What’s the difference between dementia and Alzheimer’s?
These terms are often used interchangeably, but they actually have different meanings. Dementia is not a specific disease. It’s an umbrella term for a group of brain disorders that make it hard to remember, think clearly, make decisions, or even control your emotions. It describes a wide range of symptoms. These symptoms affect people’s ability to perform everyday activities on their own. Common symptoms of dementia include:
- A decline in memory
- Changes in thinking skills
- Poor judgment and reasoning skills
- Decreased focus and attention
- Changes in language
- Changes in behaviour
Types of Dementia
Vascular dementia: This is the second most common type. About one in 10 people who have dementia have vascular dementia, which causes progressive damage to the brain due to blood vessel damage or blockages that lead to mini-strokes or brain bleeding. Doctors used to call it multi-infarct or post-stroke dementia
Unlike Alzheimer’s disease, memory loss isn’t the typical first symptom. Instead, people with vascular dementia can have different signs, depending on the area of the brain that’s affected, such as problems with planning or judgment. Currently, there are no approved drugs to treat this type of dementia, but you can do some things to keep your brain and blood vessels healthy and try to prevent future damage. These include exercising, controlling blood pressure and cholesterol, and not smoking
Dementia with Lewy bodies: Lewy bodies are abnormal clumps of alpha-synuclein protein. They build up in your cortex, the part of your brain that handles learning and memory. This type of dementia causes problems with attention and things like driving early on, along with sleeping issues, seeing things that aren’t there (hallucinations), and slowed, unbalanced movements, similar to Parkinson’s disease symptoms. Memory loss tends to show up later in the disease
Mixed dementia: Sometimes, a person has brain changes caused by more than one type of dementia. This is called mixed dementia. For example, you may have blocked or damaged blood vessels in your brain (vascular dementia) and brain plaques and tangles (Alzheimer’s disease) at the same time
Frontotemporal dementia (FTD): This form of dementia involves the loss of nerve cells in the front and side areas of your brain — behind your forehead and ears. Personality and behaviour changes and trouble with language are the main symptoms. Some people also have a hard time with writing and comprehension
Symptoms usually show up around age 60 — earlier than they usually start with Alzheimer’s disease. Types of frontotemporal dementia include behavioural variant FTD (bvFTD), primary progressive aphasia, Pick’s disease, corticobasal degeneration, and progressive supranuclear palsy
Creutzfeldt-Jakob disease (CJD): This rare form of dementia happens when a protein, called a prion, folds into an abnormal shape, and other proteins start to do the same. This damages brain cells and triggers a fast mental decline. People with CJD also have mood changes, confusion, twitchy or jerky movements, and trouble walking. Sometimes, the disease is passed down through families, but it also can happen for no known reason. One type, called variant CJD (or mad cow disease, also known as bovine spongiform encephalopathy), has spread from cattle to people in certain situations
Huntington’s disease: This is caused by a problem with a gene you get from one of your parents. It affects the central part of your brain — the area that helps you think, move, and show emotion. Symptoms typically start between ages 30 and 50. Uncontrolled arm, leg, head, face, and upper body movements are the first signs. The brain changes also lead to problems with memory, concentration, judgment, reasoning, and planning. People with Huntington’s disease also have issues with depression, anger, and crankiness. There’s no known cure for it
Normal pressure hydrocephalus: The Alzheimer’s Association includes this buildup of spinal fluid in the brain as a form of dementia. Symptoms include slowed thinking, problems with decision making, trouble concentrating, behaviour changes, difficulty walking, and loss of bladder control. It typically strikes adults in their 60s or 70s. Surgery to put a shunt in your brain to get rid of extra fluid can help
While dementia is a general term, Alzheimer’s disease is a specific brain disease. It is marked by symptoms of dementia that gradually get worse over time. Alzheimer’s disease first affects the part of the brain associated with learning, so early symptoms often include changes in memory, thinking and reasoning skills. As the disease progresses, symptoms become more severe, including confusion, behaviour changes and other challenges
Alzheimer’s Disease (AD)
This is the most common type of dementia. About 60% to 80% of people who have dementia have Alzheimer’s. It’s a progressive condition, which means it gets worse over time, and it usually affects people over 65 years old. There’s currently no cure
It happens when proteins (called plaques) and fibres (called tangles) build up in your brain and block nerve signals and destroy nerve cells. Memory loss may be mild initially, but symptoms worsen over time
Common Alzheimer’s symptoms include:
- Trouble remembering names, events, or conversations
- Problems concentrating
- Personality changes, like not caring about things you used to, mistrust of others, or aggression
- Mood changes
- Depression
- Impaired judgment or decision making
- Confusion
It gets more difficult to carry on a conversation or do everyday tasks. A doctor can’t say you have Alzheimer’s with absolute certainty, but there are things they can do to be fairly sure. They include testing your attention, memory, language, and vision and looking at images of your brain. These images are taken with an MRI (magnetic resonance imaging) machine, which uses powerful magnets and radio waves to make detailed pictures
Treating Alzheimer’s Disease vs. Other Types of Dementia
Neither Alzheimer’s nor most other types of dementia have a cure. Doctors focus treatments on managing symptoms and keeping the disease from getting worse
Some of the treatments for dementia and Alzheimer’s overlap
- Cholinesterase inhibitors can help with memory loss in certain types of dementia and Alzheimer’s
- Glutamate inhibitors help with learning and memory in both dementia and Alzheimer’s
- Sleep medications may help with sleep changes
- Antidepressants can help with depression symptoms
- Antipsychotic medications may help with behaviour changes
Some types of dementia respond to treatment, depending on what is causing it. Your doctor may recommend:
- Stopping the use of drugs and alcohol
- Treating a B12 deficiency
- Treating hydrocephalus (extra fluid on the brain)
- Getting blood sugar under control
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