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August 10, 2015
by Samantha Jeckewicz
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Skipping Breakfast a Bad Idea for People with Type 2 Diabetes

diabeticRunning out the door without eating breakfast isn’t a good idea for anyone, but new research suggests that for people with type 2 diabetes, skipping the morning meal may wreak havoc on blood sugar levels for the rest of the day.

In a small clinical trial, researchers found that when people with diabetes skipped breakfast, their lunchtime blood sugar levels were 37 percent higher than on a day they ate breakfast. And blood sugar levels were still higher at dinnertime on the day the study volunteers skipped breakfast — 27 percent higher, the study said.

“This is of high relevance since skipping breakfast has progressively increased over the past decades in Western society,” said the study’s lead author, Dr. Daniela Jakubowicz, a professor of medicine at Tel Aviv University in Israel.

What’s more, she said, high blood sugar levels after meals are strongly associated with a rapid decline in beta-cell function. Beta cells are the cells in the pancreas that produce insulin, a hormone that’s necessary for the body to use the carbohydrates in food as fuel.

High blood sugar peaks are also linked to earlier development of heart disease complications, Jakubowicz added.

Results of the study were published recently in Diabetes Care.

Jakubowicz and her team showed earlier that eating a big breakfast and a light dinner may be beneficial. In a study published in February in Diabetologia, the researchers found that people with type 2 diabetes who ate a big breakfast and a light dinner had blood sugar levels that were 20 percent lower than people who had a small breakfast and big dinner.

In the current study, the researchers recruited 22 people with type 2 diabetes. Their average age was 57 years old. Their body mass index (BMI) was just over 28. BMI is rough estimate of how much body fat a person has, and a BMI of 28 means a person is overweight, but not obese.

Over two days, all of the participants ate the same meal at every meal — milk, tuna, bread and a chocolate breakfast bar, Jakubowicz said. On one day, they ate three meals — breakfast, lunch and dinner. On the second day, they skipped breakfast, but had lunch and dinner.

On the day they ate three meals, the average glucose peak after lunch was 192 milligrams per deciliter (mg/dL). After dinner, it was 215 mg/dL, the study revealed. But on the day of no breakfast, the average glucose peak climbed to 268 mg/dL after lunch and to 298 mg/dL after dinner, the researchers said. (A normal blood sugar level is below 126 mg/dL.)

Jakubowicz said it seems that beta cells “lose their memory” due to the prolonged fast. “Therefore, it takes additional time after lunch for the beta cells to recover, causing small and delayed insulin responses, and resulting in exaggerate elevation of blood glucose levels throughout the day on the no-breakfast day,” she said.diabetes-blood-sugar

Maudene Nelson, a certified diabetes educator and nutritionist at Columbia University in New York City, also noted that skipping breakfast led to higher levels of glucagon secretion, which raises blood sugar levels. “Once blood sugar levels are high, it’s harder to clean up ‘the mess’ as the day goes on,” explained Nelson, who wasn’t involved with the study.

“In the past, I’ve been somewhat laid back when people tell me they skip breakfast or only have coffee, because we all have our habits,” Nelson said, adding that the findings inspire her to tell patients skipping breakfast is not OK.

Jakubowicz said protein is an important component of any breakfast. She said it aids in “intellectual concentration” and helps you feel full. Nelson said good sources of protein include eggs, yogurt, cottage cheese or beans. She said the tuna offered in the study was also a good source of protein, and she said lean ham, preferably low-sodium, could be an occasional option.

Nelson also recommended adding fruit or a whole grain to breakfast. But most cereals don’t have enough fiber to be a good choice for people with type 2 diabetes, she said.

Jakubowicz’ final advice for people with type 2 diabetes is simple: “Never skip breakfast.”

She said it’s not clear if the results would be the same in people with type 1 diabetes, and that she’s planning a trial to see the effects of skipping breakfast in people with type 1 diabetes. She also noted that for women with diabetes in pregnancy (gestational diabetes), skipping meals isn’t healthy for the baby, and could lead to excessive weight gain.

