If you notice a loved one becoming forgetful, you may worry that they have Alzheimer's disease or dementia. But these conditions are not the same, says Dr. Aaron Ritter, a dementia expert who directs the Memory & Cognitive Disorders Program at Hoag Hospital.
"Alzheimer's Disease is a disease that causes a group of symptoms that usually progresses to a stage called dementia," Ritter says.
Dementia is "an umbrella term to describe memory and thinking problems severe enough to interfere with daily living," says Dr. Rade Vukmir, vice president of medical affairs at Alzheimer's Association.
Alzheimer's Disease is the most common type of dementia. However, dementia can be caused by other brain diseases and injuries including stroke and Parkinson's disease. Identifying the cause of dementia can affect treatment options.
Both Alzheimer's and dementia are different from short-term memory loss or normal age-related memory loss, Vukmir says.
Continue reading to learn more about Alzheimer's vs. dementia, and why knowing the difference is important for patients and their care teams.
What is Alzheimer's?
Alzheimer's is a progressive brain disease. It causes neuron cells, the brain's messengers, to die. Ultimately, this leads to the brain shrinking and related complications from severe loss of brain function — such as dehydration, malnutrition or infection — that can ultimately be fatal.
Causes and risk factors
Researchers believe there are two ways that Alzheimer's disease causes brain damage:
- Plaque formation: A protein called beta-amyloid slowly builds up and forms plaques. These plaques interfere with nerve signals, and may trigger inflammation.
- Tangles: A protein called tau helps stabilize nerve cells in healthy individuals. But in people with Alzheimer's, tau forms tangles. This eventually causes neurons to die.
- Older people: The risk for Alzheimer's is about 1/3 for those over age 85.
- People of color: African American people are twice as likely to develop Alzheimer's than white people, and Hispanic people are 1.5 times as likely to develop Alzheimer's.
- People with family history. The genetic connection is particularly strong for early-onset Alzheimer's, where symptoms appear before the mid-60s.
Symptoms of Alzheimer's
Many people associate Alzheimer's with severe symptoms, like an inability to speak or remember names. However, "it starts with small symptoms — forgetting appointments, repeating, difficulty with complex calculations — and progresses over years to more severe symptoms," Ritter says.
Early symptoms of Alzheimer's are often subtle, Burke says. They can include:
- Memory loss that interferes with day-to-day life
- Trouble with problem solving
- Confusion with place and time
- Trouble completing tasks
- Vision problems that impact balance or driving ability
- Changes to judgment
- Trouble recalling words or names
- Misplacing things
- Becoming withdrawn
- Changes to personality
Advances in diagnostic testing, including brain scans and MRIs, have led to more people getting diagnosed at the early stage of the disease, Ritter says. https://5f23c6778af7212b808e73dfd58e5a0c.safeframe.googlesyndication.com/safeframe/1-0-40/html/container.html
Treatment of Alzheimer's
"There are no cures for Alzheimer's Disease, but there are treatments that may improve symptoms and help memory," Ritter says.
Oral medications can help improve memory and cognition. There is also a specific type of immunotherapy, called aducanumab, that is approved by the U.S. Food and Drug Administration (FDA) as a treatment for Alzheimer's. This is the first FDA-approved therapy to address the underlying biology of Alzheimer's disease—reducing the beta-amyloid plaques in the brain that are characteristic of the disease.
Scientists continue to work to identify effective treatments with similar therapies—targeting the amyloid and tau plaques and tangles — showing great promise and other potential pathways being targeted as well.
- Good sleep hygiene
- Adjusting expectations, like accepting rides from family members
- Following a healthy diet
- Educating yourself about the disease and planning for the future.
Coping with Alzheimer's
After diagnosis, it's important to seek education and support from doctors, community members and others who have navigated Alzheimer's.
That can "help a person and their family understand what is going on with their brain and develop a lifestyle to optimize brain function and to create a life that does not require the same type of memory," Ritter says.
Support is essential not just for the patient, but for caregivers too. Studies show that 75% of caregivers worry about their own health, and 60% say caregiving stress is high or very high.
"Enlisting the help of family and friends to help with caregiving responsibilities or joining a caregiver support group can make a big difference," Vukmir says.
What is dementia?
Dementia is a stage of impaired brain function that can have many different types of causes.
