Who can determine the diagnosis on the type of Alzheimer's/dementia?

I can understand and relate to your frustration. I had such a terrible time getting my mother seen for a diagnosis, since everyone denied she had it. After diagnosis, there still is no clear explanation of her condition, I think it is because the doctors really don't know enough, I thought a doctor would sit down and explain things to me clearly, it seems any information that I have acquired I had to sit and do the research myself and come to my own conclusions, very irritating.

I know how you feel. Two psychiatrists later, and I still am not sure except they just say Alzheimer's. Maybe neurologist would be a better bet. That will be my next step if I really think it is necessary. She's 91, and I've maybe put her through enough. I don't know. Good luck. I would try it, the psychiatrists haven't really given specifics.

When my mother was diagnosed, I read every book in the library related to dementia. Mom was put under the umbrella of dementia with the title of "Alzheimer Type Dementia". For now, that umbrella may be the best diagnosis you will have. The Alz type meds have helped considerably. Her fogginess is better, but there's no denying her diagnosis.

The first time we got a diagnosis for my mom we were told it was "99 percent" certainty was Alzheimer's. Then after brain scan tests were done, we were told she had had many tiny little strokes in the base of the brain (where Parkinson's originates, I believe), which made it "vascular dementia." (Those first two diagnoses were given during a 2-week hospital stay a few years ago.) Then, after about 6 months, upon followups with a neurologist who had seen her over the years, he gave us the diagnosis of "mixed dementia," explaining that she definitely had "vascular" dementia and that she also very likely had an overlap of Alzheimer's as well. She definitely presents more as vascular dementia then Alzheimer's, though who knows how it will look 6 months, 1 year or farther down the line. None of them seem any better than the other and every person who has a form of dementia needs to be handled in an individual manner. That's what it seems like to me, at any rate. Do all the research on dementia that you can; read all the books and literature you can; and then try to meet your loved one where they are. You will never make them well; you can only try to make them and yourself as comfortable as you can. Good luck.

Fifty percent of people over the age of 80 have memory difficulties, ninety percent of those are Alzheimer's. The Alzheimer's type cannot be confirmed until after death with an autopsy of the brain. Alzheimer's does not show on MRI or CT scans. In my mother's case the doctor said it was either a series of mini strokes or Alzheimer's. I'm not sure how he was able to reach that conclusion.

Hopefully, with all the research that is being done and proposed they will find the cause (I personally believe that there isn't a single cause, rather a combination of many different contributors), develop a process for diagnosing one dementia from another and maybe, hopefully find a cure and recommendations so one does not develop it.

Contact the Alzheimer's Foundation. They can help you with any Geriatric Physicians in your area and do give Alzheimer's seminars. What we have learned is what you already know - it is confusing and alot of information. Also, Alz foundation gave us this tidbit - no two alz/d cases are alike - they are like your fingerprints! Each brain is in effect, like a fingerprint and giving a "perfect" diagnosis is impossible. Good luck! We are all there with you!

Read: "The 36 Hour Day". It will give you a few "aha" moments!

Somewhere in my research I read an into that stated: "If you know someone with Alzheimer's, you know someone with Alzheimer's." This refers to the individuality and complexities of this disease. After 8 years of grasping for insight by observing and reseaching Mom's tests, behaviors, diagnoses, etc., and trying to figure out what's next, I understand that it is a "focus and act on the specific need of now and today" and "proceed with a non-specific, very generalized, flexible plan for the undeterminable expectIons of the future." This is not to be taken as a defeated attitude but rather to reassure you. Your patience and acceptance and companianship will enable you to see what is needed at each curve and you will be able to make necessary decisions (some not so easy) to accommodate each stage as it develops. Don't worry so much about the future or you may sabotage the time you have now to get to know and understand the immediate needs of your loved one. (If you are a bible person, read Matt.6:34)

