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Published April 06, 2013, 11:35 PM

Minding Our Elders: Different dementia types can co-exist

DEAR CAROL: I’m confused about my husband’s Alzheimer’s diagnosis. He was first diagnosed with Alzheimer’s disease three years ago, but now we are told he is showing Parkinson’s symptoms. The doctor talks to all of us like we should know everything about dementia and Parkinson’s, and our questions just seem to annoy him.

By: Carol Bradley Bursack, INFORUM

DEAR CAROL: I’m confused about my husband’s Alzheimer’s diagnosis. He was first diagnosed with Alzheimer’s disease three years ago, but now we are told he is showing Parkinson’s symptoms. The doctor talks to all of us like we should know everything about dementia and Parkinson’s, and our questions just seem to annoy him. The more I read about the different types of dementia the more confused I get. This new information about Parkinson’s disease has just made it worse. Are there different types of Alzheimer’s? – Lila

DEAR LILA: You aren’t alone in your confusion about dementia, specifically Alzheimer’s, however I’m surprised that the doctor wasn’t clear in explaining the differences to you. Even the most brilliant doctor can’t be as effective as he or she should be if there’s no clear communication with patients and their advocates.

Simply put, there are many types of dementia, with Alzheimer’s being the most common type. There is early onset Alzheimer’s, sometimes referred to as younger onset Alzheimer’s, which is when a person shows symptoms before the age of 65. Most Alzheimer’s disease presents symptoms at a later age and is then just designated dementia of the Alzheimer’s type, or Alzheimer’s disease.

A neurologist’s opinion is generally sought for a dementia diagnosis. Researchers are increasingly becoming aware that people may suffer from more than one type of dementia, a situation which they generally refer to as mixed dementia. For example, a combination of Alzheimer’s disease and vascular dementia isn’t uncommon. Therefore, a definite diagnosis isn’t always easy.

We’ll assume, from your note, that the doctor did find evidence that your husband has dementia of the Alzheimer type. Now, three years later, the doctor sees evidence of Parkinson’s disease. Parkinson’s disease is a separate disease from Alzheimer’s, though a percentage of people with Parkinson’s do develop Alzheimer’s disease or another type of dementia, such as Lewy body dementia, in addition to the Parkinson’s disease itself.

Since your husband’s doctor may be a very good physician, and often it’s not easy to find another specialist, I’d ask the nurse if there’s a person in the medical center who can explain your husband’s illnesses to you so that you really understand what he, and you as his caregiver, will be facing. If you have the option of finding a more communicative specialist, you could also consider making a change in physicians.

I’d also suggest that you contact the Alzheimer’s Association in your home community or online at www.alz.org, as well as the National Parkinson’s Foundation at www.parkinsons.org. Both organizations will be able to help guide you as you and your husband travel this road together. The more information you gather, the more confident you’ll feel about coping with the diseases. Attending support groups for people who are caregivers for loved ones with dementia should also be helpful. There are many online caregiving support groups, as well.

Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at www.mindingourelders.com. She can be reached at carol@mindingourelders.com.

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