“What is normal aging? One common scenario is that I’m in the kitchen, cooking a meal, and I need to go get something in another room, all the sudden I find myself standing in a room wondering why I’m here,” he said. “It’s not really a sign of dementia -- it’s a sign of trying to do too many different things at once.”
Clients shouldn’t be concerned if they drive to a store, shop, and emerge unable to figure out where they parked their car in a large parking lot. On the other hand, if they panic and call the police to report a lost or stolen car while standing right next to it, they might have a problem.
As people age, some level of cognitive decline is almost assured, said Simmons. Approximately 80 percent of people over age 70 will report significant problems with memory or finding words -- but most of these people do not have dementia.
An associated condition, delirium, is also at times mistaken for dementia. The difference, said Simmons, is that delirium is reversible, while dementia and its associated disorders are not.
“You don’t want to create a plan around something that can be fixed, like delirium,” said Simmons, who added that medical settings can often manifest delirium in patients: Hospitals are difficult to sleep in and can be disorienting, and many of the drugs commonly used to treat illness and injury can cause a temporary decline in cognitive function.
To execute a plan for dealing with dementia, it’s helpful to know a diagnosis, an expected length of time to plan for, how long the disease is going to take to progress, and the likely age of onset for dementia; the difficulty is that the answers to these questions can vary widely from person to person. Some forms of dementia strike in extreme old age -- others display onset during a client’s prime earning years. Some dementias progress quickly over just a couple of years, while others may leave clients struggling with cognitive decline over the course of decades.
For Alzheimer’s, the most common age of onset is between 75 and 80, but genetic factors can cause onset of symptoms in clients in their 50s and 60s.
“If you develop it early, it’s a very rapid and horrible disease,” said Simmons. “Whatever makes a 50-year-old get Alzheimer’s is what frightened me the most. Dr. Alzheimer’s first case only lived five years. I have a few patients now who are young and they’re going to be lasting a long time in communities where they’re paying $11,000 or $12,000 a month.”
Today, a person with early-onset Alzheimer’s disease who receives quality medical care can live for 10 years or more, said Simmons.
Vascular cognitive dementia is caused by a multitude of mini-strokes over time, essentially giving the client a different brain over time. Clients with chronically high blood pressure or cholesterol problems may gradually develop vascular dementia as parts of their brain die from small strokes. With treatment, patients with vascular dementias can live for decades.