Hi all,
I have had a professional career with hospice, and in senior long term care. Needless to say I've seen ALZ patients at various stages and with different "names" attached to their condition or behavior.
My mom was diagnosed with vascular dementia as well as having a brain MRI that showed shrinkage in the frontal and parital( top) part of the brain. Brain shrinkage in the elderly is a natural part of aging, but the speed and degree to which the brain shows that shrinkage can lead a doctor to assume that the dementia is definately ALZ related. Most forms of progressive dementia lead to ALZ. A good neurologist trained in ALZ can become very accurate at determining if the dementia is likely to be true ALZ. The only way it can absolutely be diagnosed is if an autopsy is done after death, and there is evidence of what is called ameloyed plaque deposits in the brain tissue. I know first hand how difficult it is to deal with the progression of the disease from a personal standpoint. I used to speak with many families about the stages of the disease, and what types of care approach would be best and when, but when it comes to my own mother I struggle with the idea of what needs to come next. Right now she is still at home with a caregiver during the day until about 7pm. She is a gem, and loves mom to no end. She also knows that mom is now to the point where she is noncompliant with taking her meds if they're not handed to her, and refuses to follow other doctor orders that are important for her other health issues as well as her safety. The cost of bringing in more help will be more than moving her to a very nice assisted living. She would have 24/7 supervision and peers to interact with instead of being alone most of the time with the CG. It's not possible for me to care for her in my home, as she'd be alone a lot here with us as well, and I'd have to have someone stay here with her when we were gone. Besides, she doesn't want to leave her own home, which will make moving her to AL difficult.
As others have said, learn as much as you can, stay connected with others that are going through the same thing, and by all means spend as much time as you can with your parent, because things can change literally over night. Cherish the little moments even if they seem childlike. Try to move through the times when they get nasty, mean and say awful things, because that truly isn't your parent, it's a deep seeded change in personality that can be part of the disease process.
Hang in there. and keep in touch.

Your husband sounds exactly like mine! He has trouble with sentences, often uses the wrong word, and knows who people are. Mine also has trouble following instructions or learning new things or dealing with changes, which were actually his first symptoms. He usually understand what is going on, if it's not complicated, but has trouble saying that he understands. Guessing what he is trying to say is incredibly frustrating for him and me!!

Mine was diagnosed with Lewy Body Dementia, the second most common dementia, which has some Parkinson's like symptoms. It took me 7 years to get him diagnosed, but when I got him to the right doctor it was immediate.

His dementia came first, but when he started having a tremor (a Parkinson's symptom) a chiropractor told us to consider Parkinson's and told me to ask the local Parkinson's support group. They pointed me in the direction of the right doctors. The first one was at a movement disorder center that was afiliated with Parkinson's, but also addressed other movement disorders. It wasn't exactly Parkinsons, but they knew the difference and were able to treat it. The first neurologist (an MD) he saw there refered him to a neuropsychologist, a PhD, who did an all day cognitive test to confirm that it was Lewy Body Dementia..

People with Parkinson's usually develop dementia later in their disease progression. With Lewy Body, the dementia comes first and then the Parkinson's like sysmptoms. Which comes first, makes a huge difference with the diagnois.

We recently switched to the Veteran's Administration hospital, and the diagnois was confirmed by another neurologist and another neuropsycologist.

It is very important to get the correct diagnois, because Lewy Body Dementia (LBD) responses well to some medications and Alzheimers doesn't. There are also some meds that you should NEVER give LBD, because they cause irreversible damage. They are meds that are often given to people with dementia, who are behaving badly.

There my be other doctors, who can diagnose this, but my advice is get thee to a neurologist!!