August 5, 2015
by Samantha Jeckewicz
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How Much Water Should You Really Drink Each Day?

Experts have revised healthy water consumption recommendations to encourage healthier hydration.

Water is necessary for carrying nutrients to your cells, flushing bacteria from your system, preventing dehydration, and replacing fluids lost from sweating, but you may not need to drink as much as you thought.  The Harvard Health Letter published new water recommendations challenging the long-standing eight 8-ounce glasses-a-day rule, which they say weren’t based on science but instead an educated guess on what the body needs to stay hydrated.

Harvard recommends drinking 30 to 50 ounces a day, which is equivalent to approximately four to six glasses of water. However, the team isn’t just recommending water to drink at this optimal standard, but fluids in general to aid in hydration. Even certain foods like watermelon, lettuce, spinach, and soups provide the body with fluids that can work in tandem with water to retain and process a healthy amount of water. Women who are pregnant or breastfeeding and those who engage in a lot of exercise may need more than the standard six glasses.

Recently, a panel of experts from around the world collaboratively wrote a study published in the Clinical Journal of Sports Medicine that also warned how drinking beyond thirst can be hazardous for your health. Athletes are at the greatest risk of drinking to the point of exercise-associated hyponatremia, which occurs when the kidneys become flooded by large quantities of water, unable to process the liquid efficiently. The sodium levels in the human body aren’t able to balance the amount of water, eventually leading to swelling cells and — in severe cases — death.

How The Brain Processes Thirst

“Using the innate thirst mechanism to guide fluid consumption is a strategy that should limit drinking in excess and developing hyponatremia while providing sufficient fluid to prevent excessive dehydration,” according to the guidelines, published in the  Clinical Journal of Sport Medicine.

Going overboard can be avoided so long as you listen to your body and recognized when you’re thirsty. Thirst is one of the basic survival instincts, as it performs several crucial bodily functions, according to the Society of Neuroscience. In addition to flushing and cleansing the body, water maintains body temperatures; transports vitamins, minerals, hormones; and lubricates joints, eyes, and intestines.

But how do we really know we’re thirsty? The instinct to drink water keeps us alive. Adults can’t survive for more than a week without water, while children can die in a period of a few hours if left in a hot car, according to Scientific American. Thirst is regulated by a messaging network between the brain and various parts of the body. The negative feedback from organs and other parts turns on the thirst mechanism located in the brain, which cues us to pour a glass of water. As humans age, the loop can weaken and put the elderly population at risk for dehydration and a host of other health issues.


July 31, 2015
by Samantha Jeckewicz
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2 Diet Changes That Will Give You An Immediate Energy Boost

You got a solid eight hours of sleep last night… so why are you still so groggy? Dietitian and fitness expert Rebecca Scritchfield says that when her otherwise healthy clients complain of low energy levels, they’re often missing two very important nutrients in their diet.

“If you know your sleep is in check [and] you’re getting a good amount of exercise, it’s definitely time to take a look at the food intake and how high quality is your diet,” she says.

Scritchfield has her clients keep a food journal, and when she looks at their records she consistently sees these two important nutrients lacking in their diet:

The B Vitamins Foods rich in the B vitamins include fruits, vegetables, seeds, nuts, legumes, milk and dairy products.

This is a big class of vitamins, Scritchfield says, so it’s important to eat a wide variety. “They help your body unleash the energy out of food,” she explains.

Iron Because iron carries oxygen to all of the cells in our bodies, Scritchfield says eating iron-rich foods like beef, chicken, beans, legumes and eggs will have a direct impact on day-to-day energy levels. Women in particular often fall short on iron, so it’s important to monitor your intake.

When Scritchfield’s clients change their diet to include more of these two nutrients, she says they often report that they feel better instantly. “I think it’s a combination of mental and physical,” she says. “Because they feel better and they’re not trying to cope with their low energy by just eating sugary foods.”

The key to remember, Scritchfield says, is that feeling good starts with taking care of yourself. “Get good sleep and eat well, and you will feel better and you will feel that energy come back,” she promises.


