studies to learn more about plaques, tangles, and other biological features of Alzheimer's. Advances in brain imaging techniques enable researchers to actually see the development and spread of these abnormal amyloid and tau proteins in the living brain as well as changes in brain structure and function. Scientists are also exploring the very earliest steps in the disease process by studying changes in the brain and body fluids that can be detected years before Alzheimer's symptoms appear. Findings from these studies will help improve our understanding of the causes of Alzheimer's and make diagnosis easier. One of the greatest mysteries of Alzheimer's is why does it largely affect older adults? Research on normal brain aging is exploring this question. For example, scientists are learning how age-related changes in the brain may harm neurons and affect other types of brain cells to contribute to Alzheimer's damage. These age-related changes include, once again, atrophy, or shrinking of the brain, especially certain parts of the brain. Also inflammation. Also blood vessel damage, production of unstable molecules called free radicals, and mitochondrial dysfunction. Which is a breakdown of energy production within a cell. In most cases, Alzheimer's does not have a single genetic cause. Instead, it's likely influenced by multiple genes in combination with lifestyle and environmental factors. Changes in genes called genetic variations may increase or decrease a person's risk of developing the disease. Scientists currently know of more than 80 genetic regions associated with Alzheimer's. Of the genetic variants associated with Alzheimer's so far, only 3 are known to cause the actual disease. And although it happens rarely, when someone inherits when someone inherits an altered version of one of these genes, the APP, the PSEN1, or PSEN2, they will likely develop Alzheimer's before age 65 and sometimes much earlier. Now, this is interesting. People with Down syndrome also have a higher risk of developing Alzheimer's earlier in life. Down syndrome results from having an extra chromosome 21, which carries the APP gene that produces the amyloid precursor protein. Too much of this protein leads to buildup of beta amyloid plaques in the brain. Estimates suggest that 50% or more of people living with Down syndrome will develop Alzheimer's disease, with symptoms appearing starting in their 50s and 60s. Now, there's another genetic variation which I've talked about in the past, and this is the one that's called the APOE ApoE gene, and it has several forms. It's known to influence the risk of Alzheimer's disease, specifically the ApoE4. This one increases a person's risk of developing Alzheimer's and is also associated with developing Alzheimer's earlier in life for certain populations. The ApoE4 E2 may provide some protection against Alzheimer's. Changes in different genes, along with other biomedical, lifestyle, and environmental factors, play a role in potentially developing Alzheimer's. Still, it is never known for certain if any individual will or will not develop the disease. The bottom line: it's a crapshoot for all of us. Yeah, to put it bluntly. Research suggests that a host of factors beyond genetics may play a role in the development and course of Alzheimer's. There is a great deal of interest, for example, in the relationship between cognitive decline and vascular conditions such as heart disease, stroke, and high blood pressure, as well as metabolic diseases such as diabetes and obesity. Ongoing research will help us understand whether and how reducing these risk factors for these conditions may also help reduce the risk of developing Alzheimer's disease. To date, it's recommended that a nutritious diet, along with physical activity and social engagement and mentally stimulating pursuits, have all been associated with helping people stay healthy as they age. These factors might also help reduce the risk of cognitive decline and Alzheimer's disease. Researchers are testing some of these possibilities in clinical trials. Finally, as we know, Alzheimer's disease is complex, period. And it is therefore unlikely that any one drug or other intervention will successfully treat it in all people who are living with this disease. In ongoing clinical trials, scientists are developing and testing several possible treatment interventions. While there is currently no cure for Alzheimer's disease, medications are emerging to treat the progression of the disease by targeting its underlying causes. There are also medications that may temporarily improve or stabilize memory and thinking skills in some people and may help manage certain symptoms and behavioral problems. Additionally, people with Alzheimer's also may experience sleeplessness, depression, anxiety, agitation, and other behavioral and psychological symptoms. But scientists are continuing to research why these symptoms occur and are exploring new medications and non-drug strategies to manage them. Research shows that treating these symptoms may make people with Alzheimer's feel more comfortable and also help relieve caregiver burnout and stress. Antidepressants Antipsychotics and anti-anxiety drugs may be helpful for some people with Alzheimer's disease, but experts agree that these medications should be used only after other strategies to prevent— to promote physical and emotional comfort, such as avoiding stressful situations, have been tried. So, it's always important to talk with your doctor about what treatment will be most effective for your situation. This content has been provided by the National Institutes on Aging, or NIA. Scientists and experts do review this content to ensure that it's accurate and up to date, and it was last reviewed on April 5th, 2023. I want to include real news that you can use in today's episode because I found something that I find was just fascinating and interesting, and I wanted to share it with you. Scrolling makes you reactive. Drolling makes you reflective. Most people think burnout comes from overwork, but often it's from overstimulation. Every scroll, every ping, and every swipe spikes our dopamine. You feel busy but not fulfilled. You feel stimulated but not stable. Your brain gets stuck in what's called survival mode. Constant mental noise, shorter attention spans, less empathy and patience. When you walk, disconnect, or move slowly, the chemistry actually flips. Serotonin and oxy— Oxytocin rise. Prefrontal activity, which is the logic and leadership center of our brains, comes back online. You start to think clearly again. This is not just relaxation, it's regulation. And regulation is what separates reactivity from leadership. High performers aren't the ones doing the most, they're the ones thinking the clearest. So, 3 ways to expand your mind: redesign your digital space, remove social apps from your home screen and turn off suggested feeds, increase scrolling friction and regain focus. Notice the world again. Your brain filters out what you stop paying attention to. So sit quietly, observe nature, and look for patterns, light, and sound. And then make a new connection. Maybe you want to speak to your barista, compliment a stranger. Connection activates neurochemicals that scrolling cannot replicate. Reactivity shrinks your world. Reflection expands it. And that is hopefully some real news you can definitely use in your everyday life. So that'll do it for today's episode of The Truth Lies in Alzheimer's Show. I'm Lisa Skinner, your host. I hope you've enjoyed the information that I have shared with you today and that it helps somebody out there who may eventually be experiencing dementia. So as always, I wish you a great rest of your week, for all of you to stay happy and healthy, and I'll be back next week with another episode of The Truth Lies in Alzheimer's Show. Take care for now. Bye-bye.

Thank you for listening to Truth, Lies Alzheimer's. We hope you found something in today's episode that helps. We understand that caring for a loved one with dementia can be the challenge of a lifetime, but you don't have to do it alone. If you're ready for exclusive access to even more great content and resources, head on over to Facebook and join Lisa Skinner's Minding Dementia support group. We're a community of like-minded caregivers, and we're here to help.