Alzheimer’s vs. Dementia: Are They the Same Thing?

While you may hear people use the terms Alzheimer’s and dementia, do you know that they are not the same thing? If you didn’t, you are not alone, as these two terms are sometimes confused. Dementia is a general term describing multifaceted symptoms of cognitive decline. Alzheimer's is one type of dementia. You may think of it like this: Alzheimer’s is a type of dementia, like a “Cadillac is a type of car.”

Having a better understanding of dementia will aid in timely identification. Early diagnosis helps you to obtain information, treatment, and support. Treatment may vary depending on the type of dementia diagnosed.

What is dementia?

Dementia is an umbrella term describing a group of symptoms leading to progressive loss of memory and cognitive function. While dementia risk increases with age, dementia is not a normal part of aging. Normal aging may include low vision, impaired hearing, weakening muscles, and even minor memory lapses. Still, aging does not mean a person will develop dementia. To identify dementia, knowing the risk factors and warning signs will heighten awareness for early detection.

Five risk factors for dementia

• Increased age: The risk of dementia doubles every five years from ages 65 to 90, although signs of dementia can show in people under 60.
• Family history: A person is at a higher risk of developing dementia if they have a biological parent or sibling with the diagnosis.
• Race/ethnicity: Statistics show that older African Americans and Hispanics are at greater risk of dementia.
• Cardiovascular health: Hypertension, high cholesterol, and smoking cause an increased risk of dementia.
• Brain injury: If a person has had a severe brain injury in the past, the risk of developing dementia increases.

Ten warning signs of dementia

• Memory loss and confusion that affects everyday activities.
• New difficulty reading, writing, or solving everyday problems.
• Difficulty completing everyday, familiar tasks (i.e., preparing a meal).
• Disorientation to time or place (becoming lost in a previously familiar location).
• Difficulty with visual images or spatial information (i.e., Increased falls, difficulty driving).
• Difficulty finding the “right words” or using unusual words.
• Misplacing things and being unable to “retrace steps.”
• Repeating stories or questions.
• Loss of regard for people’s feelings or acting impulsively.
• Personality or mood changes (i.e., withdrawal from activities, apathy, impaired judgment).

If there are concerns about a person with one or more of these symptoms, they need to contact their healthcare provider. Screening tests will assess cognition, memory, attention, and problem solving. A physical exam, lab tests, and diagnostic imaging such as CT (computed tomography) or MRI (Magnetic resonance imaging) may identify the cause.

If the reason is dementia, treatment to manage symptoms or slow down the progression of the disease may be possible. Treatment may include medications and non-pharmacological therapies such as counseling by a therapist. The cognitive decline could also be from a treatable cause and may be reversible. Conditions such as depression, metabolic disorders, or adverse drug reactions can present as a cognitive impairment but may be repairable.

The most common types of dementia

Alzheimer’s Disease. Alzheimer's is the most prevalent type of dementia, responsible for 60 to 80% of all cases, and there is currently no known cure. The Alzheimer’s Association reports that over six million Americans may live with some stage of Alzheimer’s.

An accumulation of protein plaques called beta-amyloid between nerve cells is one of the features responsible. This plaque will clear on its own during sleep in a healthy person. Another protein called tau builds up as it tangles inside neurons. The accumulation of these two proteins disrupts nerve conduction impairing memory and function.

As time goes on, simple tasks become challenging to complete. Symptoms present gradually, so early changes in memory may go undetected. Families often compensate for the subtle deficits or don't recognize the significance. As a result, a marked decline may have already occurred when a person seeks medical attention. Treatment may include medications such as cholinesterase inhibitors to slow the progression of cognitive decline. Consult your medical practitioner to determine the best course of treatment.

Vascular Dementia. Vascular dementia occurs in about 10% of all dementias. Vascular disease can cause small areas of damage over time or have a sudden onset. Diagnostic imaging may confirm a diagnosis of vascular dementia by revealing areas of impaired circulation that damage brain tissue. The presentation of someone with vascular dementia depends on the location of the brain affected. Treating hypertension, diabetes, and high cholesterol by your medical practitioner may prevent further vascular damage.

Mixed Dementia. Mixed dementias are a combination of two or more types that occur concurrently and are often seen in people over 75 years of age. A common variety of mixed dementia is Alzheimer’s combined with vascular dementia. Another combination is Alzheimer’s and Lewy body dementia. People diagnosed with mixed dementia present with feature symptoms of more than one type. Therefore, assessment and treatment by a medical practitioner will determine the course of treatment based on the diagnosis.

Dementia with Lewy Bodies. Abnormal protein deposits called “Lewy bodies” cause this type of progressive dementia. The Lewy body protein develops in nerve cells and disrupts the neurotransmitter dopamine. This disturbance causes memory fluctuations, hallucinations, and impaired motor control. It is the second most common type of dementia after Alzheimer’s, with an estimated 1.4 million Americans affected.

People diagnosed with Parkinson’s disease and REM sleep disorder are at higher risk of Lewy body dementia. Incidents are more prevalent in men, and there is no known cure. Treatment with cholinesterase inhibitors to slow progression may be helpful, along with other medications to manage symptoms. A consultation with a medical practitioner will determine the best course of treatment.

Frontotemporal Dementia. Frontotemporal dementia (FTD) is a form of dementia in younger adults between the ages of 40 and 65. Nerve cells affected are in the frontal and temporal lobes of the brain. Frontal symptoms include socially inappropriate behavior such as stealing, swearing, impaired judgment, or sexual behavior. Temporal lobe changes present as types of aphasia associated with speaking or understanding. There is no known cure. Cholinesterase inhibitors are not helpful with this type of dementia and sometimes worsen symptoms. An accurate diagnosis by a medical practitioner will determine the best course of treatment.

Dementia is not one disease but is a general term representing multifaceted symptoms of cognitive decline. Alzheimer's is one type of dementia but is the most predominant in North America. Each type of dementia described here has a physiological cause that specifies treatment. Contacting a medical practitioner or Alzheimer's Association about memory concerns is the first step. Early detection and diagnosis will determine the treatment plan to optimize quality of life.