All forms of dementia are not the same. There are many types of brain diseases or conditions that cause cognitive impairments in thinking, memory, and judgment. Often there is confusion on the difference between these conditions and how they are treated.
According to Dr. Julie Schneider from the Rush Alzheimer’s Disease Center in Chicago, people can have multiple diseases that can affect the brain. Generally chronic progressive conditions, there is no cure for most causes of dementia, but the importance of the right diagnosis can inform the most appropriate treatment, and the best care and a plan for the future.1
The aging brain
There has been much reporting about the effects of aging on the brain. Some of it is evidence-based science, while other “information” is based on opinions, fads, and social media suggestions. What we know is that damage to particular regions of the brain are associated with different types of dementia.2
What is Alzheimer’s?
Alzheimer’s disease is a type of dementia that causes problems with memory, thinking, and behavior. It accounts for 60 to 80% of all cases of dementia.1,2 Alzheimer’s is characterized by a buildup of plaques and tangles in the brain. But there are other causes for the varied forms of dementia.
What is dementia?
Dementia is a broad term used to describe a decline or deterioration in mental ability that interferes with daily functioning.2 It is not a specific disease. It affects behavior by causing changes in memory, mood, interfering with thinking, concentration, and judgment. This impacts the daily life of patients and their families.
In making a diagnosis of dementia, two or more core mental functions are deemed significantly impaired. These include:
Communication and language
Ability to focus and pay attention
Reasoning and judgment
There is no diagnostic test for Alzheimer’s and other types of dementia. They are diagnosed after collecting substantial information including a complete medical history, physical exam, blood work, and reported changes in thinking and functioning.
There are risk factors for developing dementia. These include age, genetics, heart health, lack of regular use of mental faculties, inconsistent social interaction, exercise, and diet. As with many medical conditions, it is recommended to not smoke and to maintain healthy blood pressure, cholesterol level, blood sugar level, and a healthy weight.
Is dementia reversible?
Some forms of dementia are not chronic or permanent. During an exam, it is possible that symptoms that appear to be dementia are due to a treatable condition. A small percentage of dementias are reversible. They are usually due to side effects from other medical conditions.3
Medication interactions or reactions are the most common causes of reversible dementia. Dietary or vitamin B12 deficiencies, infections, tumors, alcohol or drug abuse, inflammatory and hormonal dysfunction, environmental toxins, and chronic depression can also lead to changes in mental health.3
Other types of dementia
Other types of dementia include:
Young onset dementia: Occurs when symptoms start before age 65. It represents 2-8% of dementia cases.
Mild Cognitive Impairment: Involves difficulty with memory, language, thinking or judgment, greater than the changes associated with normal aging.
Vascular dementia: Can be caused by stroke or blood vessel damage and oxygen deprivation. One-third of the people who have strokes go on to develop dementia. This raises the importance of vascular health and stroke prevention. Represents up to 10 percent of dementia cases.
Mixed dementia: Has characteristics of Alzheimer’s disease and vascular dementia.
Frontotemporal dementia: Affects areas of the brain that control personality, language and behavior. It can cause insensitivity, and inappropriate behavior or decision making. Represents less than 10% of dementia cases.
Parkinson’s dementia: Caused by a build-up of alpha-synuclein proteins in the brain when there is a decline in thinking and reasoning, experienced a year or more after the onset of motor symptoms.
Lewy body dementia: Affects thinking and movement. It is characterized by abnormal deposits of alpha-synuclein protein inside neurons. Represents up to 10% of dementia patients.
Creutzfeldt-Jakob disease (CJD): A rare and fatal form of dementia. It’s caused by a protein found in the brain called a prion.
Huntington’s disease: A genetic disorder that causes nerve cells in the brain to die. It can cause personality changes such as irritability, depression, and mood swings, and eventually trouble with memory, concentration, or decision making.
Down syndrome: A genetic disorder distinguished by an extra copy of the 21st chromosome, it generally affects learning and is characterized by developmental delays. People with Down syndrome are prone to an over-production of the protein that leads to the development of Alzheimer’s disease.
Hamilton, J. Is It Alzheimer's Or Another Dementia? The Right Answer Matters. Available at: https://www.npr.org/sections/health-shots/2019/03/18/703944116/is-it-alzheimers-or-another-dementia-the-right-answer-matters. Accessed 5.24.19.
What is Dementia? Available at: https://www.alz.org/alzheimers-dementia/what-is-dementia. Accessed 5.24.19.
Other Dementias. Available at:https://alzheimer.ca/en/Home/About-dementia/Dementias?gclid=EAIaIQobChMI8d6jsJi14gIVD47ICh2EYgESEAAYASAAEgJOv_D_BwE. Accessed 5.24.19.