Normal Aging vs. Alzheimer's

A hot topic at yesterday's Caregivers Town Hall Forum in Carlsbad was how to distinguish a normally aging brain from one with dementia, particularly Alzheimer's. Dr. Daniel Sewell, a UCSD geriatric psychiastrist and member of the George G. Glenner Alzheimer's Family Centers Medical Advisory Board, offered these examples to help you tell the difference:

Normal Aging: Being more outspoken.
As we accumulate more life experiences, we can feel more compelled to share those experiences and particularly lessons learned from them with others. We can at least appear more opinionated because, again, we have many years of keen observations upon which to draw conclusions.
Dementia: Being inappropriate when speaking.
Those with brain cell damage say things that violate rules of etiquette and/or are deemed socially inappropriate. They do not filter their thoughts before speaking them, regardless of the need for sensitivity.

Normal Aging: Being less concerned about what others think.
As we age, we become more competent -- and confident -- in our decisions and less dependent on approval or validation from others.
Dementia: Being disrespectful of others' rights and boundaries.
Someone with dementia may use another's property or possessions without permission and be confused and hostile when confronted.

Normal Aging: Becoming hypochondriacal.
The more aware of our bodies, the more we consider suggestive symptoms of illnesses we hear or read about.
Dementia: Becoming preoccupied or delusional about non-existent illnesses.
These people become so convinced of an illness despite medical evidence to the contrary that it becomes a major preoccupation or they become delusional.

Normal Aging: Becoming more vigilent.
As we age, we become more aware of the need to adapt our lifestyles or environment to avoid hazards that can produce, say, falls that can have dire consequences. An example is taking more time going down steps and always using a handrail.
Dementia: Developing disabling anxiety.
While normally aging people will take steps to reduce risks, those with dementia begin to altogether avoid people and places for fear of something that may not ever happen. For example, rather than taking more precautions going down stairs, this person refuses to use stairs out of an abnormal fear.

Normal Aging: Worrying about becoming a victim of fraud.
We constantly hear of criminals who exploit the elderly, and it makes seniors more aware of such situations.
Dementia: Becoming excessively paranoid of people.
Someone with dementia is not just wary but suffers from paranoid delusions that limit their quality of life.

Normal Aging: Coping with loss.
As we age, we start to outlive people important to us. Healthy-brained seniors acknowledge the loss and over time replace lost members of their social network.
Dementia: Becoming socially withdrawn.
Those with an abnormal brain isolate and withdraw from their social networks many months following a loss.