Understanding Alzheimer’s & Dementia

As we age, it’s common to become a little more forgetful. But when does “Where did I put my glasses?” shift from normal aging to something more concerning? When is it simply a distraction, and when could it be Alzheimer’s disease or another form of dementia?

Understanding the difference matters. Early awareness, discussion, and planning can significantly impact quality of life.

What Is Alzheimer’s Disease?

Alzheimer’s disease is a progressive brain disorder and the most common cause of dementia. Although risk increases after age 65, doubling approximately every five years. Alzheimer’s can affect younger individuals as well.

Alzheimer’s is a physical disease of the brain that begins years before symptoms appear. Over time, abnormal proteins called amyloid plaques and tau tangles build up, damaging neurons and interfering with communication between brain cells. As brain cells die, memory, reasoning, and daily functioning decline.

According to the Alzheimer Society of Canada, as of January 1, 2025:

771,939 Canadians were living with dementia
414 new cases develop every day
By 2030, nearly one million Canadians could be living with dementia

Alzheimer’s disease is the most common specific progressive disease.

Dementia is the umbrella term used to describe symptoms affecting memory, thinking, and the ability to carry out everyday activities.

10 Warning Signs of Dementia

(Alzheimer Society of Canada)

Memory changes affecting daily life: Forgetting important dates, events, or repeatedly asking the same questions.
Difficulty performing familiar tasks: Trouble following routines like cooking or managing bills.
Language challenges: Struggling to find the right words or follow conversations.
Disorientation in time and place: Getting lost in familiar areas.
Poor judgment: Dressing inappropriately for the weather or making unsafe decisions.
Problems with abstract thinking: Difficulty understanding numbers or symbols.
Misplacing items: Putting objects in unusual places and being unable to retrace steps.
Mood or personality changes: Increased fearfulness, withdrawal, or suspicion.
Loss of initiative: Reduced interest in hobbies or hygiene.
Visual and spatial challenges: Difficulty judging distance, recognizing faces, or reading.

If these signs are persistent or worsening, speak to a healthcare provider.

Atypical Alzheimer’s: When Symptoms Look Different

Some individuals develop atypical Alzheimer’s, where symptoms begin in different brain regions:

Posterior Cortical Atrophy (Visual Variant): Difficulty recognizing faces, judging distance, or navigating.
Logopenic Variant (Language/Aphasia): Hesitant speech, word-finding difficulty.
Behavioral Variant (Frontal Variant): Impulsivity, lack of empathy, compulsive behavior.
Dysexecutive Variant: Trouble planning, organizing, or problem-solving.
Motor Variant: Movement issues, apraxia, rigidity.

What Causes Dementia?

Dementia is not a single disease; it is a syndrome caused by various underlying conditions.

1. Alzheimer’s Disease

Protein build-up (amyloid and tau) damages brain cells over time.

2. Vascular Dementia

Caused by reduced blood flow to the brain.

Types include:

Multi-infarct dementia (multiple small strokes)
Subcortical vascular dementia (Binswanger’s disease)
Single-infarct dementia

Risk factors include high blood pressure, diabetes, smoking, and high cholesterol. Lifestyle plays a major role in prevention.

3. Lewy Body Dementia (LBD)

Caused by alpha-synuclein protein deposits (Lewy bodies). Symptoms may include:

Visual hallucinations
Parkinson’s-like movement symptoms
REM sleep disruption
Fluctuating alertness

4. Frontotemporal Dementia (FTD)

Often diagnosed under age 65. Impacts personality, behavior, or language. Includes:

Behavioral variant FTD
Primary Progressive Aphasia (PPA)
Movement disorders (MND/ALS, CBS, PSP)

5. Young-Onset Dementia

Occurs before age 65 and affects approximately 28,000 Canadians. Symptoms may be subtle at first and can significantly impact employment and family life.

Important note: Memory changes in perimenopause and menopause can mimic early symptoms, but dementia is progressive and worsening over time.

6. Mixed Dementia

More than one type of dementia occurs simultaneously, often Alzheimer’s combined with vascular or Lewy body disease.

Is It Aging or Dementia?

Early symptoms are often mild cognitive impairment (MCI) and may not immediately interfere with daily life.

If you notice:

Persistent decline
Increasing forgetfulness
Changes in behavior or functioning

Consult a family doctor. Early diagnosis allows for better symptom management and future planning.

