What’s the difference? is a new editorial product that explains the similarities and differences between commonly confused health and medical terms, and why they matter.

Changes in thinking and memory as we age can occur for a variety of reasons. These changes are not always cause for concern. But when they begin to disrupt daily life, it could indicate the first signs of dementia.

Another term that can crop up when we’re talking about dementia is Alzheimer’s disease, or Alzheimer’s for short.

So what’s the difference?

What is dementia?

Dementia is an umbrella term used to describe a range of syndromes that result in changes in memory, thinking and/or behaviour due to degeneration in the brain.

To meet the criteria for dementia these changes must be sufficiently pronounced to interfere with usual activities and are present in at least two different aspects of thinking or memory.

For example, someone might have trouble remembering to pay bills and become lost in previously familiar areas.

It’s less-well known that dementia can also occur in children. This is due to progressive brain damage associated with more than 100 rare genetic disorders. This can result in similar cognitive changes as we see in adults.

So what’s Alzheimer’s then?

Alzheimer’s is the most common type of dementia, accounting for about 60-80% of cases.

So it’s not surprising many people use the terms dementia and Alzheimer’s interchangeably.

Changes in memory are the most common sign of Alzheimer’s and it’s what the public most often associates with it. For instance, someone with Alzheimer’s may have trouble recalling recent events or keeping track of what day or month it is.

We still don’t know exactly what causes Alzheimer’s. However, we do know it is associated with a build-up in the brain of two types of protein called amyloid-β and tau.

While we all have some amyloid-β, when too much builds up in the brain it clumps together, forming plaques in the spaces between cells. These plaques cause damage (inflammation) to surrounding brain cells and leads to disruption in tau. Tau forms part of the structure of brain cells but in Alzheimer’s tau proteins become “tangled”. This is toxic to the cells, causing them to die. A feedback loop is then thought to occur, triggering production of more amyloid-β and more abnormal tau, perpetuating damage to brain cells.

Alzheimer’s can also occur with other forms of dementia, such as vascular dementia. This combination is the most common example of a mixed dementia.

Vascular dementia

The second most common type of dementia is vascular dementia. This results from disrupted blood flow to the brain.

Because the changes in blood flow can occur throughout the brain, signs of vascular dementia can be more varied than the memory changes typically seen in Alzheimer’s.

For example, vascular dementia may present as general confusion, slowed thinking, or difficulty organising thoughts and actions.

Your risk of vascular dementia is greater if you have heart disease or high blood pressure.

Frontotemporal dementia

Some people may not realise that dementia can also affect behaviour and/or language. We see this in different forms of frontotemporal dementia.

The behavioural variant of frontotemporal dementia is the second most common form (after Alzheimer’s disease) of younger onset dementia (dementia in people under 65).

People living with this may have difficulties in interpreting and appropriately responding to social situations. For example, they may make uncharacteristically rude or offensive comments or invade people’s personal space.

Semantic dementia is also a type of frontotemporal dementia and results in difficulty with understanding the meaning of words and naming everyday objects.

Dementia with Lewy bodies

Dementia with Lewy bodies results from dysregulation of a different type of protein known as α-synuclein. We often see this in people with Parkinson’s disease.

So people with this type of dementia may have altered movement, such as a stooped posture, shuffling walk, and changes in handwriting. Other symptoms include changes in alertness, visual hallucinations and significant disruption to sleep.

Do I have dementia and if so, which type?

If you or someone close to you is concerned, the first thing to do is to speak to your GP. They will likely ask you some questions about your medical history and what changes you have noticed.

Sometimes it might not be clear if you have dementia when you first speak to your doctor. They may suggest you watch for changes or they may refer you to a specialist for further tests.

There is no single test to clearly show if you have dementia, or the type of dementia. A diagnosis comes after multiple tests, including brain scans, tests of memory and thinking, and consideration of how these changes impact your daily life.

Not knowing what is happening can be a challenging time so it is important to speak to someone about how you are feeling or to reach out to support services.

Dementia is diverse

As well as the different forms of dementia, everyone experiences dementia in different ways. For example, the speed dementia progresses varies a lot from person to person. Some people will continue to live well with dementia for some time while others may decline more quickly.

There is still significant stigma surrounding dementia. So by learning more about the various types of dementia and understanding differences in how dementia progresses we can all do our part to create a more dementia-friendly community.

The National Dementia Helpline (1800 100 500) provides information and support for people living with dementia and their carers. To learn more about dementia, you can take this free online course.

Nikki-Anne Wilson, Postdoctoral Research Fellow, Neuroscience Research Australia (NeuRA), UNSW Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

There are renewed calls this week for the Australian government to implement a range of measures aimed at improving our diets. These include restrictions on junk food advertising, improvements to food labelling, and a levy on sugary drinks.