In short, Ritter says, Dementia means that the disease in one's brain is severe enough that they require assistance in daily activities or living independently.
There are many different causes of dementia. Alzheimer's is the most common cause, but there are other types of dementia, including:
- Vascular dementia. This is linked to stroke and other conditions that affect blood flow to the brain. Symptoms may appear suddenly after strokes or mini-strokes, rather than the gradual progression associated with Alzheimer's.
- Lewy body dementia. This is a type of dementia characterized by changes to movement and balance. People with Lewy body dementia may have visual hallucinations and strange sleep-wake schedules.
- Fronto-temporal dementia. This type of dementia causes changes to personality and behavior.
Unfortunately, the cause isn't always clear.
"Although physicians can almost always determine if a person has dementia, it may be difficult to identify the exact cause," Vukmir says.
Important: Sometimes similar symptoms of Dementia can be caused by depression or another mental health condition, what Ritter calls pseudodementia. It's important to undergo diagnostic tests and brain imaging to rule out reversible causes of pseudodementia, like medication side effects or sleep troubles, Ritter says.
Risk factors of dementia
Certain people are at higher risk for dementia. Risk factors include:
- Age: This is the strongest risk factor for dementia.
- Family history
- Race: Black people are twice as likely to experience dementia than white people.
In addition, other health conditions are linked with dementia, including:
- High blood pressure
- High cholesterol
- Traumatic brain injury
- Huntington's disease
- Parkinson's disease
- Creutzfeldt-Jakob disease.
Symptoms of dementia
"Symptoms of dementia can vary greatly depending on the cause," Vukmir says. However, there are common symptoms, he says, including:
- Problems with memory, including forgetting new or old memories
- Difficulty keeping attention
- Problems with communication, including using strange words to refer to objects
- Issues with reasoning, judgment and problem solving
- Significant vision changes
- Difficulty with coordination and motor function
- Psychological symptoms including hallucinations and paranoia
Treatment of dementia
Since dementia isn't a disease, there are no treatments for it. Instead, doctors must diagnose and treat the cause of the dementia, Ritter says.
"We do things like brain scans, neurological examinations, and memory tests to determine the underlying cause of dementia and then try to treat the disease to slow it down or improve symptoms," Ritter says.
There's limited evidence that Alzheimer's treatments may help people with other forms of dementia, Vukmir says.
"These treatments do not address the underlying biology of the disease, but may help reduce symptoms temporarily," he says.
People with dementia need support with day-to-day living and this may go on to include a need for help with simple, everyday tasks like bathing, eating and using the toilet. Many people with dementia need around-the-clock care: about half of nursing home residents have dementia. And yet, because of barriers to care, people with dementia are four times more likely to live in the community, often cared for by family members, than they are to live in supported housing.
Differences between Alzheimer's and dementia
Although dementia and Alzheimer's can have similar impacts on a person's life, there are important differences between them.
- Is a state of brain function where a person requires asssitance and cannot fully care for themselves or function independently
- Can be caused by Alzheimer's or other brain diseases and brain injuries
- Characterized by symptoms including memory loss and trouble with cognition
- Symptoms can come on suddenly or slowly
- Treatments depend on root cause
- Is a specific disease
- Ultimately leads to the condition of dementia
- Limited treatment options, with more being developed
- Progresses over time, ultimately leading to death
- Have no cure
- Have some treatments that may help with symptoms
- Impact the patient and their caregiver, oftentimes family members.
Alzheimer's is a specific brain disease that causes problems with memory, cognition, and brain function. It is the most common cause of dementia, a state where a person's brain function is so impaired that they cannot take care of themselves. However, conditions other than Alzheimer's, including stroke or Parkinson's disease, can cause dementia too.
Neither Alzheimer's or other forms of dementia have cures. However, there are treatments available that may help symptoms, and more are being developed constantly, Ritter says.
"In a very short period of time, we are going to have more specific treatments for different diseases that cause dementia," Ritter says.
While it's normal for memory to decline with age, the impact of Alzheimer's and dementia are not part of the healthy aging process, so people who are concerned should talk to their doctors, Vukmir says.
"It is really important for people to understand that Alzheimer's and other dementias are not a normal part of aging, or something older adults and their families should accept passively," he says.