What are Other Types of Dementia?
While some cognitive decline is normal with aging, cognitive impairment is not. Cognitive impairment tends to be a bit more marked and is caused by a disease or neurological changes, and involves issues with memory, language, thinking, and judgment - changes that are more serious than the typical age-related decline.1
There are a variety of disorders that can cause cognitive impairment and symptoms similar to those of Alzheimer’s, which is why a thorough diagnostic evaluation is so important if you’re experiencing neurological symptoms. In addition, bringing a trusted friend or loved one to diagnostic evaluations can be helpful because they can help determine if there has been a decline in cognition over time.
Someone experiencing cognitive symptoms should be evaluated by a neurologist who specializes in memory disorders. These doctors are highly trained to distinguish symptoms of Alzheimer’s disease from other neurologic disorders. The treatments may be different, depending on the diagnosis.
Vascular dementia
Vascular dementia (VaD) is a progressive worsening of memory and cognitive function, similar to Alzheimer’s disease. VaD can be caused by stroke or chronically reduced blood flow to the brain, which eventually results in dementia.2
There is no cure, but some of the medications used in Alzheimer’s disease for memory and mood problems can also be used to treat VaD, since it can be associated with amyloid plaques. Other things like lifestyle modifications like those for Alzheimer’s disease can be helpful as well.
Progressive supranuclear palsy
Progressive supranuclear palsy (PSP) is a brain disorder affecting movement, gait, balance, speech, swallowing, vision, mood, behavior, and cognition. It is caused by neurological nerve cell damage, particularly above clusters of nerve cells in the brain called nuclei.
The disease is progressive, which means it gets worse over time. A hallmark of PSP is the inability to aim and move the eyes in a typical way, causing blurred vision.
There is no effective treatment for PSP, but symptoms can be managed with medication or therapies.3
Corticobasal degeneration
Corticobasal degeneration is a progressive disorder of the brain that involves nerve cell loss and shrinkage of various areas of the brain, including the cerebral cortex and the basal ganglia.4
Symptoms of the disease are similar to Parkinson’s disease, including lack of coordination, rigidity, visual-spatial impairment, impaired balance, halting speech, trouble swallowing, and more. The symptoms usually start on one side, but eventually become more pronounced and occur on both sides of the body. Language problems are also a symptom, such as word-finding difficulties. There are also memory deficits and personality changes.
Right now, there is no treatment to slow or stop the progression of the disease, and symptoms are typically treatment-resistant. Treatments used for Parkinson’s usually aren’t effective. Drugs used in Alzheimer’s disease to improve memory, such as cholinesterase inhibitors, are sometimes prescribed. Sometimes speech therapy or occupational therapy can help for a short time, but not long-term.4
Multiple system atrophy
Multiple system atrophy (MSA) is a progressive neurodegenerative disorder. The hallmark feature of MSA is a combination of symptoms affecting the autonomic nervous system and movement.5 The autonomic nervous system controls involuntary things like digestion or blood pressure. There is a progressive loss of functioning because of various kinds of nerve cells dying in the brain and spinal cord.
Symptoms can include fainting, erectile dysfunction, loss of bladder control, tremor, rigidity, clumsiness, trouble swallowing, and speech or gait problems. Symptoms may overlap those of Parkinson’s disease in the beginning of MSA.5
Some MSA symptoms can be treated with medication, but there is no known way to slow or stop the progression of the disease, and there is no cure.5
Lewy body disease or Lewy body dementia
Lewy body disease, also called Lewy body dementia or dementia with Lewy bodies, is the second most common kind of progressive dementia after Alzheimer’s disease.
This disease is characterized by visual-spatial problems, reduced executive function, and fluctuations in attention. Lewy body dementia also causes problems with movement similar to Parkinson’s disease such as rigidity and slowness of movement. REM sleep behavior disorder, in which a person acts out their dreams, is a common symptom of Lewy body dementia.
In this disorder, protein deposits called Lewy bodies arise in nerve cells in the brain, particularly in areas necessary for cognition, memory, and movement.6 Lewy bodies are also associated with Parkinson’s disease. The symptoms, then, are almost a combination of the two disorders.
There is no cure for Lewy body disease, but the various symptoms an individual has may be treated with medications used for Parkinson’s disease to help with movement, and modifying behaviors and the environment.6
Mixed dementia
Mixed dementia is a term used when an individual has a combination of two or more kinds of dementia.7 Mixed dementia might be the most common cause of dementia in the elderly population, with some studies postulating that mixed vascular-degenerative dementia (VaD and another kind of degenerative dementia) is the most common cause. Alzheimer’s disease was usually not the only kind of dementia found on autopsy in older adults.
