Alzheimer’s disease is not a sexy diagnosis. No one wants to have it. Though the disease can be slowed somewhat and sometimes managed gracefully, there is no cure. Alzheimer’s is progressive and deadly, the sixth leading cause of death in the U.S.
So it is not uncommon that individuals with a diagnosis of Alzheimer’s frequently question whether or not the diagnosis is correct.
There is no one test that can confirm a diagnosis of Alzheimer’s. Although dementia is one of the first symptoms of Alzheimer’s, there are many other conditions that cause dementia. If an individual is not confident in a diagnosis, he or she should ask for a second opinion or see a specialist at a well-known medical center or university.
Some dementias can be caused by treatable conditions such as depression, drug interactions, thyroid problems, certain vitamin deficiencies, and overuse of alcohol or other drugs. Some conditions that look like Alzheimer’s can be treated and reversed.
A diagnosis of Alzheimer’s disease should include a thorough medical history, mental status testing, a physical and neurological exam, and a number of tests (such as brain imaging) to rule out other causes of dementia. If these other causes are found, they should be treated first, before a diagnosis is made.
According to the Centers for Disease Control and Prevention, Alzheimer’s disease is by far the leading cause of dementia, affecting 50 to 70 percent of people suffering from dementia, and that is why the two terms are often used interchangeably.
Other neurological diseases that cause symptoms of dementia include:
- Lewey body dementia: caused by abnormal, microscopic clumps of protein that form deposits in the brain. Symptoms include visual hallucinations, fluctuation in lucidity, and Parkinson’s-like tremors.
- Vascular dementia: occurs when blood flow is blocked, reducing oxygen and nutrients to the brain. Symptoms can occur suddenly, especially in people with high blood pressure.
- Frontotemporal dementia: generally occurs in people between ages 50 and 65 because of cell deterioration and shrinkage in the brain’s frontal lobes.
- Traumatic brain injury, usually caused by repetitive head trauma.
- Dementia associated with Parkinson’s disease occurs when Parkinson’s begins to affect other parts of the brain.
Why is it important to know the difference between dementia and cognitive diseases such as Alzheimer’s? Bottom line: because there are some causes of dementia that, unlike Alzheimer’s, can be reversed. When dementia first appears, it is important to see a doctor to be evaluated, and when appropriate, treated.
It is important to know the difference because there are some causes of dementia that, unlike Alzheimer’s, can be reversed.
Dementia-like symptoms can occur as a result of an infection or high fever. Lyme disease or brain infections such as meningitis or encephalitis can mimic dementia, all of which respond to treatment with antibiotics.
Other treatable conditions that cause dementia are depression, drug reactions or interactions, metabolic and endocrine problems (thyroid disease is one example), and some vitamin deficiencies. A thorough neurological screening should be considered when dementia symptoms are identified. With screening, including blood tests, a mental status evaluation, neuropsychological testing, and sometimes a brain scan, doctors can diagnose the cause of the dementia symptoms in 90 percent of cases.
“Numerous conditions that can make someone demented are treatable and potentially reversible,” Joel Kramer, a professor of neuropsychology at the University of California, San Francisco.
These reversible conditions include “improper medication or substance use, cerebrovascular disease, seizures, autoimmune conditions, metabolicconditions, infections, and even tumors,” Kramer said. “Some of the medicines that help with Alzheimer’s disease can actually make patients with other disorder worse. Likewise, some of the treatments for other disorders may not be helpful to Alzheimer’s disease.”
If you’re worried about mental decline (maybe you’ve got a parent with dementia, or a symptom or two), you don’t need to live in fear, in doubt, or in resignation. In the Serenity Prayer, we ask God for the courage to change the things we can, the serenity to accept the things we can’t change, and the wisdom to know the difference. To know the difference between Alzheimer’s and dementia, visit your doctor, and if necessary, seek out specialized diagnostic care.
While science can’t yet cure the cognitive decline associated with dementia, getting clear on what may be causing symptoms is key to making changes now that can preserve your mental function into the golden years.