Garland Law Offices, P.A.

Baseball Champion Sues Daughter-In-Law, denies having Dementia

“Orlando Cepeda wants to know where his money went. He also wants to learn what happened to all of his baseball memorabilia, including his 1967 National League Most Valuable Player Award, and wants to be made whole.”

Eighty-two-year-old Giants great Orlando Cepeda filed a lawsuit against his daughter-in-law Camille Cepeda alleging elder financial abuse, fraud and infliction of emotional distress, as reported in the article “Giants great Orlando Cepeda denies having dementia, sues daughter-in-law for fraud” from the San Francisco Chronicle. He also accused her of negligence in handling his finances, after giving her power of attorney in 2018.

Cepeda accuses Camille of spending his money on personal expenses, including lease payments on a $62,000 Lexus, a Louis Vuitton handbag, expensive wine and taking out at least $24,000 in cash from his accounts. It also claims that she has placed all of his baseball memorabilia in a storage locker and will not give him the key or the location of the locker. That includes his National League Most Valuable Player trophy, which he wants back.

This is the latest news from a dispute that began after the Hall of Famer married his second wife, Nydia. They had two of Cepeda’s four sons, including Ali Cepeda, who is married to Camille. The parents are now not speaking to their son, and some of the brothers, four in total, have taken sides and are not speaking to each other.

Cepeda granted his daughter-in-law power of attorney in April 2018, two months after he suffered a heart attack and irreversible brain damage caused by oxygen deprivation. She was to have access to his accounts and pay his bills. Before the heart attack, she had handled his financial and business affairs.

On May 29, Camille filed a petition with the court seeking conservatorship of Cepeda, stating that he has dementia and cannot make his own financial decisions. Two of Cepeda’s sons, including Camille’s husband Ali, filed papers supporting her petition.

In Cepeda’s response, he cited two neuropsychological reports, including one done in May, that declared that he was fit to make his own medical decisions and understands all but the most complex financial issues. Cepeda says that his daughter-in-law filed for conservatorship to cover up the fraud that he is alleging in the lawsuit. He says that he does not need a conservator, and if anyone should have that role, it would be his wife Nydia.

The lawsuit filed by Cepeda offers a glimpse into why he believes she wants conservatorship, saying he doesn’t have the capacity to understand the nature and consequences of his remarriage, nor his decision to remove Camille as power of attorney and grant it to Nydia.

The suit alleges that Camille was opposed to the marriage from the start and even suggested they stage a fake ceremony that would not be legally sanctioned.

Cepeda’s lawsuit seeks damages, legal fees and demands that Camille return his memorabilia and all financial records she has allegedly refused to provide to account for how she handed his money. The suit also cites a $62,000 withdrawal to pay Cepeda’s tax bill, which was not actually paid. The filing says she was negotiating with the IRS, but she will not provide the documentation that he needs to settle with the government. Nor did she pay a medical bill for $6,800, although she did cash a check from the insurance company that was sent to pay for it.

Cepeda remains hopeful that the entire matter may be settled, before the case returns to court.

“It’s very painful,” Cepeda told a reporter. “I love my family. I love my kids. But this is life. You have to do what you have to do.”

Reference: San Francisco Chronicle (June 26, 2020) “Giants great Orlando Cepeda denies having dementia, sues daughter-in-law for fraud”

Elder Financial Abuse Fraud Occurs, When No One’s Watching

“Take, for example, the sad and sordid tax case of Mary Ellen Cranmer Nice vs. United States of America, which would not have existed if an attentive financial advisor hadn't noticed the large IRA distributions that were allegedly stolen right from under a matriarch’s nose.”

The case of Nice vs. U.S. is a dramatic example of what can happen when there are no professionals involved in an elderly person’s finances and one person has the power to make transactions without supervision. In the article “Tax case reveals possible intrafamily fraud” from Financial Planning, a trusted son allegedly decimated his mother’s IRA and left her estate with $500,000 tax bill.