With this kind of dementia, it can be hard to tease out which symptoms are from Alzheimer’s disease or another kind of dementia. Most people with mixed dementia are diagnosed with one specific type, and their treatment is specific to their diagnosis.7
There is no prescribed treatment for mixed dementia.7
Parkinson’s disease dementia
Parkinson’s disease dementia (PDD) is when a person with Parkinson’s disease exhibits changes in thinking and behavior. In PDD, the movement symptoms that go along with Parkinson’s disease come first, then the cognitive symptoms appear; in Lewy body dementia, the opposite is true.8
In PDD, symptoms can include trouble focusing, visual-spatial problems, or impairments in judgment. They may also have hallucinations, sleep disturbances such as REM sleep behavior disorder, and develop depression or anxiety.8
There is no cure for PDD, but the symptoms can be addressed with medications – although individuals with Parkinson’s may be very sensitive to drugs, so prior to starting any treatment, the medical team should be consulted.8
Frontotemporal dementia or Frontotemporal lobar degeneration
Frontotemporal dementia, also called frontotemporal lobar degeneration (FTD or FTLD) is actually a group of disorders whose main characteristic is neurodegenerative changes of the brain.
The symptoms can vary, but FTD is progressive, with changes in behavior and personality, as well as thinking and communicating. The three main areas of where these changes are seen include behavior, language, and/or motor function. FTD is caused by progressive damage and loss of nerve cells in both the frontal and temporal lobes of the brain; many people with the disease also have protein buildup that impairs normal functioning of these nerve cells as well.
There are no approved treatments for FTD, but the specific symptoms can be treated, and treatment mainly consists of managing symptoms.9
Creutzfeldt-Jakob disease
Creutzfeldt-Jakob disease (CJD) is a degenerative, fatal brain disorder. It usually occurs later in life, around 60 years of age, and most people die within one year of onset.
Early symptoms include memory problems, changes in behavior, coordination problems, and visual disturbances. As CJD progresses, symptoms can include significant mental impairment, involuntary movements, blindness, limb weakness, and coma. CJD is caused by abnormal forms of proteins called prions. There are normal prions and abnormal prions; an abnormal one is the cause of CJD. There is sporadic CJD in which there are no known causes, hereditary CJD caused by genetic mutations and acquired CJD caused by eating meat from cows infected with bovine spongiform encephalopathy (mad cow disease). There is no treatment to either control or cure CJD as of now.
Treatment typically focuses on minimizing symptoms and keeping the individual as comfortable as possible.10
Normal pressure hydrocephalus
Normal pressure hydrocephalus (NPH) is an abnormal accumulation of cerebrospinal fluid (CSF) in the brain. This makes the brain cavities get bigger, putting pressure on the brain.
Symptoms can include progressive cognitive impairment, dementia, trouble walking, and bladder control issues. Symptoms can mimic CJD, Parkinson’s, and other neurological diseases, so it’s important to rule out other diagnoses.
Treatment of NPH involves inserting a shunt into the brain to drain the excess CSF, enabling the brain to shrink back to its normal size.11
Primary progressive aphasia
Primary progressive aphasia (PPA) is a progressive disease that slowly causes damage to the areas of the brain responsible for speech and language.
Symptoms mainly include trouble expressing oneself in language or trouble knowing words for certain things or pronouncing words. Memory and cognition typically remain intact, although trouble with reading and writing may develop as the condition progresses.
Treatment usually entails speech therapy to learn alternate ways of expression.12
Huntington’s disease
Huntington’s disease is an inherited, progressive condition that causes the breakdown and cell death of nerve cells in the brain.
Symptoms typically arise in one’s 30s and 40s, but can also occur later or earlier in life. Symptoms usually involve movement, cognition, or mood, and can include involuntary jerking movements, muscle rigidity, abnormal eye movements, trouble organizing or focusing, lack of impulse control, perseveration, word finding difficulties, social withdrawal, sleep disturbances, and depression.
There are no treatments to stop or cure Huntington’s disease, but medications are used to address symptoms.13
Wernicke-Korsakoff Syndrome
Wernicke’s encephalopathy is a degenerative brain disorder caused by a deficiency of thiamine, or vitamin B1, and damages the thalamus and hypothalamus. Korsakoff syndrome is a memory disorder that is caused by a vitamin B1 deficiency and causes damage to nerve cells, as well as cells in the brain and spinal cord, especially those having to do with memory. While these are different syndromes, some scientists think they are actually different stages of the same disorder, which is why you’ll often see them linked together. These syndromes are associated with alcoholism, eating disorders, dietary deficiencies, and the effects of chemotherapy.
Symptoms can include confusion, vision problems, low blood pressure, lack of muscle coordination, and coma.
Treatment includes administration of vitamin B1, along with nutrition and hydration. Sometimes drug therapy is also involved. Most symptoms can be reversed, but memory function may never be fully recovered.14
If you’re experiencing cognitive symptoms, let your doctor know as much as you can about what’s going on. They will determine what tests to run to help provide you with an accurate diagnosis. Treatment is often specific to the neurological disease, so a correct diagnosis is crucial.
