2/26/22 by Nicole Ruggiano, PhD, MSW
When I’m working in the community, one of the most common questions I get from caregivers is, “What is the difference between Alzheimer’s disease and dementia?” The truth is, they are the same thing, though the answer is a little more complicated than that.
Dementia is a syndrome, which is a medical term for a group of symptoms that a person has at the same time. People with dementia often have multiple symptoms, such as memory loss, confusion, and personality changes. Alzheimer’s is a disease that causes many of the symptoms we see in people with dementia. However, Alzheimer’s disease is only one condition that causes dementia symptoms.
Alzheimer’s disease
The brain has billions of neurons that communicate with each other for daily functioning. For people with Alzheimer’s disease, proteins in the brain begin to clump together and form plaques and tangles between the neurons. These protein clumps will cause the neurons to die. It also makes it hard for the neurons to communicate with one another. When enough neurons die, the person may start to show signs of forgetfulness and confusion.
The Alzheimer’s Association has a set of diagrams that show this process that can be viewed here.
Vascular Dementia
This type of dementia happens when there is reduced blood flow to the brain that causes damage to the brain. For instance, diabetes and high blood pressure can start to damage the brain over time if they aren’t controlled. Also, a stroke may block blood flow to the brain and cause damage. This damage may result in confusion and memory loss, just like Alzheimer’s disease.
Lewy Body Dementia
Like Alzheimer’s disease, Lewy Body dementia is caused by proteins clumping together in the brain. However, the proteins that cause Lewy Body dementia are different than the ones in Alzheimer’s disease. People with Lewy Body dementia often have memory problems and confusion, but it is different from Alzheimer’s disease in that it impacts the person’s movement. It may cause the person to shake or cause stiffness that makes it difficult to walk. The proteins that cause Lewy Body dementia are also related to Parkinson’s disease, which also causes problems with movement. Lewy Body dementia can also cause hallucinations.
Frontotemporal Dementia
FTD can be caused by multiple conditions (like a stroke), but refers to damage that occurs in the parts of the brain behind the forehead or ears. So, it impacts the functions that take place in those parts of the brain. FTD may make it difficult to talk or carry on a conversation. They may also have odd behaviors.
My Own Story of Grandmom Lilian
Often, primary care providers tell families that their loved one has dementia, but do not give them more information on the types of dementia or what to expect. Back in the 1990s, my grandmother, Lilian, developed dementia. Doctors thought it was due to a set of mini strokes that no one knew she had. Over time, her speech got worse until she mainly communicated with us using gibberish that no one else could understand. She would carry on conversations that did not make sense even though she seemed to think that she was having real conversations. It wasn’t until I became a researcher that I realized she had FTD, which caused her communication problems. I asked my Dad if any doctors ever told him that and he said that no one had ever told him that.
Why Does It Matter?
The different types of dementia have many of the same symptoms. However, there are good reasons to try and get a good diagnosis when someone looks like they have dementia.:
- While medications cannot cure causes of dementia, there may be medications that help with some of the symptoms associated with them.
- Caregivers may be able to seek out other caregivers dealing with the same type of dementia to learn more from each other and have good moral support from other who understand.
- By better understanding the changes we see with our loved ones can help family members cope better with the challenges associated with dementia.
The Take Away
Keep track of your loved one’s symptoms. Families often report memory issues and confusion that their loved one has because those are the behavioral changes that upset them the most. However, changes in movement or speech can give a provider more information to help with clinical decision making. When you see changes in your loved one, make a note of:
- What changes you see.
- When they happen (for instance, in the morning or at night).
- How often they happen.