Mrs. Nice and her husband had been married for more than 60 years. Before he died in 2002, her husband arranged to leave significant assets for his wife’s care. Their son Chip was named executor of the husband’s estate and moved in with his mother. In 2007, she was diagnosed with dementia. As her condition deteriorated, Chip allegedly began fraudulent activities. He gained access to her IRAs, causing distributions to be made from the IRAs and then allegedly taking the funds for his own use.

Chip also filed federal income tax returns for his mother, causing her to execute a fraudulent power of attorney. The federal tax returns treated the IRA distributions as taxable income to Mrs. Nice. She not only lost the money in her IRA but got hit with a whopping tax bill.

In 2014, Mrs. Nice’s daughter Julianne applied for and received a temporary injunction against Chip, removing him from her mother’s home and taking away control of her finances. Chip died in 2015. A court found that Mrs. Nice was not able to manage her own affairs and Mary Ellen was appointed as a guardian. Julianne filed amended tax returns on behalf of her mother, claiming a refund for tax years 2006-07 and 2009-13. The IRS accepted the claim for 2009 but denied the claims for 2006 and 2010-2013. The appeal for 2009 was accepted, but the IRS never responded to the claim for 2007. Julianne appealed the denials, but each appeal was denied.

By then, Mrs. Nice had died. Julianne brought a lawsuit against the IRS seeking a refund of $519,502 in federal income taxes plus interest and penalties. The suit contended that because of her brother’s alleged fraudulent acts, Mrs. Nice never received the IRA distributions. Her tax returns for 2011-2014 overstated her actual income, the suit maintained, and she was owed a refund for overpayment. The court did not agree, stating that Julianne failed to show that her mother did not receive the IRA funds and denied the claim.

There are a number of harsh lessons to be learned from this family’s unhappy saga.

When IRA funds are mishandled or misappropriated, it may be possible for the amounts taken to be rolled over to an IRA, if a lawsuit to recover the losses occurs in a timely manner. In 2004, the IRS issued 11 private-letter rulings that allow lawsuit settlements to be rolled over to IRAs. The IRS allowed the rollovers and gave owners 60 days from the receipt of settlement money to complete the rollover.

Leaving one family member in charge of family wealth with no oversight from anyone else—a trustee, an estate planning attorney, or a financial planner—is a recipe for elder financial abuse. Even if the funds had remained in the IRA, a fiduciary would have kept an eye on the funds and any distributions that seemed out of order.

One of the goals of an estate plan is to protect the family’s assets, even from members of their own family. An estate plan can be devised to arrange for the care of a loved one, at the same time it protects their financial interests.

Reference: Financial Planning (March 6, 2020) “Tax case reveals possible intrafamily fraud”

When Should You Have ‘The Talk’ with Your Kids?

“An immature or troubled child could try to misuse your money or goad you into handing over assets you might need later. Complicated family dynamics, or just your desire for privacy, may make you hesitant to open up.”

Talking about who will control your assets is always a tricky thing, says AARP.org in a recent article “Do Your Kids Know Where to Find All Your Money if Tragedy Strikes?” The risk of adult children being caught unawares or without access to a parental funds could lead to big problems, if the parents should die or become incapacitated unexpectedly. Experienced estate planning attorneys know the conversation is better had now, than pushed into the background with a giant surprise in the future.

When a parent’s finances are revealed only after their death, or if dementia strikes, the unexpected responsibility can create a lot of stress. However, there are also reasons not to tell. If a child has a substance abuse problem, or is in a bad marriage, this information may be best kept under wraps. There is no one-size-fits-all solution. However, there are some universal rules to consider.

Short on cash? Don’t make a secret of it. If you might end up needing help during retirement, it’s best to tell your children early on. Family members have helped each other since there were families, but the earlier you involve them, the more time they have to help you find more resources and make plans.

