What’s the difference between Alzheimer’s and dementia?

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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?

Lightspring/Shutterstock

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.

Elderly woman looking at calendar
People with dementia may have trouble keeping track of dates. Daisy Daisy/Shutterstock

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.

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    • What happens to your vagina as you age?

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      The vagina is an internal organ with a complex ecosystem, influenced by circulating hormone levels which change during the menstrual cycle, pregnancy, breastfeeding and menopause.

      Around and after menopause, there are normal changes in the growth and function of vaginal cells, as well as the vagina’s microbiome (groups of bacteria living in the vagina). Many women won’t notice these changes. They don’t usually cause symptoms or concern, but if they do, symptoms can usually be managed.

      Here’s what happens to your vagina as you age, whether you notice or not.

      Let’s clear up the terminology

      We’re focusing on the vagina, the muscular tube that goes from the external genitalia (the vulva), past the cervix, to the womb (uterus). Sometimes the word “vagina” is used to include the external genitalia. However, these are different organs and play different roles in women’s health.

      What happens to the vagina as you age?

      Like many other organs in the body, the vagina is sensitive to female sex steroid hormones (hormones) that change around puberty, pregnancy and menopause.

      Menopause is associated with a drop in circulating oestrogen concentrations and the hormone progesterone is no longer produced. The changes in hormones affect the vagina and its ecosystem. Effects may include:

      • less vaginal secretions, potentially leading to dryness
      • less growth of vagina surface cells resulting in a thinned lining
      • alteration to the support structure (connective tissue) around the vagina leading to less elasticity and more narrowing
      • fewer blood vessels around the vagina, which may explain less blood flow after menopause
      • a shift in the type and balance of bacteria, which can change vaginal acidity, from more acidic to more alkaline.

      What symptoms can I expect?

      Many women do not notice any bothersome vaginal changes as they age. There’s also little evidence many of these changes cause vaginal symptoms. For example, there is no direct evidence these changes cause vaginal infection or bleeding in menopausal women.

      Some women notice vaginal dryness after menopause, which may be linked to less vaginal secretions. This may lead to pain and discomfort during sex. But it’s not clear how much of this dryness is due to menopause, as younger women also commonly report it. In one study, 47% of sexually active postmenopausal women reported vaginal dryness, as did around 20% of premenopausal women.

      Other organs close to the vagina, such as the bladder and urethra, are also affected by the change in hormone levels after menopause. Some women experience recurrent urinary tract infections, which may cause pain (including pain to the side of the body) and irritation. So their symptoms are in fact not coming from the vagina itself but relate to changes in the urinary tract.

      Not everyone has the same experience

      Women vary in whether they notice vaginal changes and whether they are bothered by these to the same extent. For example, women with vaginal dryness who are not sexually active may not notice the change in vaginal secretions after menopause. However, some women notice severe dryness that affects their daily function and activities.

      In fact, researchers globally are taking more notice of women’s experiences of menopause to inform future research. This includes prioritising symptoms that matter to women the most, such as vaginal dryness, discomfort, irritation and pain during sex.

      If symptoms bother you

      Symptoms such as dryness, irritation, or pain during sex can usually be effectively managed. Lubricants may reduce pain during sex. Vaginal moisturisers may reduce dryness. Both are available over-the-counter at your local pharmacy.

      While there are many small clinical trials of individual products, these studies lack the power to demonstrate if they are really effective in improving vaginal symptoms.

      In contrast, there is robust evidence that vaginal oestrogen is effective in treating vaginal dryness and reducing pain during sex. It also reduces your chance of recurrent urinary tract infections. You can talk to your doctor about a prescription.

      Vaginal oestrogen is usually inserted using an applicator, two to three times a week. Very little is absorbed into the blood stream, it is generally safe but longer-term trials are required to confirm safety in long-term use beyond a year.

      Women with a history of breast cancer should see their oncologist to discuss using oestrogen as it may not be suitable for them.

      Are there other treatments?

      New treatments for vaginal dryness are under investigation. One avenue relates to our growing understanding of how the vaginal microbiome adapts and modifies around changes in circulating and local concentrations of hormones.

      For example, a small number of reports show that combining vaginal probiotics with low-dose vaginal oestrogen can improve vaginal symptoms. But more evidence is needed before this is recommended.

      Where to from here?

      The normal ageing process, as well as menopause, both affect the vagina as we age.

      Most women do not have troublesome vaginal symptoms during and after menopause, but for some, these may cause discomfort or distress.

      While hormonal treatments such as vaginal oestrogen are available, there is a pressing need for more non-hormonal treatments.

      Dr Sianan Healy, from Women’s Health Victoria, contributed to this article.

