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In everyday conversation, it’s common to use the terms “Alzheimer’s” and “dementia” as if they mean the same thing. “A lot of people think they are interchangeable, but there are differences” Claire Sexton, D. Phil., director of scientific programs and popularization for Alzheimer Association, points out. Knowing the difference can help you (and, in turn, your loved ones) navigate the world of brain health a little easier and get the correct diagnosis.
Dementia vs Alzheimer’s disease
“Dementia is an umbrella term for a range of diseases characterized by cognitive decline, and then Alzheimer’s disease is the most common type of dementia under this umbrella,” explains Zaldy S. Tan, MD, MPH, director of the Cedars-Sinai Health System Memory and Aging Program. So, although they are related, they are not interchangeable terms. Dementia as a whole is tricky because “there is no questionnaire that you can fill out and say, ‘Oh, I have this type of dementia,’” says Dr. Tan. “It’s very complex and the presentations vary from person to person, so if you have two people and they both have Alzheimer’s disease, their presentation can be very different.”
Types of dementia
We think that 60-70% of people with dementia have Alzheimer’s disease, according to World Health Organization. However, the remaining 30-40% of dementia cases consist of a wide variety of conditions. For example, there is vascular dementia, Lewy body dementia, frontotemporal dementia, traumatic dementia, dementia associated with infectious disease, and even alcohol-related dementia-Just to name a few. “Each of them then has their own unique signature in the brain – their own characteristics, progression and symptoms – but they can also sometimes occur together, so there is a mixed pathology,” says Sexton. Dementia is just an umbrella term that refers to any condition that impairs cognition, but there are many conditions that can hinder intelligence. Alzheimer’s disease is the most common.
“The FDA approved drugs that we have are primarily for Alzheimer’s dementia because it is the most common type of dementia and the one that is the subject of the most research,” says Dr. Tan. “For other forms of dementia, such as Lewy body dementia, frontotemporal dementia, Parkinson’s dementia– there really is no specific drug approved by the FDA. However, he says, a person diagnosed with another form of dementia can still be prescribed a drug designed to treat Alzheimer’s disease. “The reason is that Alzheimer’s disease can coexist with other forms of dementia and treating it with these drugs can help a person’s overall memory or thinking,” says Dr. Tan.
How Alzheimer’s Disease Is Different
When onset, Alzheimer’s disease tends to affect your learning and memory more than other types of dementia, which could be more likely to impact your planning or language. In the brain of a person with Alzheimer’s disease, there are accumulations (often called plaques) of fragments of beta-amyloid protein between nerve cells as well as tangles of the tau protein within cells. Scientists aren’t sure exactly how these plaques and tangles contribute to Alzheimer’s disease, but some believe they disrupt communication between nerve cells and interfere with normal cellular processes, according to the Alzheimer Association. As the disease progresses and more of the brain is affected, a person may experience behavioral changes, confusion, delusions, and difficulty speaking or walking. Other types of dementia can progress differently, depending on the parts of the brain affected.
Where are mild cognitive impairments integrated?
Diagnosing and determining a person’s type of dementia can also be tricky because some people don’t have full-blown dementia – they have what doctors call mild cognitive impairment or MCI. With dementia, says Dr Scharre, you often need other people to do activities for you that you could handle on your own (like paying bills or turning on the TV), but with MCI you can still do those things. things even if you need a little incentive. (“Your cable bill is due soon, you should go online and pay it.” “Click on the black remote before the gray one to watch TV.”) “So you are forgetful, you are less efficient and you may have – need verbal cues, but you can still do the function yourself, that’s MCI, ”says Dr. Scharre.
What to do if you are worried about your memory
If you think you are having warning signs of dementia (like getting lost in a familiar place, forgetting things, or regularly skipping social events) the first thing you should do is see a doctor. Dr Scharre recommends asking for a cognitive assessment during your annual checkup so that your results can be compared from year to year and declines can be identified and treated immediately, just like a colonoscopy, screening for blood pressure or cholesterol test.
“As with any medical condition, generally the earlier you identify it, the more treatment options you have and generally the better off you are,” he says. “Some forms of dementia have treatable causes while others like Alzheimer’s disease are also treatable, but not reversible or curable. This new drug approved by the FDA for Alzheimer’s disease, for example, only works at the stage of mild cognitive impairment – this is where its sweet spot is and if you start to have even a little more than mild dementia, that is not helpful.
Your doctor will likely start with a detailed medical history and perform an exam cognitive assessment which helps identify which areas of the brain (such as those responsible for memory, language or decision making) are affected. The doctor will also do a physical exam neurological examination to test things like reflexes, motor skills, sensory ability, balance, coordination, and nerve function. Plus, “you might get an MRI of the brain or neuroimaging of the brain which can show things like inflammation, strokes, tumors and things of that nature,” says Dr Scharre. Finally, he says blood tests will help show if your kidneys, liver, and thyroid are working well and if your vitamin B12 levels are adequate. “You put all of these things together and generally the diagnosis is fairly straightforward if you have experience and knowledge of these different conditions,” says Dr. Scharre.
How to prevent dementia
Just because your mom or brother has developed some form of dementia doesn’t mean you are meant to have it as well. “The good news is that there is things we can do in our life to reduce our risk, says Sexton. “Stay active – physically active, cognitively active and socially active – and reduce cardiovascular risk factors. Obesity, hypertension and diabetes are other known risk factors for dementia. Therefore, monitoring and managing these conditions can help. Of course, there are no guarantees, but it is a good idea to do whatever you can now to reduce the likelihood that you will have dementia later.
“This is an extremely active area of research,” says Sexton. She says major discoveries are on the horizon in the areas of diagnostic blood tests for dementia, modifiable risk factors like air pollution and risk factors that vary between different populations of people. So keep an eye out for the news and check out these sites to see if you or a loved one qualifies to participate in research studies.
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