July 29, 2015
by Samantha Jeckewicz
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Heart Disease 101

What is Heart Disease?

heart-palpitationsThe heart is like any other muscle in body and it requires adequate blood supply to provide oxygen to allow the muscle to contract and pump. Not only does the heart pump blood to the rest of the body, it also pumps blood to itself via the coronary arteries. These arteries originate from the aorta (the major blood vessel that carries oxygenated blood away from the heart) and then branch out along the surface of the heart.

When one or more coronary arteries narrow, it may make it difficult for adequate blood to reach the heart, especially during exercise. This can cause the heart muscle to ache like any other muscle in the body. Should the arteries continue to narrow, it may take less activity to stress the heart and provoke symptoms. The classic symptoms of chest pain and shortness of breath due to atherosclerotic or coronary artery disease are called angina.

Should one of the coronary arteries become completely blocked, usually due to a blood clot that forms, blood supply to part of the heart muscle is completely lost and that piece of muscle dies. This is called a heart attack or myocardial infarction (myo=muscle + cardia=heart  + infarction= tissue death).

Heart disease, for this article, will be limited to describing the spectrum of atherosclerosis or hardening of the arteries that ranges from minimal blockage that may produce no symptoms to complete obstruction that presents as a myocardial infarction. Other topics, such as myocarditis, heart valve problems, and congenital heart defects will not be covered.

What are the risk factors for heart disease?

Factors that increase the risk of developing atherosclerotic heart disease include the following:

  • Smoking
  • High blood pressure (hypertension)
  • High cholesterol
  • Diabetes
  • Family history
  • Obesity

Since heart disease, peripheral artery disease, and stroke share the same risk factors, a patient who is diagnosed with one of the three has increased risk of having or developing the others.

What causes heart disease?

Heart disease is the leading cause of death in the United States and can be attributed to the lifestyle factors that increase the risk of atherosclerosis or narrowing of arteries. Smoking, along with poorly controlled hypertension, and diabetes, causes inflammation and irritation of the inner lining of the coronary arteries. Over time, cholesterol in the bloodstream can collect in the inflamed areas and begin the formation of a plaque. This plaque can grow and as it does, the diameter of the artery for blood flow narrows. If the artery narrows by 40% to 50%, blood flow is compromised or decreased enough to potentially cause the symptoms of angina.

In some circumstances, the plaque can rupture or break open, leading to the formation of a blood clot in the coronary artery. This prevents oxygen-rich blood from being delivered to the heart muscle beyond that blockage and that part of the heart begins to die. This is a myocardial infarction or heart attack. If the situation is not recognized and treated, the affected muscle cannot be revived and is replaced by scar tissue. Long term, this scar tissue decreases the heart’s ability to pump  effectively and efficiently and may lead to ischemic cardiomyopathy (ischemic=decreased blood supply + cardio=heart + myo=muscle + pathy=disease).

Heart muscle that lacks adequate blood supply also becomes irritable and may not conduct electrical impulses normally. This can lead to abnormal electrical heart rhythms including ventricular tachycardia and ventricular fibrillation. These are the heart arrhythmias associated with sudden cardiac death

What are the symptoms of heart disease?

The classic symptoms of angina, or pain from the heart, are described as a crushing pain or heaviness in the center of the chest with radiation of the pain to the arm (usually the left) or jaw. There can be associated shortness of breath or sweating. The symptoms tend to be brought on by activity and get better with rest. Some patients may complain of indigestion and nausea while others may have upper abdominal, shoulder, or back pain.

Unfortunately, not all pain from coronary artery disease presents in this manner. The more we learn about heart disease, the more we realize that symptoms can be markedly different in different groups of people. Women, people who have diabetes, and the elderly may have different pain perceptions and may complain of overwhelming fatigue and weakness or a change in their ability to perform routine daily activities like walking, climbing steps, or doing household chores. Some patients may have no discomfort at all.

Most often, the symptoms of heart disease become worse over time, as the narrowing of the affected coronary artery progresses over time and blood flow to that part of the heart decreases. It may take less activity to provoke symptoms and it may take longer for those symptoms to resolve with rest. This change in exercise tolerance is helpful in making the diagnosis.