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Do I, or my Loved-One Have Dementia? How to have the dementia discussion.

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Discussing with yourself the question of a dementia diagnosis is not easy. For many of us, being a little forgetful and distracted can be a normal part of ageing. But if you are concerned that these little slights in memory could be something more, it’s important to discuss it with your family early on your concerns so that they too can help keep track of their observations, and if they notice any decline and progression in your symptoms.

Discussing a dementia diagnosis with a loved one can be a lot more difficult, as they may be less receptive to discussing dementia, especially if they are also feeling scared about the possibility of a diagnosis, or if they are already experiencing changes in personality from the disease.

To start with, if you are concerned, start by keeping a journal so that you can document examples to support your concerns. This is also helpful when seeing a doctor. However, it’s important when broaching the subject with your loved one, not to use this journal in a confrontational manner. We are all more receptive to listening openly to others when we are treated with respect and without judgment.

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Having a conversation with a loved one about concerns they have about dementia:

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Time & Place: Choose a time and place that takes into consideration your loved one's safety and comfort. For example, in their home during a time of day when they are alert, where they can sit and chat freely and without interruption.

One-on-one: Keep the conversation intimate. No one likes to feel ‘ganged up on’. This may require more than one conversation, or another family member or friend also having this discussion with them at a later date, if the initial discussion is not effective.

Kindness & Empathy: Approach the discussion focusing on your observations and concerns. Stay away from accusing, e.g., You’re always forgetting stuff! I think you have dementia and should see a doctor.” Don’t use the word Dementia! As mentioned before, the diagnosis of dementia can be scary to hear. Instead, use statements like, “ I noticed you have been struggling to remember where you put your glasses a lot lately. Have you noticed it? Reassure them that you love and care about them, and that your intention is their well-being. Just focus on the symptoms, don’t jump to any conclusions regarding a diagnosis.

Listen: Active listening and patience are essential. Validate how they are feeling. Don’t engage if they react negatively. If they do, allow them time to process what you are saying and come to terms with it. If they remain agitated and defensive or deny your observations, you or another family member or friend will have to approach the subject again at a later date, keeping in mind that if there is something in the approach to the conversation you can do differently next time to help reach a better outcome. Just try not to leave it too long, as the earlier a diagnosis of dementia, the better and more successful the treatment options.

Encouragement: Focus on keeping the conversation positive. Suggest seeing a doctor to discuss memory and ageing, and to rule out other issues.

Support: Once your loved one is amenable to seeing a doctor, reassure them that they are not alone in this. That you will be there providing emotional and physical support. This can include setting up the doctor's appointment, transporting, and attending the visit. Let them know that no matter what, you will be there to figure things out together and take any necessary next steps.

The thought of a loved one getting a diagnosis of dementia can be stressful and frightening for the family, too. Just remember that blaming, shaming, or forcing a loved one to see a doctor can create a negative experience and outcome for everybody.

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What to do if a loved one refuses to see a doctor:

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Don’t give up! There is a list of referrals and resources at the end of this article that you can contact for support.

Try Again: A different time and a different day could lead to different results. It’s also ok to ask others for help. This could be a different family member, friend, or community leader. Someone they trust and respect.

Request a favour: Encourage your loved one to go see their doctor as a favour to put your mind at ease.

Family Doctor: You can contact their GP. Due to privacy laws, the doctor can not share patient information with you, but you can share your observations and concerns with them. You can even share your journal if you have kept one to help provide detailed times, dates, and examples. Once they are aware of the information, they can discuss it with your loved one at their next visit. If you share the same GP, suggest that you need a visit and that they can go with you.

Motivation: Try offering an incentive like suggesting that you could make a doctor's appointment and then go to their favourite coffee shop or out to lunch.

If immediate safety concerns arise, call 9-1-1 or the BC Crisis Line (310-6789).

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Diagnosis & Treatment

There is no single test for dementia.

Diagnosis may include:

Physical exam
Cognitive screening (MMSE, MoCA, Mini-Cog)
Bloodwork
Lumbar puncture
CT, PET, or MRI scans

Treatment focuses on:

Medications for symptom management
Lifestyle adjustments
Cognitive Stimulation Therapy
Occupational and speech therapy
Counseling for individuals and families

There is currently no cure, but early intervention improves quality of life.

