| Alzheimer's isn't the only explanation for dementia. | | | | brain and brain stem. The onset of Parkinson's |
| Other causes include vascular dementia caused by | | | | disease itself involves damage to nerve cells that |
| strokes, Lewy body disease, Parkinson's disease, | | | | control muscle movement. |
| frontotemporal dementia, and other disorders. Proper | | | | How the symptoms compare to Alzheimer's: The |
| diagnosis can influence treatment. | | | | symptoms of Parkinson's are usually diagnosed first |
| Dementia isn't a disease; it's a symptom. The term | | | | because the dementia develops in the disease's later |
| refers to a loss of brain function, as evidenced by | | | | stages. Parkinson's dementia does not typically |
| memory loss, impaired judgment, behavior changes, | | | | involve problems with language. |
| learning difficulties, and communication problems. One | | | | How it's diagnosed and treated: When dementia |
| in seven Americans over age 70 has some form of | | | | occurs in someone with Parkinson's, a medical history, |
| dementia, according to 2007 data from the nationally | | | | physical exam, and neurological exam are used to rule |
| representative Health and Retirement Study -- but | | | | out other possible causes. There are no approved |
| not all dementia is alike. It's caused by a variety of | | | | medications for treatment of dementia with |
| illnesses, some of which can be treated. | | | | Parkinson's disease, although symptoms can be |
| The number-one thing to do when someone exhibits | | | | managed as part of the overall therapy to manage |
| memory loss or other mental or behavioral changes is | | | | the effects of the disease. |
| to make sure the person gets a thorough medical | | | | What it is: Frontotemporal dementia is associated |
| evaluation. | | | | with rare diseases or disorders that affect the frontal |
| Alzheimer's disease accounts for most cases of | | | | lobe or front of the temporal lobes of the brain. Pick's |
| dementia -- 69.9 percent. In fact, the older the | | | | disease is one example. Pick's involves abnormal |
| person, the more likely that the problem is due to | | | | deposits of the tau protein in the brain (called Pick |
| Alzheimer's disease: Alzheimer's accounts for almost | | | | bodies). Damage to the frontal and temporal lobes |
| 80 percent of dementia in people age 90 or older, | | | | affects personality, memory, and behavior. |
| compared with just 46.7 percent among people in | | | | How the symptoms compare to Alzheimer's: |
| their 70s. | | | | Frontotemporal dementia is associated with impaired |
| But other diseases, disorders, and medical conditions | | | | judgment, changes in personality, mood swings, |
| share similar symptoms and may be managed in | | | | problems with language, and a decreased interest in |
| different ways. Unlike Alzheimer's, some of these | | | | activities that were once enjoyed. Symptoms can |
| other dementias can be reversible. | | | | occur suddenly. |
| Note: Early memory problems aren't always | | | | Though frontotemporal dementia is a progressive |
| considered dementia. When they show up on | | | | disease, personality and behavioral symptoms tend to |
| memory tests but don't significantly affect daily living, | | | | occur early on, whereas disorientation (getting lost) |
| mental impairments may reflect a lesser condition | | | | tends to occur late. (It's typically reversed in |
| known as mild cognitive impairment (MCI). | | | | Alzheimer's.) Semantic memory (memory of the |
| What it is: Vascular dementia accounts for 17.4 | | | | meaning of words and objects) is more affected |
| percent of all cases of dementia. It happens when a | | | | than episodic (time related) memory. |
| stroke interferes with blood flow to the brain. Usually | | | | Uninhibited or inappropriate behavior is common in |
| the culprit is multiple small strokes (infarcts) caused | | | | people with frontotemporal dementia. They may |
| by blood clots or thickened or ruptured small arteries | | | | demonstrate a marked lack of empathy, acting |
| that connect to the center of the brain. (This is called | | | | without regard to what other people think or feel. |
| multi-infarct dementia.) It may also be caused by one | | | | How it's diagnosed and treated: In addition to the |
| big stroke (which would be referred to as | | | | findings of a full medical exam, a brain scan may |
| post-stroke dementia). | | | | show evidence of atrophy (deterioration) of the |
| How the symptoms compare to Alzheimer's: Vascular | | | | frontal or temporal lobes. There are no medical |
| dementia may appear to be Alzheimer's because it, | | | | treatments available, so the emphasis is on managing |
| too, involves memory problems, confusion, | | | | symptoms for better quality of life. |
| disorientation, and trouble following directions. In this | | | | What it is: This fatal disease is caused by a genetic |
| condition, however, recall of day-to-day events | | | | abnormality that destroys certain nerve cells in the |
| (episodic memory) becomes impaired, but recognition | | | | brain and lowers levels of neurotransmitters. Mental, |
| -- of people, for example -- doesn't. Alzheimer's | | | | emotional, and behavioral declines follow. |
| generally affects both. | | | | Although HD victims are born with the defective |
| Unlike Alzheimer's, vascular dementia often begins | | | | gene, they don't usually experience symptoms until |
| abruptly. Memory loss may progress to hallucinations, | | | | middle age. If a parent has the defective gene, |
| agitation, or withdrawal. Symptoms may clearly | | | | there's a 50 percent chance that a child will have |
| worsen after each successive stroke. | | | | inherited the gene. Some 30,000 Americans have HD. |
| Other signs of possible stroke may be observed, | | | | How the symptoms compare to Alzheimer's: |
