What If It’s Not Alzheimer’s?

Overview

Published: 10/15/2012

by Carrie Steckl, Ph.D.

Photos

The words “Alzheimer’s” and “dementia” are often used interchangeably, but this can create confusion for caregivers and health care professionals alike. If you’ve often wondered what the difference is between Alzheimer’s disease and dementia, here is a simple rule to remember:

 

Everyone who has Alzheimer’s disease has dementia, but not everyone who has dementia has Alzheimer’s disease.

 

That’s right – dementia is the broader of the two terms. Dementia is essentially a brain syndrome characterized by difficulties with memory, language, judgment, behavior, and daily functioning (not necessarily in that order). Dementia can be caused by many different diseases and conditions. Think of dementia as an umbrella under which many types of dementia fall.

 

Alzheimer’s is the most common type of dementia (according to the Alzheimer’s Association, anywhere from 60 to 80 percent of dementia cases are due to Alzheimer’s disease). But what if it’s not Alzheimer’s? If dementia is caused by another medical condition, then different treatment approaches may be required. Imagine how tragic it would be if your loved one was diagnosed with Alzheimer’s disease when the dementia is actually due to something else – something that could be better managed with a more appropriate treatment protocol. That’s why a thorough diagnostic workup is so important.

 

Here are some types of dementia that are often confused with Alzheimer’s disease:

 

Vascular dementia – This is the second most common cause of dementia after Alzheimer’s disease. Vascular dementia results from blocked or reduced blood flow to the brain. Sometimes this is due to a major stroke; other times, it’s due to a series of smaller strokes called transient ischemic attacks (TIAs).

 

Lewy body dementia – Many experts feel that Lewy body dementia (also called “dementia with Lewy bodies”) is the third most common type of dementia behind Alzheimer’s and vascular dementia. Lewy body dementia is caused by abnormal deposits of the protein alpha-synuclein. These deposits were named Lewy bodies after the researcher that discovered them.

 

Frontotemporal dementia – Frontotemporal dementia occurs in the frontal lobes (behind the forehead) and temporal lobes (behind the ears) of the brain. There actually are several subtypes of frontotemporal dementia that affect behavior, personality, language, and movement more than memory. Frontotemporal dementia is more common among people in their 50s and 60s than in older people.

 

Creutzfeld-Jakob disease (CJD) – CJD is a prion disease that occurs when prion proteins (which are found throughout the body but have unknown functions) fold into abnormal shapes that destroy brain cells. Prion diseases also occur in non-human mammals such as deer and cows. CJD is extremely rare and tends to progress rapidly.

 

Huntington’s disease – Huntington’s is caused by a defective gene. It is quite rare in the general population, but anyone who inherits the gene will develop the disease. Huntington’s initially affects movement but progresses over time to affect mood, memory, and thinking.

 

Parkinson’s disease – Not everyone with Parkinson’s will develop dementia, but some people with the disease will eventually develop symptoms similar to Alzheimer’s or Lewy body dementia.

 

Normal pressure hydrocephalus – This occurs when excess cerebrospinal fluid accumulates in the brain and creates problems with thinking and reasoning. It can sometimes be treated with a shunt that drains the excess fluid, but symptoms may or may not resolve.

 

Wernicke-Korsakoff syndrome – This severe memory disorder is caused by a deficiency of thiamine (vitamin B-1), often due to long-term alcohol abuse. “Wernicke” refers to an acute reaction to this deficiency that often (but not always) precedes the “Korsakoff” syndrome of dementia.

 

It’s also important to note that dementia can be due to more than one disorder, such as Alzheimer’s disease and vascular changes. In these cases, the term “mixed dementia” is used. For more information about the different types of dementia, see http://www.alz.org/dementia/types-of-dementia.asp.