A neurologist where we used to live diagnosed my husband with Parkinson's about 18 months ago. He also started showing signs of dementia within a few months. Last December, he really started having major problems with dementia/psychosis/hallucinations, etc. When I took him to the ER (which then-neurologist said to do because of the hallucinations), they mentioned Dementia with Lewy Bodies. I started researching online. After another visit with the neurologist we were using, I felt that nothing was being done. We also had an appt with our regular family dr, an internist, as a result of the ER visit. She suggested a 2nd opinion with a different neurologist. This guy sent my husband for all kinds of tests: MRI of the brain, EEG, carotid artery ultrasound, neuro-psych exam (which required 3 visits including a 3-hr test), blood work, PT, OT and a meeting with a speech pathologist. After meeting with the neurologist again, he confirmed Parkinson's and Alzheimer's which is also what the the neuro-psychologist said. As tooyoung said above, a lot of what is diagnosed is determined on the "chicken or the egg" concept: which came first...the tremor or the dementia; are there hallucinations with it? when did they start...before or after the start-up of carbadopa/levadopa, a common Parkinson's med. Since my husband is on the Exelon Patch, carbadopa/levadopa and Lexapro, he is better...not cured, not "normal", but better than he was 2 months ago when I though I'd have to put him in a facility even though he can still shower, shave, feed himself, dress himself, etc. I was frantic! It's better, but there are still changes in his behavior and personality that are frightening. I feel like I'm walking on eggshells all the time because I can't figure out what triggers his very negative reactions. This is a very frustrating, time-consuming and costly journey. Hang in there! We're here to listen and tell you what we have learned from our experiences. Call the Alzheimer's Assoc, call the Dementia with Lewy Bodies Association, call your local mental health group....don't give up! There is help out there and there is no way to be absolutely sure what is going on because so many times the patient does have a combination of several different types of dementia....it is only by trial and error in medication can the right combination be established....you will learn more patience that you ever thought you were capable of....and all of these places will offer you help, support and information. Good luck and God bless!

I had my husband to a neurologist who diagnoised his A/D. He never said what type of A/D he has. He did an MRI and the oral test. I guess at his next appointment to the neurologist I will ask him. Thanks to all of you for your help

Who can determine the exact type of dementia your husband has? An expert examining brain tissue. Unfortunately, as other posters have said, that brain tissue can only be obtained after death. There are many research projects underway world-wide to try to come up with bio-markers of the various kinds of dementia so accurate diagnosis could be made without waiting for an autopsy. Wouldn't it be helpful to have a blood test that could reveal that this patient has both Alzheimer's and Vascular Dementia? But we are not there yet. :(

When autopsies are done and compared with the doctors' diagnosis before death, it is clear that the diagnosis accuracy rate is terribly low. This is less surprising when the doctor was a GP not particularly experienced in dementia, but it is also true of reputable centers specializing in dementia.

Of course there is not an autopsy done on all persons who die with dementia, and our confirmed knowledge of things like the percentage of cases with mixed dementia and what the most common combinations are and what percent of dementia patients have Alzheimers and what percent have Dementia with Lewy Bodies etc is all based on the small percentage who have autopsies. And when you read statistics that are based on pre-death diagnosis, remember that a large percent of those are found to be inaccurate. So our knowledge of how to diagnose dementia is not where researchers (and all of us!) want it to be.

Which isn't the answer you want to hear, lexi2011, but the fact is it can be very difficult to come up with an exact dementia diagnosis.

Because your husband has Parkinson's, it is logical to look into Lewy Body Dementia. Persons with Parkinson's have protein deposits (called Lewy bodies) in their brains. These deposits can cause the symptoms of Parkinson's and/or the symptoms of LBD. There is a pretty straight-forward list of diagnostic features for LBD. If the patient exhibits a certain number and certain combination of them, he would be considered to have either "possible" or "probable" LBD (depending on the number.) You can find this list on the website of the Lewy Body Dementia Association. http://www.lbda.org

While I think it is logical to consider LBD when someone with Parkinson's also has dementia, I don't mean to imply that is the only type of dementia that can occur with Parkinson's. Just that it is worth looking into.

thanks jeannegibbs fyi, what I failed to say is that my husband was diagnoised with Alzheimers three 1/2 yrs ago. Just recently we were told he started parkinsons. He is on aricept and namenda, nothing for parkinsons at this time.

lexi2011, your husband may have had AD 3.5 years ago, and have also developed LBD since. His diagnosis 3.5 years ago could have been wrong (very common) and he might have had LBD all along. That the Parkinson symptoms didn't develop until much later is not unusual.