Too often, however, the first presentation of heart disease may be a myocardial infarction, where a plaque ruptures causing one of the coronary arteries to occlude and prevent blood flow to the heart. This can lead to crushing chest pressure, shortness of breath, sweating, and perhaps sudden cardiac death.



July 22, 2015
by Samantha Jeckewicz
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Naps May Improve Our Frustration Tolerance

well_sleep-tmagArticleA short nap could reduce impulsive behavior and improve the ability to withstand frustration, a small study suggests.

Researchers studied 40 people aged 18 to 50. After three nights of normal sleep, the participants took computer-based tests of frustration tolerance — which consisted of trying to complete an impossible task — and completed questionnaires on sleepiness, mood and impulsivity. Then they were randomly assigned to take an hour’s nap, or to watch a nature video. At the end of the process, they were tested again. The study appears in Personality and Individual Differences.

Before the nap period, everyone spent about the same amount of time on the unsolvable task, but afterward nappers, who all reported having slept at least part of the time, spent significantly more time working at it than they had before their nap, while non-nappers gave up sooner. Nappers also rated their behavior as less impulsive than non-nappers.

The lead author, Jennifer R. Goldschmied, a doctoral student at the University of Michigan, acknowledged that the sample is small, involved mainly college students and may not be applicable to other populations. The sleep calculations also did not use electronic devices to precisely measure sleep and wakefulness.

Still, she said, “These results are valuable and have put us on the route to understanding how we can utilize naps. Now people are starting to understand how powerful short bursts of sleep can be.”


July 20, 2015
by Samantha Jeckewicz
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5 Steps for Avoiding Medicare Scams

tips-and-tricks-RIGHT-SIZEYou’re sitting at home one afternoon, three weeks prior to the start of Open Enrollment, when you get a call from a friendly Center for Medicare Services (CMS) employee. The caller tells you that Medicare is issuing new cards, and that you need to provide your Medicare number in order to receive yours. The catch? The caller doesn’t work for CMS, and he’s actually trying to steal your identity.

Elder abuse in the Digital Age is a serious problem—studies have shown that 2 in 10 older adults have been financially exploited. Read on for five key tips on avoiding common types of Medicare scams.

1. Know the difference between identity theft, Medicare fraud and improper care

Identity theft happens frequently under the guise of Medicare, as in the example above. Someone pretending to work for the Center for Medicare Services may contact you and tell you they need your personal information in order to update your account, but they’re actually looking for a way to steal your identity—i.e. your savings.

Medicare fraud happens when Medicare is billed for services or supplies you never got. Examples include a healthcare provider billing Medicare for care you didn’t receive, or someone using your Medicare card to acquire medical care for themselves—or bill for fake services and then pocket the money. If you suspect that Medicare is being charged for a service you didn’t ask for (or you don’t recognize the provider on the claim) you can call the federal government’s official Medicare hotline at 1-800-MEDICARE.

Improper care does not qualify as Medicare fraud, although it is still something to be monitored and reported. Your Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) can help you if you want to file a complaint about the quality of your medical care.

2. Watch out for anyone asking for identifying information

The most important rule to remember? Medicare will never call, email, or visit you and ask for your personal information. Examples of personal information include your Medicare number, social security number, bank account number, birthday, and address.

Scam artists may claim that Medicare is issuing new cards or forms, or that they need your financial information to process payment on an overdue medical bill. Even if they accurately cite a few numbers from your checks, do not assume the call is legitimate. Medicare already has this information and does not need to collect it from you.

Key takeaway: If anyone trying to “help you” with Medicare asks for your personal or financial information, assume it is a scam. Hang up the phone, delete the email, or close the door immediately.

3. Compare plans with a trustworthy adviser

Medicare is a massive enterprise that affects millions of people—which means countless insurance salespeople pitching policies that they promise will “save you thousands.” While some of the plans they suggest may be plans you recognize—even the ones that your friends and families use—not all policies are right for everyone.

