What Is the Difference Between Dementia and Alzheimer’s Disease?
Alzheimer’s is the most common type of dementia
Alzheimer’s is the most common type of dementia
Alzheimer’s disease and dementia are often used to mean the same thing, but there is a difference.
Dementia is a syndrome, not a specific disease. It is a general term, like heart disease. It describes a group of symptoms that affect memory, reasoning and daily tasks. Different diseases that affect the brain cause dementia.
In contrast, Alzheimer’s disease is a specific illness and the most common cause of dementia. It is a progressive condition that gets worse over time. Other types of dementia include vascular dementia and Lewy body dementia. Parkinson's disease and frontotemporal dementia.
Currently there is no cure for dementia. However, treatments are available that can help manage symptoms and, in some cases, slow the progression of the disease.
Alzheimer’s disease accounts for 60 to 80 percent of people with dementia, according to the Alzheimer’s Association. About 6.7 million people, mostly aged 65 and older, have this disease in the United States. Alzheimer’s is the third leading cause of death in California and the sixth in the U.S.
“The sooner we can diagnose and treat someone with Alzheimer’s disease, the better that person’s quality of life,” says Gregory Sahagian, MD, a neurologist at Scripps Clinic and medical director of Scripps neuroscience services. “If you or a loved one is approaching the age where your risk for Alzheimer’s disease begins to increase, talk to your physician about screening.”
Is dementia part of aging?
Age is the main risk factor for dementia, with risks rising after age 65. However, dementia is not a normal part of aging.
It’s normal to forget things sometimes as we get older. However, dementia symptoms are much more severe. Repeated memory problems are often the first warning sign.
Early onset Alzheimer’s is less common. It happens in fewer than 10 percent of cases, typically appearing in the 40s and 50s.
Other risk factors
Genetics plays a role, especially in Alzheimer’s disease. People with a family history of the disease have a higher risk. Other risk factors include head injuries, heart disease and lifestyle factors, such as smoking and lack of physical activity.
Women account for about two-thirds of Alzheimer's disease cases. This may be due to women living longer than men.
African American and Hispanic seniors have a higher risk of Alzheimer’s disease. This may be due to health disparities, including limited access to the resources they need for good health.
Could it be something other than dementia?
Some people may show symptoms like dementia but do not have the disease. These symptoms can have other causes like depression, untreated sleep apnea or delirium.
Some medications can also cause similar symptoms. Other possible causes include thyroid problems, certain vitamin deficiencies and alcohol abuse. These issues are usually treatable and can be reversed.
What causes Alzheimer’s disease?
The exact cause of Alzheimer’s disease is not fully known, but research continues. Many factors may influence who develops the disease.
A main feature of Alzheimer’s is the amyloid plaques and tau tangles that build up in the brain. These plaques and tangles interfere with how brain cells work and communicate with each other.
As people age, they often get some plaques and tangles in their brains. However, people with Alzheimer’s often have many more of these.
What are the stages of dementia?
Stages of dementia can vary depending on the underlying cause. Some forms of dementia, like Lewy body dementia and frontotemporal dementia, may progress rapidly over a few years.
Alzheimer’s disease develops in stages, starting from mild and moving to severe. The first cells to get damaged are in the parts of the brain that control memory, language and thinking.
At first, a person may find it hard to remember recent events or talks. They might keep asking the same question repeatedly.
As the disease worsens, more serious symptoms show up. The person may feel confused and lost. They might also begin to mistrust their loved ones and caregivers. Serious memory loss can happen, along with problems with communication, movement and swallowing.
Caregiving becomes more important as the disease gets worse. Over 16 million adults care for someone with Alzheimer’s or another type of dementia. If the family cannot hire a professional caregiver, someone else must take care of the person in need. This responsibility often falls on the spouse, children or other family members and friends.
How is diagnosis done?
There is no specific test for Alzheimer’s disease. Recognizing symptoms is key for diagnosis and treatment.
Neurologists and other specialists diagnose and manage patients with Alzheimer’s and other types of dementia. A series of tests is needed to make a diagnosis. These may include memory and cognitive evaluations, physical and neurological tests, lab work, brain scans and genetic testing.
“We can diagnose Alzheimer’s disease through clinical examination,” Dr. Sahagian says. “Careful evaluation of the patient’s mental state and a medical history will result in a highly accurate diagnosis.”
Common types of brain scans are computerized tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET).
PET imaging and other biomarker tests, including blood tests, are becoming more common as the technology involved improves. PET can measure amyloid plaques and tau tangles in the brain, which are hallmark features of Alzheimer’s disease.
Biomarker tests can check the levels of certain proteins in the blood or cerebrospinal fluid. These tests can help find early signs of Alzheimer’s, even before symptoms show up.
What are treatments?
Treatments for Alzheimer’s and other forms of dementia focus on managing symptoms and enhancing quality of life through medications for memory and behavior. Medications can help patients stay at home longer. They can also delay the need for long-term care.
There are two classes of oral medicines to treat symptoms of Alzheimer’s. They help improve memory loss, confusion and problems with thinking and reasoning related to the disease.
Cholinesterase inhibitors help with mild and moderate symptoms. They prevent the breakdown of acetylcholine, a neurotransmitter or chemical messenger that plays a key role in learning and memory.
Three types are commonly prescribed:
- Donepezil
- Rivastigmine
- Galantamine
Side effects may include nausea and upset stomach.
Memantine treats moderate to severe symptoms. It lowers the amount of glutamate in the brain. In Alzheimer's patients, too much glutamate can be harmful.
Doctors may prescribe memantine along with other treatments. Side effects may include headaches, constipation, confusion and dizziness.
Can dementia be prevented?
There is no certain way to prevent dementia or Alzheimer’s disease. However, you can lower your risk with some lifestyle changes.
Eat a healthy diet and stay active. Do not smoke and manage your stress. Stay socially engaged or keep your mind active.
Regular health screenings can detect risk factors for dementia, such as high blood pressure, diabetes and high cholesterol.
Is a cure coming soon?
Researchers are working to better understand, prevent and treat these conditions. Currently, there are limited treatment options but there have been significant advancements.
“As the aging population increases and the disease becomes more common, we are learning more and more about diagnosis, symptoms and treatment,” Dr. Sahagian says. “We have greater understanding of how Alzheimer’s disease affects the brain, and this has resulted in promising new research.”
Treatments and support at Scripps
Scripps provides specialized care and support for people with Alzheimer’s and other forms of dementia. This includes cognitive screens, memory testing, standard imaging tests and advanced radiology studies. In addition, Scripps partners with other local agencies to offer guidance and support to patients and their families.