I hope I don't sound like I'm trying to diagnose your husband or that I want to push the LBD diagnosis. It is just that since it is now clear there are protein deposits in your husband's brain, I'd sure ask the neurologist is LBD is a possibility.

And by the way, just for clarity of terms, AD is a type of dementia. If the neurologist has said specifically "Alzheimer's" (instead of the more generic "dementia") then you do have a diagnosis for the specific type of dementia. But given new evidence, such as the Parkinson's symptoms, it is appropriate to revisit the diagnosis.

Good luck!

Jeanne, I just went to the site you posted and read the symptoms section. I'm still confused as to whether Mom has LBD. I have posted on your other discussion, but have not heard back from you on thoughts of some of my mom's behaviors. She was diagnosed with PD over 12 years ago and started showing signs of dementia about 7 years ago. She has tremors when she is agitated or it is time for her sinamet and her cognition level is not very good. She is very OCD and is always doing something with her hands. Picking, pulling, pinching, grabbing, biting her fingers, sucking on them, etc. She tries to take apart anything she gets her hands on and has what we call spells, when she is in need of a BM. She literally goes bonkers until she has a BM! She is distracted form one second to the next and trying to get her to eat or take meds is sometimes near impossible. She sees a neurologist regularly and LBD was never mentioned. She does not have lucid moments anymore. Occasionally, or should I say very rarely, she will say something that makes sense. She has not been able to wash, dress, or feed herself for the last year. At this point, I jusy try to keep her clean, fed, dry and as comfortable as she can be.
I would appreciate any input from you Jeanne!

deefer12, in the later stages all types of dementia tend to be similar. It may not really be important any more what kind of dementia she has.

In the early stages of dementia, seven years ago or so, did her level of cognitive skills vary greatly? Sometimes nearly normal and sometimes very confused and irrational? Did she have trouble with depth perception -- hard time judging how to step over a threshold, etc.? Did she ever act out her dreams? Did she have visual hallucinations early on?

When there is Parkingson's there are Lewy Bodies in the brain, so it is reasonable to ask if the dementia symptoms might be from that. Since she sees a neurologist regularly I think I'd bring it up with the doctor. As I said, though, at this point it may just be academic. Managing her symptoms may be pretty much the same regardless of the type of dementia.

If you do talk to her neurologist about the possibility of LBD, let us know what you find out. We learn from each other!

her depth perception is almost gone now.She reaches for things that are too far away for her to get and just sits there with her hand out trying for sometimes an hour or more to reach for something she can't. She had many falls at the beginning due to crossing her legs at the ankles when she would stand up and turn. The hallucinations started after being treated with sinamet. I don't remember her having confusion and then being okay. She had major depression and lots of anxiety attacks which would incapacitate her something awful. She could no longer go to the grocery store with me as she would have an attack and hyperventilate and drool, and her nose would run and she would just get that "mask" look that I just read about on that site. She would get up not long after going to bed and be so quiet, I wouldn't hear her, When i would check on her, I would often find her on the floor where she had fallen and couldn't get back up.
she had 2 bad falls that sent her to rehab and after the second time, I quit my job to stay at home with her. that was 5 years ago this May.
So with a quick scan on that site, I am more confused than ever! I know she is at the point where nothing will help her now, although she does very well on Aricept and Namenda. We tried to take her off them due to her advanced state, but she was totally gone without them. Once she was back on, there was noticeable improvement. I tell people all the time that if a doctor tells them these meds won't help, try them anyway. Most people I know that are taking them do much better.
I have to say the worst for me is the OCD traits, as they are constant and never ending and enough to drive a person insane!!!
Thank you so much for your input and I will talk to her doctor when we see her in May.

Some Alzheimer's drugs work much better for LBD than they do for AD (less brain cell death) so it is interesting that your mom still does better on them.