Depending on your employment status or medical situation, you may need different kinds of assistance from other older adults you know. Some salespeople may employ scare tactics or other below-the-board strategies to pitch their plans, such as free lunch seminars or false claims of being affiliated with a government agency. Additionally, some scam artists work on behalf of companies that sell “Medicare drug plans” that have not actually been approved by Medicare.

To avoid these issues, get advice from a resource you can trust. My Medicare Matter’s Medicare Mini-Check, created by the non-profit National Council on Aging, is a free, brief assessment that helps you compare plans online. It can also connect you to free professional advice from licensed Medicare advisers at the Aon Retiree Health Exchange. Aon advisers have passed NCOA’s rigorous consumer protection standards, known as the Standards of Excellence.

Another excellent resource is your local State Health Assistance Insurance Program (SHIP). SHIPs provide free, one-on-one, and unbiased federally funded Medicare counseling. As they are primarily staffed by volunteers, it is wise to contact them early before the start of the busy Open Enrollment season (October 15-December 7). To schedule an appointment with one of their counselors, visit their website or call their toll-free national number at 1-877-839-2675.

4. Never sign a Medicare form without thorough examination

Some disreputable insurance agents may also try sending out release forms that allow them to make decisions on your behalf. Never sign anything Medicare-related without reading through it first—and get a friend, family member, or lawyer to review it as well.

5. When in doubt, call Medicare

If anything ever seems suspicious or uncomfortable, don’t hesitate to contact Medicare. They are there to help! You can visit or contact them toll-free at 1-800-MEDICARE with any questions or concerns you may have.


July 17, 2015
by Samantha Jeckewicz
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Microwaving Food in Plastic May Be Hurting Your Health

AAcO8mnIf you’re about to nuke your leftovers in a plastic container, you might want to dirty another dish. When heated, harmful chemicals in plastic can leech into your food, potentially increasing your risk of high blood pressure and insulin resistance, according to a series of new  studies out of NYU Langone Medical Center  in New York City. This is concerning because hypertension and insulin resistance, which is closely linked to prediabetes, are risk factors for type 2 diabetes.

According to the latest study, published this week in the journal Hypertension , two so-called safer chemicals increasingly used to strengthen plastic wrap, soap, cosmetics , and processed food containers have been linked to an increased risk of high blood pressure and type 2 diabetes in children and adolescents.

Ten years ago, compounds called phthalates were introduced to replace another chemical, called DEHP, which the same researchers had shown in previous studies to have similar negative health effects.

“Our research adds to growing concerns that environmental chemicals might be independent contributors to insulin resistance, elevated blood pressure and other metabolic disorders,” stated study author Leonardo Trasande, MD , MPP, a professor at NYU Langone.

While more research needs to be done, growing evidence supports the need for vigilance when handling and cooking food in plastics.

Follow these seven safe and simple rules for using plasticware in your kitchen:

  1. Never nuke your food in plastic. If you’re heating up leftovers, transfer them into microwave-safe glass or stoneware — or even a paper plate — to avoid harmful chemicals.
  2. Don’t put plastic in the dishwasher. Like microwave heat, hot water in the dishwasher can cause chemicals to leech out of plastic. Instead, gently hand wash plasticware in the sink.
  3. Discard plastic that’s warped or edged from overuse.  If your plastic looks worse for wear, it’s time to throw it away. Scarring on plastic is a telltale sign that protective layers are worn out, and “suggests higher leeching” according Dr. Transande.
  4. Choose aluminum foil or waxed paper over plastic cling wrap. Although foil and waxed paper aren’t microwave-safe, they make good substitutes for storing and packing food to go, and they don’t contain phthalates.
  5. Invest in glass storage containers.  Reusable glass containers are a safe and economical way to store and heat food and leftovers. Look for options that are both refrigerator- and microwave-safe so you can cool and heat in the same container.
  6. Choose bottled drinks and processed foods wisely. Trasande says you should avoid plastic containers labeled with the numbers 3, 6, or 7, which indicate they contain phthalates.
  7. Make your own meals using fresh, whole foods. If microwaveable meals are in heavy rotation in your house, ditch them in favor of home-cooked meals. Processed foods are packed with more than just the phthalates — their high sodium, fat, and sugar content can contribute to hypertension, obesity, and diabetes as well.


