The terms Alzheimer’s disease and dementia are often used interchangeably, but they’re not synonymous.
Misuse of these terms abounds with general confusion around the topic, and misconceptions spread as people continue to use these terms incorrectly.
You’ll come away from this article with a clear understanding of the difference between Alzheimer’s disease and dementia, as well as a general overview of Alzheimer’s disease and related dementias (collectively referred to as ADRD).
Dementia is a general term to describe symptoms of cognitive impairments – like difficulty with memory, reasoning, language, judgment, and other thinking skills – that is severe enough to interfere with a person’s daily life.
Alzheimer’s is a specific disease that causes dementia, but other diseases and conditions can too.
Alzheimer’s is one specific disease that causes dementia – symptoms of cognitive decline including memory loss, confusion, and difficulty with reasoning, planning, and other thinking skills.
There are many different diseases and conditions which cause dementia. Some of them are reversible and some are not.
Dealing with the prospect of dementia in yourself or a loved one can be frightening or overwhelming, but it’s important to seek an accurate diagnosis as early as possible. Treatments vary from one form of dementia to the next.
Furthermore, some forms of dementia can be reversed. Even if not, it’s often possible to slow future decline, but lost functioning can’t usually be regained.
Consider a sore throat, for example. A sore throat is a symptom that can be caused by many different illnesses and conditions such as strep throat, allergies, or a cold.
Likewise, when a person has dementia, they’re experiencing symptoms of cognitive decline. These symptoms of dementia could be caused by several different conditions, such as Alzheimer’s, Huntington’s disease, Parkinson’s disease, strokes, or even medication side effects or nutritional imbalances.
Each type of dementia has a different prognosis and specific symptoms. Let’s take a closer look at some of the major conditions that cause dementia.
The most common cause of dementia is Alzheimer’s disease, but there are many different forms. Many, like Alzheimer’s disease, are irreversible, but some forms of dementia can improve with treatment.
While most Alzheimer’s disease occurs in adults over the age of 65, early onset Alzheimer’s can affect people in their 30s or 40s. Alzheimer’s starts relatively mild and gets progressively worse over time. Healthcare providers and caregivers often refer to the stages of Alzheimer’s disease. Different scales describe the progression of the disease using various numbers or terms. The simplest and most widespread way to describe it is mild (early stage), moderate (middle stage), or advanced (late stage).
Treatments: There’s no cure, but there are treatments to ease the symptoms of Alzheimer’s or slow the rate of decline.
In 2021, a new, first-of-its-kind drug was approved for the treatment of Alzheimer’s. Called Aducanumab, this is the first drug to address the underlying cause of Alzheimer’s, the beta-amyloid plaques and tangles that accumulate in the brain. The drug is controversial because there’s currently little to no evidence that aducanumab can restore lost memory or cognitive function. However, it may slow future decline – just one of the many reasons that early diagnosis is so important in Alzheimer’s disease and dementia.
Symptoms: Symptoms can include memory loss, confusion, impaired judgment, difficulty following directions or learning new information, difficulty with language, handling money, or solving problems, limited attention span, and changes in mood, personality, or behavior. Symptoms of advanced Alzheimer’s disease also include extreme difficulty with communication, incontinence, inability to care for self, and difficulty swallowing (which often leads to aspiration pneumonia, a common cause of death for people with advanced Alzheimer’s disease.)
Risk factors: Advancing age, Down’s syndrome, and family history (especially for early onset Alzheimer’s). Head injuries, cardiovascular disease, hearing loss, depression, isolation and loneliness, and a sedentary lifestyle also appear to add to the risk.
Prevention: To reduce the risk of developing Alzheimer’s, treat hearing loss and depression, stay active, eat a heart-healthy diet full of fresh fruits and vegetables, stay engaged socially and mentally, stop smoking, maintain a healthy weight, and control cholesterol, blood pressure, and blood sugar levels.
