Education has long been thought to protect against the ravages of brain diseases like Alzheimer’s. Numerous studies seemed to suggest that the more educated were less likely to develop dementia.
But a large new study finds little difference between people with a high school diploma and those with a Ph.D. when it comes to staving off the damage to brain cells caused by dementing diseases or the rate at which mental decline progresses, once it starts.
“It’s been a longstanding idea that education might be one of those things that allows a person to tolerate these kinds of brain pathologies,” said the study’s lead author, Robert S. Wilson, a professor of neurological and behavioral sciences at the Rush University Medical Center in Chicago. “We found that the more pathology you find in the brain, the faster the cognitive decline was.”
IT STARTS OUT SLOWLY, almost imperceptibly. The misplaced keys. The forgotten birthday or anniversary. Using the wrong word or losing the thread in mid-conversation. These are often dismissed as typical signs of aging, but in some people, they may be the earliest signs that something bigger is at work – the development of dementia or Alzheimer’s disease. When a doctor diagnoses dementia or Alzheimer’s in your loved one, you should be sure to ask a lot of questions to make sure you understand your loved one’s current state of being and so you can appropriately prepare for how this progressive disease could change over time.
1. Is it Alzheimer’s or another kind of dementia?
There are several types of cognitive decline people may experience. “Dementia is simply an umbrella term,” says Dr. Susann Varano, a geriatrician at Maplewood Senior Living, a Westport, Connecticut–based senior living residence company. “If a physician says, ‘you have dementia,’ it’s the same thing as saying, ‘you have cancer.'” She says it’s critical to pinpoint exactly which type of dementia it is. “Is it Lewy body dementia? Is it vascular? Is it a frontotemporal disorder? Is it mixed dementia? Is it Alzheimer’s disease?” Although all dementias affect the brain and cognitive function, “each of those types of dementias have a different path. Some accelerate more than others and some have different presenting symptoms, so it’s very important to get the actual diagnosis of dementia.”
People living with dementia are frequently under-recognized and under-diagnosed by healthcare providers. Consequently, they do not receive the medical care they need, nor are they connected to essential home- and community-based supports. The federal duals demonstration offers opportunities to better blend funding and oversight for Medicare-funded medical care with Medicaid-funded long-term services and supports, so that people with dementia and their families can get better integrated care. This webinar offers tools and strategies to improve dementia healthcare based on approaches that have been developed within this demonstration model but that also have relevance to other healthcare systems.
California’s presentation focuses on how the state and regional Alzheimer’s organizations partnered with participating health plans serving dual eligible participants to improve detection, care planning and community supports for individuals and family caregivers dealing with diagnosed and-or undiagnosed dementia. The presentation also shares resources developed and lessons learned in implementing this initiative. Texas’ presentation focuses on the Texas Takes on Dementia initiative, and how it builds on the California initiative’s principles and adapts these for the State of Texas. Also included is a discussion of key adaptations, challenges and lessons learned.
You’ve turned 65 and exited middle age. What are the chances you’ll develop cognitive impairment or dementia in the years ahead?
New research about “cognitive life expectancy” — how long older adults live with good versus declining brain health — shows that after age 65 men and women spend more than a dozen years in good cognitive health, on average. And, over the past decade, that time span has been expanding.
By contrast, cognitive challenges arise in a more compressed time frame in later life, with mild cognitive impairment (problems with memory, decision-making or thinking skills) lasting about four years, on average, and dementia (Alzheimer’s disease or other related conditions) occurring over 1½ to two years.