Dealing with big numbers? You might want to wait. The amount of money you have worked a lifetime to save may look like an endless supply to a 22-year old. When young adults learn there’s a pot of gold, things can go south, fast. If you have a spouse and are relatively young and healthy, then all the children need to know, is that you are well set for retirement. By the time you’re closer to 80, then your children and/or a trusted financial representative and your estate planning attorney will need to know where your money is and how to access it.

How to share the details? Start by making a complete list of all of your assets, including account numbers, key contacts and any other details your executor or agents will need to handle your affairs. Put that information into an envelope and make sure that your children or your estate planning lawyer know where it is. If the information is kept on your computer or on an online portal, make sure the right people have access to the passwords, so they can access the information.

How to share the big picture? Estate planning attorneys often recommend a family meeting in their offices, with all of the children present. It’s helpful to have this meeting happen in neutral territory, and even children who tend to squabble among themselves behave better in a lawyer’s conference room. You can explain who the executor will be, and why.

Introduce them to your team. Chances are you have a long-standing relationship with your estate planning attorney, financial advisor and accountant. These are the people your children will be working with after you have passed. Having them meet before you die or become incapacitated, will be better for a working relationship that will likely occur during a stressful time.

Reference: AARP.org (April 24, 2020) “Do Your Kids Know Where to Find All Your Money if Tragedy Strikes?”

Retirement Planning and Declining Abilities

“When a loved one is experiencing cognitive decline, emotional and medical considerations often overshadow the financial planning that needs to happen. This is a potentially costly mistake.”

Whether the reason is Alzheimer’s, Parkinson’s or any of a number of illnesses that lead to dementia, it’s hard for families to think about legal or financial concerns, when a diagnosis is first made. This can lead to serious problems in the near future, warns the article “Cognitive Decline Shouldn’t Derail Retirement Planning. Here are Some Tips to Prepare Your Finances” from Barron’s. The time to act is as soon as the family realizes their loved one is having a problem—even before the diagnosis is official.

Here are some useful tips for navigating cognitive decline:

Take an inventory. Families should create a detailed list of assets and liabilities, including information on who has access to each of the accounts. Don’t leave out assets that have gone paperless, like online checking, savings, credit card and investment accounts. Without a paper trail, it may be impossible to identify assets. Try to do this while the person still has some ability to be actively involved. This can be difficult, especially when adult children have not been involved with their parent’s finances. Ask about insurance policies, veterans’ benefits, retirement accounts and other assets. One person in the family should be the point person.

Get an idea of what future costs will be. This is the one that everyone wants to avoid but knowing what care costs will be is critical. Will the person need adult day care or in-home care at first, then full-time medical care or admission to a nursing facility? Costs vary widely, and many families are completely in the dark about the numbers. Out-of-pocket medications or uncovered expenses are often a surprise. The family needs to review any insurance policy documents and find out if there are options to add or amend coverage to suit the person’s current and future needs.

Consider bringing in a professional to help. An elder law estate planning attorney, financial planner, or both, may be needed to help put the person’s legal and financial affairs in order. There are many details that must be considered, from how assets are titled, trusts, financial powers of attorney, advance health care directives and more. If Medicaid planning was not done previously, there may be some tools available to protect the spouse, but this must be done with an experienced attorney.

Automate any finances if possible. Even if the person might be able to stay in their own home, advancing decline may make tasks, like bill paying, increasingly difficult. If the person can sign up for online banking, with an adult child granted permission to access the account, it may be easier as time goes by. Some monthly bills, such as insurance premiums, can be set up for automatic payment to minimize the chances of their being unpaid and coverage being lost. Social Security or Supplemental Security Income benefits are now required to be sent via direct deposit or prepaid debit card. If a family member is still receiving a paper check, then now is the time to sign up for direct deposit, so that checks are not lost. Pension checks, if any, should also be made direct deposit.

Have the correct estate planning documents been prepared? A health care representative and a general durable power of attorney should be created, if they don’t already exist. The durable power of attorney needs to include the ability to take action in “what if” cases, such as the need to enroll in Medicaid, access digital assets and set up any trusts. A durable power of attorney should be prepared before the person loses cognitive capacity. Once that occurs, they are not legally able to sign any documents, and the family will have to go through the guardianship process to become a legal guardian of the family member.