Have you or a loved one recently been diagnosed with Alzheimer’s? Consider these 12 Questions to Ask Your Loved One’s Doctor After an Alzheimer’s Diagnosis
Vascular dementia develops when blood flow to brain cells is interrupted. This can be caused by strokes or damage to the blood vessels or circulatory system. When cognitive impairment suddenly occurs after a stroke, it’s sometimes called post-stroke dementia. Other types of vascular dementia develop more gradually over time.
Treatments: There’s no way to reverse the damage that’s already been done to the brain. Certain medications can sometimes slow the progression of vascular dementia, reduce the risk of strokes, or lower other risk factors by treating cholesterol, diabetes, or blood pressure. Physical, occupational, or speech therapy can sometimes help a person improve functioning or learn new ways to make everyday life easier.
Symptoms: The symptoms of vascular dementia vary depending on the parts of the brain that are affected. They can include confusion, trouble concentrating, disorganized thinking, difficulty planning, problem-solving, or making decisions, memory problems, restlessness, depression, or apathy.
Risk factors: Advanced age, history of strokes, heart attacks, atrial fibrillation, diabetes, high blood pressure, high cholesterol, obesity, and smoking.
Prevention: To reduce the risk of vascular dementia, eat a heart-healthy diet, control cholesterol, quit smoking, exercise regularly, and maintain a healthy weight, blood pressure, and blood sugar levels.
Frontotemporal dementia (FTD) refers to several brain diseases that affect the frontal and temporal lobes – areas responsible for behavior, language, and personality.
Most of the variants of FTD are classified as Behavioral Variant FTD (also called Pick’s disease) or Primary Progressive Aphasia. Some FTD disorders – like ALS (“Lou Gehrig's Disease”) primarily affect motor skills.
FTD is the most common type of dementia affecting individuals under 60, however, it’s generally not well understood, and it’s often misdiagnosed.
The Association for Frontotemporal Degeneration provides information, support, and resources for those living with FTD.
Treatments: There are no cures for FTD or even any known way to slow its progression, so treatment focuses on managing symptoms and supporting the person with FTD and their caregivers.
Symptoms: People with FTD may become impulsive, socially inappropriate, or emotionally flat. They may have increasing difficulty with speech and language. They may also experience dramatic personality changes. Symptoms tend to get worse over time.
Risk factors: A family history of FTD is the only known risk factor.
Prevention: Because there are no known modifiable risk factors for frontotemporal dementia, there is no known way to prevent it.
Lewy body dementia (LBD) is a common cause of dementia, affecting more than a million Americans, usually over the age of 50. LBD includes both dementia with Lewy bodies (DLB) and Parkinson’s disease dementia. LBD is easily misdiagnosed because its symptoms can be mistaken for psychiatric conditions, Alzheimer’s disease, or other brain diseases.
Parkinson’s disease dementia: In Parkinson’s disease dementia, movement and motor symptoms develop first with cognitive, behavioral, and mood symptoms developing much later. Not everyone with Parkinson’s develops dementia.
Treatments: Certain medications may be able to help manage movement or sleep-related symptoms, however, LBD can affect the way the body responds to medications, so it’s important to have an accurate diagnosis and work with a healthcare provider knowledgeable in the condition. Treatment tends to focus on supporting the person with LBD and their caregivers.
Symptoms: Some of the hallmarks of LBD include visual hallucinations, unpredictable changes in mental status (concentration, alertness, etc), and sleep disorders. Rigid muscles, Parkinsonian-like movements, balance problems, and difficulty swallowing or speaking are common in the later stages. Behavior and mood changes are common and often worsen over time.
Risk factors: Age is the main known risk factor for LBD. REM sleep behavior disorder and having a family member with LBD appear to somewhat increase the risk.
Prevention: There’s no known prevention for LBD.
Creutzfeldt-Jakob disease (CJD) is a very rare form of dementia that progresses extraordinarily quickly, in a matter of months rather than years. The disease is usually fatal within one year.
Treatment: No treatment exists for CJD. The goal of treatment is to support the patient’s comfort.
Symptoms: Rapid mental decline, memory loss, incoordination, difficulty speaking and swallowing, jerky movements, insomnia.
Risk factors: There are three potential ways to contract CJD.