Personal Planning After a Dementia Diagnosis (BC)

Planning early is one of the greatest gifts you can give your loved ones.

Planning for the Future (While Capable)

Enduring Power of Attorney (EPA)
Representation Agreement Section 9 (RA9)

Planning for Today (If Capacity Is Reduced)

Representation Agreement Section 7 (RA7)
Committeeship (court-appointed)
Temporary Substitute Decision Maker (TSDM)

Learn more at: www.nidus.ca

Aging In Place vs Long-term Care

When the time comes that the person diagnosed with dementia can no longer care for themselves directly, the decision comes down to whether it’s best to have them live in a long-term care facility or whether bringing in support to allow them to age in place (live in their home). It is also important to look at long-term planning during this time.

‍Aging in Place‍

Aging in Place enables individuals living with dementia to remain in the comfort and familiarity of their own home. This can be beneficial in reducing disorientation and confusion. It can provide more independence and allow them to continue with activities, hobbies and social interactions. This is especially helpful in the early to mid stages of their disease. Aging in place can be supported by family members or friends taking on the caregiver role in the person’s life. More At Home Society (moreathome.org) is also available to provide professional in-home support services to help individuals living with dementia remain safe, comfortable, and supported in their own homes. The time needed to support the person in their home will change as the disease progresses.

‍Long-term Care‍

Long-term care provides 24/7 care to the person living with dementia. This option is often necessary when a person requires around-the-clock supervision for their safety. This prevents wandering, although adjusting to a new environment can lead to confusion, a lack of familiar social interactions, or the inability to participate in regular hobbies or activities. This can add to anxiety and a feeling of isolation.

Dementia Resources in British Columbia

Support is available:

First Link Dementia Helpline: They can provide support and resources to families in BC to help navigate this discussion:

1-800-936-6033 (English)
1-833-674-5007 ( Cantonese or Mandarin)
1-833-674-5003 (Punjabi, Hindi or Urdu)

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Helplink BC: Non-emergency health line where a nurse or healthcare practitioner can provide information 24/7

Dial 8-1-1

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Alzheimer’s Society of BC:
‍www.alzheimerbc.org

Provincial Office

300-828 West 8th Avenue, Vancouver

email: info@alzheimerbc.org

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Alzheimer’s Resources Centres BC:

Lower Mainland & Fraser Valley

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Fraser Region

201- 15127 100th Avenue, Surrey

English: 604-449-5000

Punjabi: 604-742-4956

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North Fraser 604-298-0780

Chilliwack- Hope 604-702-4603

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North Shore & Sunshine Coast

212-1200 Lynn Valley Road, North Vancouver

604-984-8348; 1-866-984-8348

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Vancouver & Richmond

303-828 West 8th Avenue, Vancouver

290-7000 Minoru Boulevard, Richmond

English: 604-675-5150

Cantonese or Mandarin: 604-279-7120

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Vancouver Island

Greater Victoria

202-306 Burnside Road West, Victoria

250-382-2052

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North & Central Vancouver Island

4-4488 Wellington Road, Nanaimo

250-734-4170; 1-800-462-2833

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Interior & North

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North & Central Okanagan

307-1664 Richter Street, Kelowna

250-860-0305; 1-800-634-3399

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South Okanagan & Similkameen

104-35 Backstreet Boulevard, Penticton

250-493-8182; 1-888-318-1122

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Central Interior

405-235 1st Avenue, Kamloops

250-377-8200; 1-800-886-6946

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West Kootenay

778-774-2133; 1-855-301-6742

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East Kootenay

778-761-2011; 1-833-426-0534

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Northern Interior, Northeast & Northwest

302-1811 Victoria Street, Prince George

250-564-7533; 1-866-564-7533

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BC Dementia Care Society:
www.bcdementiacare.org

778-888-7445

email:info@bcdementiacare.org

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Nidus Personal Planning Resource Centre:
www.nidus.ca

604-408-7414
Email: info@nidus.ca

Reaching out early can reduce isolation and guide both individuals and caregivers.

For more information, please refer to the blogs: “What is Dementia: The 6 Types, Causes, and Symptoms” or “ A Detailed Guide to Personal Planning for Those Living with Dementia and Their Families (British Columbia).”

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