Reference: Barron’s (Jan. 11, 2020) “Cognitive Decline Shouldn’t Derail Retirement Planning. Here are Some Tips to Prepare Your Finances”

Five Estate Planning Mistakes to Avoid

“Five of the most common mistakes are easy to avoid with the right information and support, as well as a little creativity.”

While it’s true that no estate is completely bulletproof, there are mistakes that people make that are big enough to walk through, while others are more like a slow drip, draining retirement finances in a slow but steady process. There are mistakes that can be easily avoided, reports Comstock Magazine in the article “Five Mistakes to Avoid When Planning Your Estate.”

1. Misunderstanding Estate Law. Some people are so thrown by the idea of an estate plan, that they can’t get past the word “estate.” You don’t need a mansion to have an estate. The term is actually used to refer to any and all property that a person owns. Even modest people need a plan to help beneficiaries avoid unnecessary costs and stress. Talk with an estate planning attorney to learn what your needs are, from a will to trusts. Make sure that this is the attorney’s key practice area. A real estate or personal injury attorney won’t have the same knowledge and experience.
2. Getting Bad Advice. It takes a team to create a strong estate plan. That means an estate planning attorney, a financial advisor and an accountant. Be wary of firms that focus entirely on selling trusts. There’s definitely a role for trusts in estate plans, but there are many other tools that are needed. Buying an insurance policy or an annuity is not an estate plan.
3. Naming Yourself as a Sole Trustee. Naming yourself as a sole trustee puts you and your estate in a precarious position. What if you develop Alzheimer’s or are injured in an accident? A trusted individual, a family member, a longstanding friend or even a professional trustee, needs to be named to protect your interests, if you should become incapacitated.
4. Losing Track of Assets. Without a complete list of all assets, it’s nearly impossible for someone to know what you own and who your heirs may be. Some assets, including retirement funds, life insurance policies, or investment accounts, have named beneficiaries. Those people will inherit these assets, regardless of what is in your will. If your heirs can’t find the assets, they may be lost. If you don’t update your beneficiaries, they may go to unintended heirs—like ex-spouses.
5. Deciding on Options Without Being Fully Informed. When it comes to estate planning, the natural tendency is to go with what we think is the right thing. However, unless you are an estate planning attorney, chances are you don’t know what the right thing is. For tax reasons, for instance, it may make sense to transfer assets, while you are still living. However, that might also be a terrible idea, if you choose the wrong person to hold your assets or don’t put them in the right kind of trust.

Estate planning is still a highly personal process that depends upon every person’s unique experience. Your family situation is different than anyone else’s. An experienced estate planning attorney will be able to create a plan and help you to avoid the big, most commonly made mistakes.

Reference: Comstock Magazine (Dec. 2019) “Five Mistakes to Avoid When Planning Your Estate”

New Dementia Education Now Required for Physicians and Nurses

Connecticut has taken a big step in requiring that nurses and doctors are mandated to have training in recognizing and treating dementia, authorizes a plan to build dementia-capable programs and creates a portal for background checks on employees who work with the elderly.

Connecticut Senate Bill 827 adds continuing medical education training on Alzheimer’s and other types of dementia for nurses and physicians in the state, according to a recent article from McKnight’s Senior Living, “New state laws emphasize dementia training, background check database access.” This is good news for the 78,000 people living with the disease in the state. The goal is to give these medical professionals the resources they need to identify the signs and symptoms of dementia in the patients they are caring for.

Effective January 1, nurses renewing their licenses are required to take two contact hours of training or education about diagnosing and treating cognitive or mental health conditions such as Alzheimer’s disease, dementia, delirium, related cognitive impairments and geriatric depression. And physicians who are applying to renew their licenses may count toward their training requirements two hours of continuing medical education in these areas.