It has been over a year since we tried her without, so that may have changed some, but I'm not willing to take her off to see what will happen! She has had trouble with cognition for the last 2 years and I think a big part of that is how easily she is distracted. When we toilet her, she constantly tries to stand up. She pushes herself up with her hands every other second, and I'm not kidding on the timing. I by underestimating if I said she did it less than 20-30 times a minute! And the entire time I am washing her, she is grabbing anything and everything in sight! Sometimes I just have to remove anything in her line of sight so I can get her ready for bed. In the morning she is more cooperative, but by the time I get her into her wheelchair to feed her breakfast, she is cranked up and ready to run! It's like she is trying to do 20 things at once and I have to calm her down to get her to focus on eating her breakfast. It's a wild and crazy ride and by the time I get her to daycare, I am fried!
Mom only weighs around 102, but is 4 " taller than me. So it takes all my strength to haul her out of the wheelchair and into the car 4 days a week. It's especially difficult when she stiffens up her entire body and won't bend to sit down.
I have been suffering from RLS for over 20 years and have been on Requip for the last 7 years. It's dopamine, the same thing used for PD and I'm really afraid that I will be my Mom in 15 years. It's not a happy thought to live with.

Wow! This group has so many well informed members. Good stuff! I totally agree with everyone about the difficulties getting a correct diagnosis. I find it all too amazing how PD, LBD, and AD can be so intertwined. For sure there is strong evidence that LBD and PD can present as either at the same time, or one before the other. Either way the right diagnosis is tricky to get. Sometimes a PET scan can show evidence of Lewy Bodies in the brain, but not always. An MRI can't.
Living through this with my mom, like so many of you, we see symptoms come and go, change and evolve, respond to treatment or not, and behavior that sometimes leaves us feeling defenseless and overwhelmed. One thing for sure...it is apparent that no matter if a true AD or VD or Mixed Dementia, all we really have available to us right now is the ability to treat the symptoms with the approved drugs for VD and AD, and support those with meds for the depression, anxiety, paranoia, mood swings, sundowning, etc. and hang on tight, and to each other. A good neurologist should be able to choose the right combination, and find a good balance in the meds so that our loved ones are safe, comfortable, and most certainly NOT OVER MEDICATED. Mom's doctor is great, and has tried different combos in small doses until found the right mix. We both know that in time that mix will have reached is max ability to help, and then we change the plan. I think the most important thing is that no matter what the diagnosis with any of these diseases constant evaluation and change in a care plan is critical.
Thanks for all the great conversation.

Dabs, Mom has been on the same med combo for about 2 years now and it seems to continue to work as well as we can expect at this point. I recently changed her diet by eliminating most sugar. Got plain oatmeal instead of flavored, got rid of cookies and other desserts and sugary cranberry juices. She is remarkably more alert and her cognition is much better. I give meds to her with applesauce and now buy the unsweetened. I get "light" cranberry juice and cut it with water like I always did. I buy no sugar added canned fruit and fresh bananas and light yogurts for desserts and snacks.
The difference in sugars in these products amazed me! Applesauce is 20+ grams of sugar where unsweetened is 10 grams. Oatmeal is 0 grams and flavored is 12 grams. Cranberry juice is 36 and no sugar added is 39!!! Light juice is 12grams!
I now add applesauce, bananas and canned peaches to her oatmeal and when I make pancakes, I cover them with the cottage cheese and fruit combos. She is definitely better off without all the sugar! Less problems with UTI's also, as bacteria loves to feed on sugar.
The paid caregiver was feeding her all kinds of sweets and desserts to "fatten" her up, but I noticed Mom was getting worse than usual. I told her to stop bringing Mom glazed donuts and other junk like candy bars, but she would still sneak some in occasionally. Finally, after being fed way too much sugar in one day, Mom crashed and was acting really strange. So I put my foot down and got rid of all the junk in the house and checked labels on everything I buy for Mom. Within a week we all saw a drastic change in her personality and cognition. She is still in late stage dementia, but can now function so much better without the sugar. I have since read up on the subject of sugar and the affects on dementia patients and am glad i made the decision to cut most of it out of Mom's diet. Now I need to get it out of my diet!!!

deefer12, I think a lot of us look at those we are caring for a fear it will be us, and possibly sooner, because the caregiving wore us down before our time. I wish we had expirations dates and would just die peacefully in our sleep when it was our time.Sorry, that was depressing, but I that's the way I feel.

