Diagnosing the type of dementia

Different studies report different degrees of accuracy in diagnosing the type of dementia. Reporting accuracy of diagnosis is complicated by the presence of pathology of more than one type or cause of dementia in many people; however, accuracy of differentiation is increasing and should approach 90-95 per cent in specialist centres.

5. Is there proof that Alzheimer’s disease is hereditary? My mother suffers from it.

By far the most important risk factor for Alzheimer’s disease is simply old age. While Alzheimer’s disease will certainly not occur in everyone - it is not an inevitable part of ageing - the incidence does increase sharply with age. Probably the next most important risk factor is a family history of Alzheimer’s disease. The risk is greater for children and siblings of a person with Alzheimer’s disease. There is evidence that the risk to other relatives varies depending on the age at which the person developed Alzheimer’s disease. There is a greater risk for other relatives where the person developed Alzheimer’s disease at a younger age, say in their 40s and 50s, compared to those who developed it in their 80s.

In very rare families, probably only a few in Australia at present, genes have been identified which are responsible for the inheritance of Alzheimer’s disease. These families usually have a large number of relatives with early onset Alzheimer’s disease - that is, where Alzheimer’s disease develops in relatives aged in their 40s or 50s. Anyone concerned about their family history of Alzheimer’s disease should discuss this with a specialist experienced in working with people with Alzheimer’s disease.

Remember that the vast majority of people do not inherit Alzheimer’s disease. Where Alzheimer’s disease does occur, it is probably due to a complex range of factors including genetic and environmental influences. Research is progressing into the identification of causes of dementia and, over the next few years, we can expect to find out a lot more than we currently know.

6. Can younger adults in their mid 30s to 40s be afflicted by this disease? Can it strike very young adults in the late teens or 20s and, if so, are the first and ongoing symptoms the same as for older people? Is the treatment the same irrespective of age and how far away do you believe a cure is?

Although dementia usually affects elderly people, younger people aged in their 50s, 40s and even 30s are diagnosed with dementia. Dementia is very rare in people within these younger age groups. The youngest person with dementia who the Alzheimer’s Association has worked with was 36 years of age. Dementia in people under 60 is referred to as ‘early onset dementia’.

There are rare progressive brain diseases that can affect children, teenagers or young adults. It is unusual for this to be referred to as ‘dementia’, even though some of the symptoms are similar to those experienced by older people with dementia. Anyone, including younger people, concerned about dementia-like symptoms should note the symptoms and have them investigated. There are other conditions that can be mistaken for dementia.

Treatment for people at different ages

Medical treatments depend on the type of dementia and the symptoms, rather than the age of the person. Management may vary for younger people in their 40s, 50s and 60s, because they may have a range of different issues to deal with compared to older people. For example, they may be employed at the time of diagnosis, have children still at home or have financial responsibilities. The same range of services (information, counselling, support services and respite for carers) will help people of all ages. However, there are some specific programs for people with early onset dementia and their families, such as day programs for people with early onset dementia and the ‘Young Ones’ Carer Support Groups.

The availability of a cure

No one can estimate how far away a cure is. Recently there have been advances in slowing the progression of Alzheimer’s disease, and further research is looking into delaying or preventing the onset of dementia. There is also a great deal of research interest in reducing the risk of vascular dementia, the second most common cause of dementia in Australia.

7. I am in my 50s and seem to have trouble concentrating and remembering details. There have been a lot of stressful things happening in my life at work and at home. Is this normal? Or could I be getting dementia?

It is certainly normal for stress to cause loss of ability to concentrate and remember details. But so can dementia. Even being very concerned and fearful that your symptoms might be dementia may add to your concentration and memory problems. Remember that, for people in their 50s, stress is a lot more common than dementia. But it is very important to act to get to the bottom of the problem. If you can, try to reduce your stress levels - try stress reduction techniques, take a holiday or seek psychological assistance. If your concentration and memory problems persist, you should talk to your doctor.

Discuss your concerns with your doctor

It would be wise to talk to your doctor in any event, both about your stress and your concerns about dementia. If your doctor’s assessment indicates there may be dementia, further tests will be conducted to identify other conditions that can cause dementia-like symptoms or to confirm a diagnosis of dementia. There are also specialised diagnostic clinics in Victoria called Cognitive Dementia and Memory Services (CDAMS), which conduct full assessments to identify if a person has dementia or some other problem.