“With no cure for Alzheimer’s, it is imperative that we detect the signs of this disease earlier, enabling us to improve the quality of life of those with this disease,” said state Sen. James Maroney (D), who co-chairs the state Aging Committee. “This legislation makes great progress towards ensuring just that,” he added, noting that the state has the seventh oldest population in the U.S.

The new law also authorizes an update of the Connecticut Alzheimer’s Plan to build dementia-capable programs. Under the law, the executive director of the state Commission on Women, Children, and Seniors is to create a working group to find any issues in the implementation of a task force’s recommendations and to make recommendations on best practices for Alzheimer’s Disease and dementia care.

Connecticut’s governor also signed into law Senate Bill 832. This legislation mandates that the state Commission on Women, Children, and Seniors provide a portal on its website with links to publicly available databases, and the professional licensure verification database maintained by the state Department of Public Health (used for background checks of those who work with the elderly).

“Elder abuse and criminal action against those with disabilities are unacceptable, and the public should be aware who those perpetrators are in order to protect their family and friends from future act of crime against our most vulnerable populations,” commented state Senator Tony Hwang.

In addition, the new law expands the Department of Public Health’s background check program for those working in the long-term care field. In the past, people who had been convicted of certain crimes against older adults were not included in the program. Those who have been convicted of other crimes are no longer permitted to work in long-term care facility.

Reference: McKnight’s Senior Living (July 22, 2019) “New state laws emphasize dementia training, background check database access”

How Does the Disease LATE Affect Seniors?

“Doctors have newly outlined a type of dementia that could be more common than Alzheimer's among the oldest adults, according to a report published Tuesday in the journal Brain.”

The disease, called LATE, may often replicate the symptoms of Alzheimer's disease. However, it impacts the brain differently and develops more slowly than Alzheimer's. Doctors say the two are frequently found together, and in those cases may lead to a steeper cognitive decline than either by itself.

CNN’s article, “Doctors newly define another type of dementia, sometimes mistaken for Alzheimer's,” says that in developing the recent report for Brain, the international team of authors is hoping to spur research and treatments for a disease that tends to affect people over 80 and "has an expanding but under-recognized impact on public health," according to the paper.

The evidence has been growing for years. There are reports of patients who didn't quite fit the mold for known types of dementia, such as Alzheimer's. Experts say that heterogeneity has complicated dementia research, including Alzheimer's, because it hasn't always been clear what the root cause was and if doctors were treating the right thing.

The acronym LATE stands for Limbic-Predominant Age-Related TDP-43 Encephalopathy. The full name refers to the area in the brain most likely to be impacted and the protein at the center of it all.

More than ten years ago, doctors first linked the TDP protein to amyotrophic lateral sclerosis, otherwise known as ALS or Lou Gehrig's disease. It was also linked to another type of dementia, called frontotemporal lobar degeneration.

Based on autopsy studies, the new paper estimates that between 20 and 50% of people over 80 will have brain changes associated with LATE. The prevalence increases with age.

New guidelines could have an impact on Alzheimer's research, as experts say some high-profile drug trials may have suffered as a result of some patients having unidentified LATE—and thus not responding to treatment.

Advances in testing had already proven that some patients in these trials lacked "the telltale signs of Alzheimer's.”

Reference: CNN (April 30, 2019) “Doctors newly define another type of dementia, sometimes mistaken for Alzheimer's”

What Can Tim Conway’s Demise Can Teach Us About Elder Law?

“To avoid family squabbles later, think hard now before giving a loved one decision power over your finances and your health.”

Comedian Tim Conway was hilarious in his comic skits on The Carol Burnett Show in the 1970s. One of his comedy classics featured his ad-libbing and out-of-turn laughter in a famous skit, where he plays a hapless dentist with Harvey Korman as his patient. America loved Tim Conway.

Kiplinger’s recent article, “Choose Agents for Power of Attorney, Health Care Proxy Carefully” reports that the 84-year-old Conway was in the headlines recently for vastly different reasons. When he was incapacitated by dementia, his family fought over his care. One of Conway’s daughters from his first marriage and his second wife battled in Los Angeles probate court for his sole conservatorship.