Deefer12, you only mention two meds. dabs4mom mentioned anxiety and depression, paranoia, etc. Your mom might be suffering from one of those, and in her dementia it shows up as OC. I know my husband, who has LBD, get a worried and asks questions over and over. He is better with an anti-anxiety med. As jeannegibbs said, the only option we have is to treat the symptoms.

I too, notice a significant difference in my mom's behavior and functioning when the sugar intake is lower. I stopped giving her added sugars about a year and a half ago and also cut way back on the sweet stuff. She gets sweets rarely now. I mentioned this to the staff at a day program I take her to, they have now also cut down on sweets during holiday parties for everyone.

One motivator to cut down yourself, google the relationship in developing dementias and sugar intake and other junk food. Here is a link for starters:
http://health.msn.co.nz/healthnews/8525112/eating-junk-food-could-cause-dementia

Tooyoung, Mom is taking meds for PD, anxiety, depression, memory, and Seroquel at night for sleep. She was OCD her entire life. It just got more noticeable and worse with the dementia. And I'm not talking about counting or touching something so many times, or even constant hand washing. It's constant motion, like touching, grabbing, banging on her food dish, trying to get off the toilet every other second, literally! She drives herself into a frenzy if she sees a spot on the floor and will try to reach it from her wheelchair sometimes for an hour or more if I don't get it out of her sight! All 7 of her children, including me, have a touch of it in some area, but I have 2 sisters that have actually been treated for it. They also have her depression and anxiety and have been treated for both for most of their adult lives. I did not get those genes, but rather my dad's. I have autoimmune disease and several of the "side affects" of it, but my mental state is usually pretty level and steady. I would not be caring for Mom if it wasn't!
Glad, Yes, I try to tell everyone dealing with dementia patients to cut out the sugar!!! If we can get "brain fog" can you imagine what it does to someone with dementia? I have seen what it does and can do and have since convinced the CNA that helps with Mom that it is true! She has 15 years experience working with Alzheimer and dementia patients and never heard of the correlation between to two! She knows now and has stopped bringing Mom sweets from home.
Sugar may fatten up a normal person, but with my Mom, it just made her crazier and it burned off all the good calories we were putting into her.

We just got the results of my mother's MRI done through a neurologist, it shows normal brain atrophy for her age but no dementia. I still say she has Alzheimer's and since an MRI is not going to show that, we wait for the neurologist to call to decide what to do next. Maybe a neuro-phys exam?? Come on, she can not function by herself anymore.

Sharyn, I just remembered something..the neurologist gave mom some questions and memory tests. She had problem remembering the list, nor the order he gave it, etc...I think before your next visit to the Neuro, best to read up as much as possible on the different tests to determine Alzh.

Sharyn, Given all you've shared about your mom, I can't believe that the doc is telling you it's normal brain shrinkage.... yes that does happen with age, and normal forgetting goes with it, but based on your mom's behavior and such, I don't know. There are tests that can be given to determine where the cognitive function is. Google Mini Mental Response Tests, and you'll hit on a bunch of things. My mom's doc gives her one every time he sees her. Sometime she does very poorly, and sometimes she does a little better. It depends on their mood, whether or not they're tired, when they took their meds, etc. They are good tools to get a general idea, but they are totally subjective. My mom can still rattle off her social sec. #, but she can't remember more than 1 or 2 of the words he gives her for the recall part. There's so many different kinds, and the questions can be changed however the doc wants to use them. What I don't like about those is that the doc prompts her with clues when she makes a mistake, and eventually she gets the answer. That counts as a point toward the score. Somehow it seems to me that him helping her until she gets it defeats the whole purpose. Like I said, she can remember her social, or where my father worked 50 yrs. ago, probably because it's stored in her long term memory. She could have had breakfast 30 min. ago and she asks when she's going to eat, because she hasn't eaten since at least yesterday.