| such as garbled speech, dizziness or loss of | | | | Common symptoms include personality changes, |
| coordination, or weakness on one side of the body | | | | mood swings, and disorientation. Attention and |
| (face or limbs). These signs may not be apparent in | | | | judgment can be impaired early in the disease, while |
| very small strokes. Some people have both | | | | memory loss occurs later. |
| Alzheimer's and vascular dementia. | | | | As with Parkinson's, someone with Huntington's |
| How it's diagnosed and treated: It's relatively easy | | | | disease has involuntary movements that appear |
| for a physician to determine whether dementia has a | | | | jerky, clumsy, or irregular. They may appear to |
| cerebrovascular cause. An MRI or CT scan will show | | | | fidget. Eventually they lose the ability to walk, talk, |
| evidence of a stroke. A history of stroke or | | | | and swallow. |
| cardiovascular problems, as well as smoking, high | | | | How it's diagnosed and treated: Huntington's disease |
| cholesterol, high blood pressure, and diabetes are | | | | can be diagnosed by a blood test to look for the |
| major risk factors. Treating these factors can slow | | | | genetic defect. There's no cure or medical treatment, |
| the progress of dementia symptoms. | | | | so treatment focuses on improving quality of life. |
| There are no medications approved for vascular | | | | Sometimes a bacterial or viral infection that enters |
| dementia, although those used for Alzheimer's are | | | | the brain can cause dementia. For example, when |
| sometimes prescribed to help cognitive symptoms, | | | | HIV develops into AIDS, it may cause a person to |
| with mixed results. In 2006, donepezil (Aricept) was | | | | experience problems with memory and concentration, |
| linked to 11 deaths in a clinical trial evaluating its use | | | | a loss of motivation, and decreased interest in things |
| for vascular dementia, compared with none in the | | | | that were previously enjoyed. The presence of other |
| control group. | | | | AIDS symptoms, along with an HIV (blood) test, will |
| What it is: Lewy body disease occurs when protein | | | | help a physician determine whether the dementia is |
| deposits in the brain called Lewy bodies (named for | | | | HIV related. |
| Friederich Lewy, who discovered them in the early | | | | Creutzfeldt-Jakob disease is another example. It's |
| 1900s) impede normal cognitive function. Some | | | | very rare -- one case per million people per year. |
| researchers consider DLB the second most common | | | | ("Mad cow disease" is one form.) Creutzfeldt-Jakob |
| form of dementia, accounting for up to 20 percent | | | | disease is caused by transmission of a prion (an |
| of cases. Others believe DLB may be a subtype of | | | | infectious protein). The prions infect and subsequently |
| Alzheimer's disease rather than a separate disease. | | | | destroy the brain's nerve cells. Unlike dementia |
| How the symptoms compare to Alzheimer's: | | | | caused by Alzheimer's, memory problems and |
| Symptoms of both can include confusion, problems | | | | behavioral changes caused by Creutzfeldt-Jakob |
| with concentration, and some memory impairment. | | | | disease progress very quickly. |
| Hallucinations tend to be more common. Like | | | | A physician may diagnose Creutzfeldt-Jakob disease |
| Alzheimer's, DLB is progressive. People with | | | | through a medical history, a neurological exam, an |
| Alzheimer's have good days and bad days, but | | | | electroencephalogram (or EEG, which tracks the |
| people with DLB may experience changes more | | | | electrical activity in the brain), a brain scan (an MRI |
| frequently (even from one hour to the next -- and | | | | may be especially useful), and a cerebral spinal fluid |
| these changes may seem quite extreme. | | | | analysis (spinal tap). Only an autopsy can definitively |
| REM sleep behavior disorder, which causes | | | | confirm the diagnosis; the destruction of brain cells is |
| movements, gesturing, and speaking during sleep and | | | | apparent by holes in the brain tissue. |
| confusion upon awakening, is often considered an | | | | Rarely, certain conditions cause dementia that is |
| early sign of DLB. | | | | partially or completely reversible. These include: |
| People with DLB also experience problems with | | | | - A brain tumor |
| mobility, similar to those of Parkinson's disease. These | | | | - Normal pressure hydrocephalus (an irregular |
| include movements that are slow, stiff, or shaky, | | | | accumulation of cerebrospinal fluid in the brain). This |
| trouble balancing, and a shuffling walk. | | | | type of hydrocephalus usually affects people over 65. |
| How it's diagnosed and treated: A complete medical | | | | - A head injury that causes hydrocephalus or a |
| workup can help identify symptoms of DLB and rule | | | | subdural hematoma, which is an accumulation of blood |
| out other possible causes. As with Alzheimer's, the | | | | underneath the brain's covering |
| presence of dementia with Lewy bodies can only be | | | | - A thyroid or other metabolic or endocrine disorder |
| confirmed with an autopsy. | | | | How they're diagnosed and treated: Tumors, |
| There are no drugs approved for DLB. Alzheimer's | | | | hydrocephalus, and subdural hematomas can be |
| medications are sometimes given or, in the case of | | | | identified through a medical history and a brain scan. |
| movement problems, drugs used to treat Parkinson's | | | | Thyroid or other endocrine or metabolic disorders can |
| disease. Other treatment is similar to that for | | | | be identified through laboratory tests of the blood |
| Alzheimer's. | | | | and urine. About 1 in 10 dementia cases have an |
| What it is: About 1 in 5 people with Parkinson's | | | | unknown cause. |
| disease develop dementia due to Lewy bodies in the | | | | |