Conway’s case illustrates that as more adults age with blended families in charge of their care, family disputes over decision-making authority are increasing. A person’s second spouse may be listed as health care proxy or the agent under the power of attorney. However, that doesn’t mean the adult children from the first marriage—who may have hard feelings—won’t start a legal challenge.  Siblings with different opinions on the costs and quality of care also may want to find a way to take control. This may result in a judge appointing a guardian or revoking a relative’s authority. This can only mean more resentment and more legal bills.

Families can avoid the time and expense of litigation, by attempting mediation of the problem before going to court. A geriatric care manager or a social worker can assess a loved one’s care needs and offer a professional opinion to assist a family looking for a solution. There are also other strategies you can try to avoid a fight.

To begin with, choose carefully when you give a person decision-making power over your finances and your health. It’s best to select a person who’ll try to get you the best care possible and not worry about their inheritance. A child with financial problems might not be the right choice for your financial power of attorney. For seniors living alone, there are of care-management agencies that will act as agents for a fee. However, make certain that you understand the fees and costs involved.

Once you’ve designated an individual as your health care proxy, have a conversation with them about why you selected them.  You should be specific about what type of care you want to receive.

You can also guard against a potential battle, by adding terms in your will that say if your children unsuccessfully challenge your choice of agent or health care proxy, they could have their inheritance eliminated or reduced.

Reference: Kiplinger (November 29, 2018) “Choose Agents for Power of Attorney, Health Care Proxy Carefully”

What Odd Things are Connected to Dementia?

“Dementia is an umbrella term used to describe diseases associated with memory loss, like Alzheimer's disease. There are several things that are commonly known to lead to it, such as high blood pressure or a traumatic brain injury. However, as fairly recent research has found, there are also some pretty unexpected things that are linked to dementia as well.”

The Alzheimer's Association found that 5.7 million Americans are living with the disease. Every 65 seconds, someone in the U.S. develops Alzheimer's or another type of dementia.

Bustle’s recent article, “7 Weird And Surprising Things Linked To Dementia” reports that Dr. Luqman Lawal, MD, remarked "Dementia occurs when once-healthy neurons in the brain stop working, which results in a loss of cognitive functioning. This lack of ability to problem solve and remember things that have happened to them, affects their everyday routine."

In addition to memory loss, those with some form of dementia may experience other symptoms like an inability to focus, an impaired sense of judgment and an inability to problem solve. Others may have issues with communication. There are several different studies that have examined possible causes. Here are some of the most surprising things that have been linked to dementia, according to recent research:

Hearing Loss. A long-term study released in early 2018 found a "strong link" between hearing loss and dementia in seniors. About 33% of participants who experienced hearing loss were found to be more likely to have other major health issues like depression, disability and dementia.

Herpes. A study from Frontiers in Aging Neuroscience found connections between herpes simplex virus type 1 (HSV-1), which often causes mouth sores, and Alzheimer’s disease. Those with the herpes virus were 2.5 times more likely to develop dementia, than those who didn’t. Researchers also discovered that people infected with HSV-1 carry a specific gene associated with Alzheimer’s disease, ApoE4—known to increase the risk for getting the disease.

Constantly Feeling Sleepy During The Day. A 2018 study found links between sleep disturbances and Alzheimer’s disease. Feeling excessively sleepy during the day is a common symptom of several sleep disorders, such as insomnia or sleep apnea. The study said that those who often felt sleepy during the day. were three times more likely to show signs of Alzheimer's disease in the brain.

Taking in Too Much Sugar. A 2018 study published in the journal Diabetologia looked at more than 5,100 adults over 10 years and found that those who had higher blood sugar levels had faster rates of cognitive decline than those with more normal levels.