July 15, 2015
by Samantha Jeckewicz
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The Benefits of Soy for Diabetes

75When planning healthy meals, don’t overlook soy. This versatile little bean is a heart-healthy source of lean protein that’s packed with nutrients. If you have diabetes, it may be especially beneficial.

Does Soy Affect Your Glucose Levels?

Soy intake is associated with a lower risk of developing type 2 diabetes. It isn’t clear whether soy can help control diabetes if you already have the condition. A recent analysis in  The  American Journal of Clinical Nutrition reviewed 24 studies on soy and diabetes. It found that whole soy foods were slightly more effective at lowering fasting blood glucose, a measure of diabetes control, than isolated soy products. (Isolated soy products are proteins separated from the rest of the soybean, then used as ingredients to make a variety of foods.) However, the overall amount of soy in the diet did not affect fasting glucose or insulin levels.

Enjoy Soy for a Healthier Heart

Still, soy can be incredibly valuable if you have diabetes for another reason: It can improve your heart health. Two out of three people with diabetes will die from a heart attack or stroke. But soy has been shown to improve several heart disease risk factors. One analysis of eight studies found that soy intake was associated with improvements in:

  • HDL, or “good,” cholesterol
  • LDL, or “bad,” cholesterol
  • Total cholesterol
  • Triglycerides

Soy is a healthy, low-fat source of protein. It’s high in B vitamins, fiber, potassium, and essential amino acids. Soy is the only plant protein that has the same protein quality as eggs or meat. Plus, soybeans have no cholesterol.

Soy Foods to Try

When choosing a soy product, check the nutrition label for carbohydrates, so you can include the food in your meal plan in the proper amount. The number of carbohydrates in soy products varies. Common sources of soy include:

  • Edamame (fresh soybeans)
  • Soy milk (unflavored or light soy milk is best)
  • Soy nuts
  • Tempeh (a cake made from fermented soy beans)
  • Textured soy protein (a meat substitute made from soy flour)
  • Tofu

How to Incorporate Soy into Your Diet

Soy products are extremely versatile. Try these meal and snack ideas.

  • Add edamame or cubed tofu to salad, stir-fry, or pasta.
  • Blend silken tofu into a smoothie.
  • Eat edamame as a snack with a pinch of salt
  • Grill tempeh and use it like hamburger. Crumble it into casseroles. You could also grill soy veggie burgers or sausages.
  • Purée edamame into a dip.
  • Put soy nuts into plastic bags for a grab-and-go snack.



July 10, 2015
by Samantha Jeckewicz
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6 Tips for Dining Out with Diabetes

For people with diabetes, eating out—whether at a restaurant, a social function, or a friend’s home—is always a challenge.

Portions can be hefty and packed with calories and saturated fat. When you eat out, it may help to follow these simple guidelines:

Ask how entrées are prepared, and avoid fried foods or dishes served in heavy sauces or gravies.

  • Choose skinless chicken, fish, or lean meat that’s broiled, poached, baked, or grilled.
  • Get the server’s advice in selecting healthy, low-fat dishes. Restaurants are used to dealing with special diets.
  • Don’t feel obliged to clean your plate. Eat a reasonable portion, and take the remainder home.
  • Choose steamed vegetables and salads to accompany your meals. Request low-calorie dressings and toppings, and if they’re not available, ask for all dressings, butter, and sauces to be served on the side so you can use them sparingly.
  • If you take insulin and know your meal will be delayed, time your injection appropriately. You may need to eat a roll or piece of fruit to tide you over.

If you crave a dessert, share one.


June 30, 2015
by Samantha Jeckewicz
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What’s the Difference Between Alzheimer’s and Dementia

Contrary to what some people may think, dementia is not a less severe problem, with Alzheimer’s disease being a more severe problem.

When someone is told they have dementia, it means they have significant memory problems as well as other cognitive difficulties, and, these problems are severe enough to get in the way of daily living. Most of the time dementia is caused by Alzheimer’s disease.
What is the Difference Between Alzheimer's and Dementia

There is great confusion about the difference between Alzheimer’s and dementia.