Well... my brother should be arriving at mom's any time now. I have been dreading this visit soooo much. I told him that I wouldn't see him until I picked him and mom up on Friday to go to her doc. appt. Of course mom is already a basket case because she's sure that he's coming down so that we can put her away. I've been so stressed these last few days. I talked to my brother on Sunday and he starts telling me how the GC talked to him and when he asked how mom was doing she told him that he'd see a difference since his last visit, but that she's doing well. I adore the gal, and know she loves my mom so much, that it'll be very hard for her to see mom get upset and carry on when we do move her. She told me that she was so worried about her having a heart attack or stroke because she'll be so upset. Of course, if she told my brother this he'll again try to put off moving her. He all but called me a liar on Sunday when I told him about things that had gone on over the past couple weeks. Two of my mom's neighbors were over and I guess mom went into her melt down, telling them that I want to put her away, and that's why my brother is coming. They of course told her that they thought she was doing great, and that she had Maria(CG) and they think she should be able to stay in her own house. They told Maria that I'm too involved and that I worried too much. Really???? Mom can't remember to flush the toilet anymore, or take her meds unless someone hands them to her and watches her swallow them. She wants to wear the same clothes everyday, and refuses to use either her walker or can like her doctors have told her. She argues with the CG about everything because even the suggestion of doing something she doesn't want to do set her off. She doesn't use the walker even in front of me, and if I bring it up there's an argument. Don't you know that Maria told me that mom has been using the walker since Mon. Of course she is..... I'm beginning to think the she is feeding mom the line about us (ME) putting her away when I brother comes and that she better be good or else. I think I'm caught between a rock and a hard place.
I'll catch up with ya'll when this nightmare is over.... he's leaving on Monday.

I'm not surprised about sugar "causing" dementia. My grandmother had Alzheimers, a poor diet, and a major sweet tooth. My father also had some type of dementia (never diagnosed), a better diet, but also a major sweet tooth. My husband, who has Lewy Body Dementia, has the king of sweet teeth (not just tooth, plural teeth). He was a bachelor for many years, and his idea of lunch everyday all those years was a handful of candy bars. He is pre-diabetic, and the last thing I need to deal with is another medical issue on top of the LBD. So, I try to control the sweet teeth by hiding the sweets and alloting him one sweet per day.

As for the mini-mental exam someone mention, I read somewhere that by the time you test low on that you are pretty far into dementia. I found a website that has a self-administered test that is supposed to catch it earlier. I wonder why doctor's don't use it, unless they think it is better to not know sooner. There are four versions of the test. I take one every few months to make sure I'm not loosing my mind. Here is the website if anyone else is interested in checking it out: sagetest.

Other thing that has been connected to dementia is chemical exposure. The VA covers Agent Orange exposure, which they have linked to Parkinson's and it has a dementia component. The VA is also doing a study to see if there is a link to other chemicale xposure to other neurological disorders. I wouldn't be surprised by that either, since so many of us Baby Boomer grew up with the beginning of chemical use, when our houses and our food were fumigated, and they still are, but they tell they are currently using safe chemicals. Really???

They are also making some links between dementia and viral. Google Alzheimers and herpes simplex or go to HIV-associated dementia in NeurologyNow. It makes some sense, when you consider what a bacterial infection does to someone with dementia.

So many links yet so many dementias. Who knows, maybe its a combination of stuff. But too much of anything is not good for you and maybe sticking to organic foods is a good idea too.

Are the medications worth the side effects A/D?

annice, the goal is always to improve/maintain quality of life. If a medication has a side effect the question must be "is the quality of life better or worse with this drug and its side effect?" That has to be decided on a case-by-case basis.