Air Pollution. A 2017 study from the University of Southern California found connections between air pollution and dementia in older women. Tiny air pollution particles, which mostly come from power plants and cars, can get inside the body via the nose and then travel into the brain. Breathing in toxins can increase inflammation in the body. Research said that if a person had the Alzheimer's gene, excessive exposure over time to those toxic particles can "exacerbate and promote" the disease. The adverse effects were found to be much stronger in older women who had the gene. More research still needs to be performed. However, if it’s confirmed that air pollution causes dementia, it may the cause for over 20% of dementia cases.

Sense of Smell. A 2016 study found a connection between a person's sense of smell and Alzheimer’s disease. Participants who were unable to correctly identify certain odors like menthol, strawberry and lemon, were the people who were at risk for having the disease. Researchers believe that a person’s poor sense of smell can possibly be an early indicator of Alzheimer's disease.

Loneliness. A 2018 study published in the Journal of Gerontology: Psychological Sciences looked at data of over 12,000 people over 10 years. The researchers found that those who reported to having greater feelings of loneliness, were 40% more likely to get dementia. While there's no one clear explanation as to why, researchers believe some people may cope with feelings of loneliness by behaving in ways that can damage the brain, like binge drinking or being sedentary.

Again, these studies show possible links to dementia—it doesn't mean these things can cause it.

Dr. Lawal says, there are several actions you can take to limit your risk. "Don't smoke, protect yourself against concussions when participating in high-impact activities, don't over-consume alcohol, stay active and eat a balanced diet," he says.

Try to live a healthy lifestyle, to the best of your ability.

Reference: Bustle (November 5, 2018) “7 Weird And Surprising Things Linked To Dementia”

What’s the Difference Between Dementia and Alzheimer’s?

“’To be called dementia, the disorder must be severe enough to interfere with your daily life,’ says Constantine George Lyketsos, M.D., director of the Johns Hopkins Memory and Alzheimer’s Treatment Center in Baltimore.”

The terms “dementia” and “Alzheimer’s” have been around for more than 100 years. That means people probably have been getting the two terms confused for a century.

However, understanding the difference between dementia vs. Alzheimer’s is important. AARP explains this in its June article, “Dementia vs. Alzheimer’s: Which Is It?” While Alzheimer’s disease is the most common form of dementia (accounting for an estimated 60 to 80% of cases), there are several other types. The second most common form is called vascular dementia. This form has a very different cause, which is high blood pressure. Other types of dementia include alcohol-related dementia, Parkinson’s dementia and frontotemporal dementia. Each type also has different causes. In addition, certain medical conditions can cause serious memory problems that resemble dementia.

The right diagnosis means the proper medicines, remedies and support. Correctly identifying Alzheimer’s, instead of another type of dementia, may result in a prescription for a cognition-enhancing drug rather than an antidepressant. A patient may also be eligible to participate in a clinical trial for Alzheimer’s, if he or she has been specifically diagnosed with the disease.

Dementia is a nonreversible decline in mental function. It’s a catchall phrase that encompasses several disorders that cause chronic memory loss, personality changes or impaired reasoning. Alzheimer’s disease is just one of them.

Alzheimer's is a specific disease that slowly and irreversibly destroys memory and thinking skills. There’s no cure.  However, researchers have identified biological evidence of the disease: amyloid plaques and tangles in the brain. They can be seen microscopically, or more recently, using a PET scan that employs a newly discovered tracer that binds to the proteins. The presence of these proteins can also be detected in cerebral spinal fluid, but this method isn’t used often in the U.S.

Dementia is diagnosed by a doctor who must find that you have two or three cognitive areas in decline. These areas include disorientation, disorganization, language impairment and memory loss. To make that diagnosis, a doctor or neurologist will administer several mental-skill challenges.

There’s no definitive test for Alzheimer's. Physicians usually rely on observation and ruling out other possibilities. This guessing game is still used today in diagnosing the disease. It’s accurate between 85 and 90% of the time. The new PET scan may be 95% accurate, but it’s usually only recommended to identify Alzheimer’s in patients who have atypical symptoms.

Reference: AARP (June 25, 2018) “Dementia vs. Alzheimer’s: Which Is It?”