Prevention: There’s no known prevention for sporadic or familial CJD. To minimize the risk of contracting CJD via contaminated tissue, the U.S. government enforces strict policies regarding infection control procedures in healthcare and cattle handling facilities. Read more about CJD infection control measures at CDC.gov.
Adult-onset Huntington's disease typically occurs in individuals in their 30s or 40s. Rarely, children can also develop the disease.
Treatment: There is no cure or treatment to slow the progression of Huntington’s disease, but medications may be able to help with symptoms like anxiety, depression, and uncontrollable movements. Physical, occupational, and speech therapists can help develop ways to counter motor symptoms. Support for the person with Huntington’s and their family or caregiver is also important.
Symptoms: Symptoms vary from one person to another, but often include personality changes, mood swings, depression, memory loss, judgment impairment, movement disorders, difficulty speaking or swallowing, and significant weight loss.
Risk factors: Huntington’s disease is a genetic brain disease. Children of a parent with the gene mutation have a 50% chance of developing the disease. Genetic testing is possible for adults over the age of 18, but it’s important to consult with a genetic counselor before deciding to do so.
Prevention: Individuals at risk for Huntington’s disease who wish to have a baby, but want to ensure they’re not passing on the gene, have options for prenatal genetic planning. Learn more at the Huntington’s Disease Society of America.
Mixed dementia is a term used when more than one type of dementia exists simultaneously. The most common combination is Alzheimer's and vascular dementia. Dementia with Lewy Bodies is also common.
Some people have three types of dementia at once. A study funded by the National Institute on Aging (NIA) adds to the evidence base which suggests that many people with mixed dementia aren’t properly diagnosed. Most are diagnosed simply as having Alzheimer’s disease.
Treatment: It’s important to accurately diagnose which types of dementia are present so that treatments can be prescribed appropriately, based on the types of dementia identified.
Symptoms: Symptoms vary widely, based on the types of dementias that are involved and the areas of the brain that are affected.
Risk factors: There are currently no known risk factors specific to mixed dementia. However, there are several modifiable risk factors for dementia in general, which include hearing loss, low level of education, smoking, depression, physical inactivity, traumatic brain injury, social isolation, hypertension, exposure to air pollution, obesity, diabetes, and excessive alcohol use.
Prevention: To reduce the risk of dementia:
People with MCI experience more difficulty with memory and thinking skills than other people their age, but the symptoms aren’t so bad as to significantly interfere with their daily life.
Many people with MCI go on to develop Alzheimer’s disease, but not all do.
Symptoms: Frequently losing items, forgetting appointments, or having difficulty with word-finding.
Risk factors: Advanced age, presence of a gene called APOE e4
Prevention: MCI can’t always be prevented, but research has shown that controlling certain environmental factors can reduce the risk of cognitive decline.
Many forms of dementia can’t be reversed, but some can. The most common reversible type of dementia comes from depression. When depression causes cognitive functioning to slow so much that it resembles dementia it’s sometimes called pseudodementia. In these cases, thinking ability can be restored by treating the depression, often by some combination of talk therapy and antidepressant medication.
Other treatable dementias can result from medication side effects, drug or alcohol misuse, brain lesions, normal pressure hydrocephalus, hypothyroidism, and vitamin B-12 deficiency.
Not all older adults develop dementia or even experience significant memory problems. Many maintain excellent brain health and cognition throughout their life, even in advanced age.
Mild forgetfulness – such as misplacing your keys or forgetting the name of an old acquaintance – can be considered a normal part of aging, and is no cause for concern.
However, significant memory problems – like difficulty following directions, frequent repetitive questions, trouble taking care of oneself, or confusion about people, time, or familiar places – should be referred to the doctor for evaluation.
Laura Herman is an Elder and Dementia Care Professional with 23 years of experience working with seniors with dementia. She has served in a variety of roles ranging from front-line caregiver to memory care facility administrator. Her blog "ABC Dementia", or Appreciating Behavioral Communication in Dementia, focuses on helping professional and family caregivers understand and respond to behaviors in dementia.
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