In a nutshell, dementia is a syndrome, and Alzheimer’s is the cause of the symptom.

When someone is told they have dementia, it means that they have significant memory problems as well as other  cognitive difficulties, and that these problems are severe enough to get in the way of daily living.

Too often, patients and their family members are told by their doctors that the patient has been diagnosed with “a little bit of dementia.” They leave the doctor’s visit with a feeling of relief that at least they don’t have Alzheimer’s disease (AD).
The confusion is felt on the part of patients, family members, the media, and even health care providers. This article provides information to reduce the confusion by defining and describing these two common and often poorly understood terms.

What’s the difference between Alzheimer’s disease and dementia?
  • “Dementia” is a term that has replaced a more out-of-date word, “senility,” to refer to cognitive changes with advanced age.
  • Dementia includes a group of symptoms, the most prominent of which is memory difficulty with additional problems in at least one other area of cognitive functioning, including language, attention, problem solving, spatial skills, judgment, planning,  or organization.
  • These cognitive problems are a noticeable change compared to the person’s cognitive functioning earlier in life and are severe enough to get in the way of normal daily living, such as social and occupational activities.
A good analogy to the term dementia is “fever.”
Fever refers to an elevated temperature, indicating that a person is sick. But it does not give any information about what is causing the sickness. In the same way, dementia means that there is something wrong with a person’s brain, but it does not provide any information about what is causing the memory or cognitive difficulties. Dementia is not a disease; it is the clinical presentation or symptoms of a disease.
There are many possible causes of dementia. Some causes are reversible, such as certain thyroid conditions or vitamin deficiencies.
If these underlying problems are identified and treated, then the dementia reverses and the person can return to normal functioning.
However, most causes of dementia are not reversible. Rather, they are degenerative diseases of the brain that get worse over time.
The most common cause of dementia is AD, accounting for as many as 70-80% of all cases of dementia.

Approximately 5.3 million Americans currently live with Alzheimer’s Disease.

  • As people get older, the prevalence of Alzheimer’s disease increases, with approximately 50% of people age 85 and older having the disease. 
  • It is important to note, however, that although Alzheimer’s is extremely common in later years of life, it is not part of normal aging. For that matter, dementia is not part of normal aging.
  • If someone has dementia (due to whatever underlying cause), it represents an important problem in need of appropriate diagnosis and treatment by a well-trained health care provider who specializes in degenerative diseases.
In a nutshell, dementia is a symptom, and Alzheimer’s Disease is the cause of the symptom.

When someone is told they have dementia, it means that they have significant memory problems as well as other  cognitive difficulties, and that these problems are severe enough to get in the way of daily living.  Most of the time, dementia is caused by the specific brain disease, AD.
However, some uncommon degenerative causes of dementia include vascular dementia (also referred to as multi-infarct dementia), frontotemporal dementia, Lewy Body disease, and chronic traumatic encephalopathy.

Contrary to what some people may think, dementia is not a less severe problem, with AD being a more severe problem.
  • There is not a continuum with dementia on one side and AD at the extreme.  Rather, there can be early or mild stages of AD, which then progress to moderate and severe stages of the disease.
  • One reason for the confusion about dementia and AD is that it is not possible to diagnose AD with 100% accuracy while someone is alive. Rather, AD can only truly be diagnosed after death, upon autopsy when the brain tissue is carefully examined by a specialized doctor referred to as a neuropathologist.
  • During life, a patient can be diagnosed with “probable AD.”  This term is used by doctors and researchers to indicate that, based on the person’s symptoms, the course of the symptoms, and the results of various tests, it is very likely that the person will show pathological features of AD when the brain tissue is examined following death.

In specialty memory clinics and research programs, such as the BU ADC, the accuracy of a probable AD diagnosis can be excellent.
And with the results of exciting new research, such as that being conducted at the BU ADC, the accuracy of AD diagnosis during life is getting better and better.  This contribution was made by Dr. Robert Stern, Director of the BU ADC Clinical Core.