This time the recommendations come from a parliamentary inquiry into diabetes in Australia. Its final report, tabled in parliament on Wednesday, was prepared by a parliamentary committee comprising members from across the political spectrum.

The release of this report could be an indication that Australia is finally going to implement the evidence-based healthy eating policies public health experts have been recommending for years.

But we know Australian governments have historically been unwilling to introduce policies the powerful food industry opposes. The question is whether the current government will put the health of Australians above the profits of companies selling unhealthy food.

Diabetes in Australia

Diabetes is one of the fastest growing chronic health conditions in the nation, with more than 1.3 million people affected. Projections show the number of Australians diagnosed with the condition is set to rise rapidly in coming decades.

Type 2 diabetes accounts for the vast majority of cases of diabetes. It’s largely preventable, with obesity among the strongest risk factors.

This latest report makes it clear we need an urgent focus on obesity prevention to reduce the burden of diabetes. Type 2 diabetes and obesity cost the Australian economy billions of dollars each year and preventive solutions are highly cost-effective.

This means the money spent on preventing obesity and diabetes would save the government huge amounts in health care costs. Prevention is also essential to avoid our health systems being overwhelmed in the future.

What does the report recommend?

The report puts forward 23 recommendations for addressing diabetes and obesity. These include:

• restrictions on the marketing of unhealthy foods to children, including on TV and online
• improvements to food labelling that would make it easier for people to understand products’ added sugar content
• a levy on sugary drinks, where products with higher sugar content would be taxed at a higher rate (commonly called a sugar tax).

These key recommendations echo those prioritised in a range of reports on obesity prevention over the past decade. There’s compelling evidence they’re likely to work.

Restrictions on unhealthy food marketing

There was universal support from the committee for the government to consider regulating marketing of unhealthy food to children.

Public health groups have consistently called for comprehensive mandatory legislation to protect children from exposure to marketing of unhealthy foods and related brands.

An increasing number of countries, including Chile and the United Kingdom, have legislated unhealthy food marketing restrictions across a range of settings including on TV, online and in supermarkets. There’s evidence comprehensive policies like these are having positive results.

In Australia, the food industry has made voluntary commitments to reduce some unhealthy food ads directly targeting children. But these promises are widely viewed as ineffective.

The government is currently conducting a feasibility study on additional options to limit unhealthy food marketing to children.

But the effectiveness of any new policies will depend on how comprehensive they are. Food companies are likely to rapidly shift their marketing techniques to maximise their impact. If any new government restrictions do not include all marketing channels (such as TV, online and on packaging) and techniques (including both product and brand marketing), they’re likely to fail to adequately protect children.

Food labelling

Food regulatory authorities are currently considering a range of improvements to food labelling in Australia.

For example, food ministers in Australia and New Zealand are soon set to consider mandating the health star rating front-of-pack labelling scheme.

Public health groups have consistently recommended mandatory implementation of health star ratings as a priority for improving Australian diets. Such changes are likely to result in meaningful improvements to the healthiness of what we eat.

Regulators are also reviewing potential changes to how added sugar is labelled on product packages. The recommendation from the committee to include added sugar labelling on the front of product packaging is likely to support this ongoing work.

But changes to food labelling laws are notoriously slow in Australia. And food companies are known to oppose and delay any policy changes that might hurt their profits.

A sugary drinks tax

Of the report’s 23 recommendations, the sugary drinks levy was the only one that wasn’t universally supported by the committee. The four Liberal and National party members of the committee opposed implementation of this policy.

As part of their rationale, the dissenting members cited submissions from food industry groups that argued against the measure. This follows a long history of the Liberal party siding with the sugary drinks industry to oppose a levy on their products.

The dissenting members didn’t acknowledge the strong evidence that a sugary drinks levy has worked as intended in a wide range of countries.

In the UK, for example, a levy on sugary drinks implemented in 2018 has successfully lowered the sugar content in UK soft drinks and reduced sugar consumption.

The dissenting committee members argued a sugary drinks levy would hurt families on lower incomes. But previous Australian modelling has shown the two most disadvantaged quintiles would reap the greatest health benefits from such a levy, and accrue the highest savings in health-care costs.

What happens now?

Improvements to population diets and prevention of obesity will require a comprehensive and coordinated package of policy reforms.

Globally, a range of countries facing rising epidemics of obesity and diabetes are starting to take such strong preventive action.

In Australia, after years of inaction, this week’s report is the latest sign that long-awaited policy change may be near.

But meaningful and effective policy change will require politicians to listen to the public health evidence rather than the protestations of food companies concerned about their bottom line.

Gary Sacks, Professor of Public Health Policy, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.