      Louie Ye, Clinical Fellow, Department of Obstetrics and Gynecology, The University of Melbourne and Martha Hickey, Professor of Obstetrics and Gynaecology, The University of Melbourne

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

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      Levelling up the 5 love languages

      The saying “happy wife; happy life” certainly goes regardless of gender, and if we’re partnered, it’s difficult to thrive in our individual lives if we’re not thriving as a couple. So, with the usual note that mental health is also just health, let’s take a look at getting beyond the basics of a well-known, often clumsily-applied model:

      The 5 love languages

      You’re probably familiar with “the 5 love languages”, as developed by Dr. Gary Chapman. If not, they are:

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      4. Quality Time
      5. Words of Affirmation

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      So, is this a basic compatibility test?

      It doesn’t have to be!

      We can, if we’re aware of each other’s primary love languages, make an effort to do a thing we wouldn’t necessarily do automatically, to ensure they’re loved the way they need to be.

      But…

      What a lot of people overlook is that we can also have different primary love languages for giving and for receiving. And, missing that can mean that even taking each other’s primarily love languages into account, efforts to make a partner feel loved, or to feel loved oneself, can miss 50% of the time.

      For example, I (your writer here today, hi) could be asked my primary love language and respond without hesitation “Acts of Service!” because that’s my go-to for expressing love.

      I’m the person who’ll run around bringing drinks, do all the housework, and without being indelicate, will tend towards giving in the bedroom. But…

      A partner trying to act on that information to make me feel loved by giving Acts of Service would be doomed to catastrophic failure, because my knee-jerk reaction would be “No, here, let me do that for you!”

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      • Not: “what’s your primary love language?” ❌
      • But: “what’s your primary way of expressing love?” ✅
      • And: “which love language makes you feel most loved?” ✅

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      So far, so simple, right? You and your partner (or: other person! Because as we’ve just seen, these go for all kinds of dynamics, not just romantic partnerships) need to be aware of each other’s preferred love languages for giving and receiving.

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      There’s another pitfall that many fall into, and that’s assuming that the other person has the same idea about what a given love language means, when there’s more to clarify.

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      • What does it mean to be transgender?

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        What does it mean to be transgender?

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        This article first appeared on Public Good News and is republished here under a Creative Commons license.

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      • We looked at over 166,000 psychiatric records. Over half showed people were admitted against their will

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        Picture two people, both suffering from a serious mental illness requiring hospital admission. One was born in Australia, the other in Asia.

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        We examined more than 166,000 episodes of voluntary and involuntary psychiatric care in New South Wales public hospitals between 2016 and 2021. Most admissions (54%) included at least one day of involuntary care.

        Being brought to hospital via legal means, such as by police or via a court order, was strongly linked to involuntary treatment.

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        People born in Africa or the Middle East were 32% more likely to be treated this way.

        Overall, people who spoke a language other than English were 11% more likely to receive involuntary treatment compared to those who spoke English as their first language.

        Some international researchers have suggested higher rates of involuntary treatment seen in people born overseas might be due to higher rates of psychotic illness. But our research found a link between higher rates of involuntary care in people born overseas or who don’t speak English regardless of their diagnosis.

        We don’t know why this is happening. It is likely to reflect a complex interplay of factors about both the people receiving treatment and the way services are provided to them.

        People less likely to be treated involuntarily included those who hold private health insurance, and those referred through a community health centre or outpatients unit.

        Our findings are in line with international studies. These show higher rates of involuntary treatment among people from Black and ethnic minority groups, and people living in areas of higher socioeconomic disadvantage.

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        Both the NSW and Australian mental health commissions have called involuntary psychiatric care an avoidable harm that should only be used as a last resort.

        Despite this, one study found Australia’s rate of involuntary admissions has increased by 3.4% per year and it has one of the highest rates of involuntary admissions in the world.

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        When Australia signed up to the UN Convention on the Rights of Persons with Disabilities, it added a declaration noting it would allow for involuntary treatment of people with mental illness where such treatments are “necessary, as a last resort and subject to safeguards”.

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        Others question if involuntary treatment could ever be removed entirely.

        Where to from here?

        Our research not only highlights concerns regarding how involuntary psychiatric treatment is implemented, it’s a first step towards decreasing its use. Without understanding how and when it is used it will be difficult to create effective interventions to reduce it.

        But Australia is still a long way from significantly reducing involuntary treatment.

        We need to provide more care options outside hospital, ones accessible to all Australians, including those born overseas, who don’t speak English, or who come from disadvantaged communities. This includes intervening early enough that people are supported to not become so unwell they end up being referred for treatment via police or the criminal justice system.

        More broadly, we need to do more to reduce stigma surrounding mental illness and to ensure poverty and discrimination are tackled to help prevent more people becoming unwell in the first place.

        Our study also shows we need to do more to respect the autonomy of someone with serious mental illness to choose if they are treated. That’s whether they are in NSW or other jurisdictions.

        And legal reform is required to ensure more states and territories more fully reflect the principal that people who have the capacity to make such decisions should have the right to decline mental health treatment in the same way they would any other health care.

        If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.

        Amy Corderoy, Medical doctor and PhD candidate studying involuntary psychiatric treatment, School of Psychiatry, UNSW Sydney

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

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