10/25/2021
This week education is about:
What's the difference between Alzheimer's and other forms of dementia? Here, neurology experts break it down.
Alzheimer’s disease is one cause of dementia, Kaiser explains, but there are actually a number of other common diseases that cause dementia as well. Here, Kaiser and other neurology experts break down the differences between these diseases and the various ways doctors go about diagnosing and treating each one.
What is dementia?
“Dementia in general just means that someone has cognitive changes that affect their function or activities,” says Dr. Halima Amjad, a board-certified physician and assistant professor of Medicine at Johns Hopkins University School of Medicine in Baltimore, Maryland.
Memory loss is a common symptom of dementia, as well as one of the main symptoms of Alzheimer’s disease, so people often equate dementia with memory loss, Kaiser says; however, memory loss isn’t the only way dementia symptoms can impact patients. Depending on the type of dementia, he says patients may experience cognitive declines that impact their abilities to:
Reason.
Comprehend.
Make calculations.
Use language.
Negotiate space or orientation.
Interpret what they see.
What are the most common causes of dementia?
To understand dementia more fully, it’s helpful to know the causes and common symptoms of each specific type. “There are groups of symptoms that tend to be associated with the different types of dementia,” Kaiser says. “But even within the subtypes, there is so much overlap between symptoms of the different types of dementia.”
Here is what sets each type of dementia apart:
Alzheimer’s disease:
Alzheimer’s disease is a progressive brain disease that impacts and impairs healthy functions in the brain. “In Alzheimer’s dementia, short term memory loss is most often seen first, with people repeating themselves, misplacing things or forgetting conversations, plans and appointments,” Amjad says.
Alzheimer’s can also affect spoken language skills and visual perceptual skills, Amjad says. Activities affected early are usually high level activities, like:
Driving.
Managing medications.
Managing bills or finances.
Using a computer or smartphone.
Cooking.
Lewy Body dementia:
Lewy body dementia (LBD) is a type of progressive dementia that can diminish a person’s ability to think, reason and process information. It’s one of the most common forms of dementia, and it impacts over a million people in the U.S.
“Lewy body dementia may present with hallucinations or behavioral issues,” says Huma Sheikh, a board certified neurologist and the CEO of NY Neurology Medicine in New York. Hallucinations are present in 80% of cases of LBD. Sheikh says early symptoms may also include:
Agitation.
Difficulty with executive functioning skills, such as planning, self control and organization.
Memory problems.
Changes in cognitive function, such as loss of reasoning and attention.
Lewy body dementia is closely related to Parkinson’s disease, so Amjad says those with LBD may also exhibit symptoms similar to Parkinson’s disease, such as tremors, slow movements and falls.
Vascular dementia:
Vascular dementia is caused by reduced blood flow to the brain, typically due to a stroke or chronic illness, Sheikh says. Symptoms can occur suddenly or slowly over time as blood vessels that supply blood to the brain become damaged or blocked. “That can begin to affect a person’s cognitive function, including memory problems, as well as difficulty with language and spatial orientation,” Sheikh explains.
Vascular dementia may present differently depending on the location of the blocked or damaged blood vessels in the body, Sheikh says, but symptoms can include:
Confusion.
Slowed thinking.
Difficulty concentrating.
Uneven gait.
Problems with organization, memory or reasoning.
Frontotemporal dementia:
“Frontotemporal dementia (FTD) either presents with changes in personality or behavior or changes in language,” Amjad says. It’s a form of dementia that predominantly affects the frontal or temporal lobes of the brain, which control personality, language and movement.
The symptoms of FTD will depend on which areas of the brain are affected, but Amjad says some of the common symptoms to look out for with this type of dementia include:
Psychiatric symptoms, like depression, anxiety or paranoia.
Memory loss or slower recall.
Confusion.
Decreased ability to move or speak with ease.
Rare brain disorders
Though rare, some cases of dementia are caused by Huntington’s disease, a hereditary brain disorder that damages cells in various parts of the brain, or Creutzfeldt-Jakob disease, a rare, degenerative brain disorder that can be hereditary, but often occurs with no known risk factors.
Other causes of dementia symptoms
Dementia symptoms are not always caused by progressive brain diseases like those explained above. Amjad says dementia-like symptoms can also be caused by other ailments, including:
Vitamin B-12 deficiency.
Medication side effects.
Alcohol use.
Thyroid problems.
Untreated depression or anxiety.
A build-up of fluid around the brain.
Regardless of the cause, it’s important to see a doctor anytime you experience symptoms that could be related to dementia.
“Checking for these [causes] is important, since the symptoms can be reversed with treatment,” Sheikh says. “However, these are known as pseudo-dementia. For the real dementias, like Alzheimer’s disease, unfortunately, there is currently no cure.”
— DR. HALIMA AMJAD, A BOARD-CERTIFIED PHYSICIAN
How is dementia diagnosed?
“There isn’t a single test that confirms dementia,” Amjad says. “Rather, clinicians use different sources of information to determine if someone has dementia, and if they have dementia, what type of dementia it is.”
If you or a loved one are experiencing symptoms, a primary care physician can help assess your symptoms and refer you to the appropriate specialist. “Most important is the history of what has been happening and noticed by the patient and also their family or friends,” Amjad says. “Having information and observations from someone else who knows the patient is often key. A physical exam is also important to rule out other medical or neurological issues that could be causing the symptoms.”
Additional evaluations and cognitive testing are typically performed by a neuropsychologist, Amjad says. This may include MRIs or testing to determine changes in specific areas of cognition, including:
Memory.
Attention.
Language.
Visual perceptual abilities.
Executive function.
Higher level thinking.
Speaking with a doctor about your symptoms may seem overwhelming and scary, but Kaiser says it’s important to monitor your brain health and spot problems as early as possible so doctors can determine the best treatment. “I always try to encourage people to err on the side of getting evaluated,” he says. “Act and get informed because knowledge is power.”
