Dementia and Alzheimer’s: The Differences and Similarities

Did you know that Dementia and Alzheimer’s disease are not the same thing?  Dementia is a syndrome. It is the name used to describe specific symptoms that impact memory, the performance of daily activities, and communication abilities. Several conditions and diseases fall under the umbrella term of dementia. Alzheimer’s disease is the most common type of dementia. 

Memory loss affects approximately 40% of adults over the age of 65. This does not mean all those people have dementia. Memory impairment is part of the natural process of aging. When there are other symptoms involved, dementia could occur. However, dementia is not part of the natural process of aging. 

Statistics to Consider

As boomers age, the total number of people with dementia will rise. Researchers estimate more than 7 million people aged 65 or older had dementia in 2020. They also estimate that 9 million Americans could be living with dementia by 2030 and almost 12 million by 2040.  Within that group, 6.5 million Americans aged 65 and older are living with Alzheimer’s in 2022. In Colorado, 76,000 people had Alzheimer’s in 2020, and 92,000 will have it in 2025. 

These statistics are not mentioned to scare you, but they should give you pause. It’s important for older Coloradans and the people who love them to be aware of these conditions to watch for symptoms, and to know what resources are available should you need them. 

Let’s review some differences and similarities between the condition of dementia and Alzheimer’s disease. Then, we’ll outline some available resources for patients and their families. 

Dementia is a Syndrome, Not a Disease

Dementia is a general name for a decline in cognitive ability that impedes or hinders a person’s lifestyle.  Dementia is not a disease. It is a set of specific symptoms.

Symptoms of Dementia

Dementia is progressive, meaning it gets worse over time. Early symptoms could be occasional forgetfulness, getting lost in familiar environments, and losing track of time. As dementia gets worse, symptoms could include confusion or disorientation, repetitive questioning or conversation, frequent forgetfulness, and poor decision making. Advanced symptoms could be difficulty remembering family or friends, difficulty in problem-solving or reasoning, aggression, depression, and the inability to care for themselves. 

These symptoms depend on which type of dementia a person has. Patients can have more than one type of dementia, which is called mixed dementia. Older adults with mixed dementia usually experience symptoms of two or more types of dementia.

Causes of Dementia

Aging is the most likely cause of dementia. Degenerative diseases like Parkinson’s and Huntington’s can cause dementia. Infections like HIV and vascular disease could cause dementia. Even traumatic brain industry, stroke, depression, and drug use can be a cause. Whatever the cause, the result is damage to brain cells, triggering dementia. 

Risk Factors

Those over 65 years old are most at risk, although it can occur in younger adults. If dementia runs in the family, there is a  greater risk. Also, many people with Down Syndrome develop dementia. Of course, unhealthy life choices like not exercising or eating well can put a person at greater risk. That also includes excessive drinking and smoking. Conditions like high blood pressure, high cholesterol, and obesity are also risk factors. Studies have shown that women and people of color are at greater risk for dementia. 

Types of Dementia

Sometimes the cause will trigger a certain kind of dementia. Other than Alzheimer’s, types of dementia include:

Vascular dementia

Vascular dementia is caused by damage to blood vessels in the brain. Blood vessel damage can cause strokes or affect cognitive ability in other negative ways. 

Lewy Body Dementia

Lewy bodies are abnormal protein clumps found in the brains of people with Alzheimer’s disease and Parkinson’s disease. This is one of the more common types of progressive dementia.

Frontotemporal dementia

This is a group of diseases characterized by the breakdown of nerve cells and their connections in the frontal and temporal lobes of the brain.

Mixed Dementia

Little is known about this type of dementia. Autopsies of people with dementia who were 80 and older showed they had several types of dementia. More study is needed to know how mixed dementia affects symptoms and treatments.

Treatment of Dementia

In most cases, dementia isn’t reversible. However, many types can be treated to manage symptoms. Doctors treat dementia caused by Lewy Body dementia and Parkinson’s disease with cholinesterase inhibitors, which increase the communication between nerve cells to improve symptoms. Treatment for vascular dementia will attempt to prevent further damage to the brain’s blood vessels, which could cause a stroke.  As dementia progresses, there will come a time when your loved one will need constant monitoring for their safety. That is when a memory care facility would be necessary for most patients. 

Alzheimer’s Overview

Alzheimer’s is a specific progressive form of dementia or disease of the brain that damages brain cells and causes problems in memory and cognitive function. We don’t know the specific cause of Alzheimer’s, and no cure is available. Although younger adults can contract Alzheimer’s, symptoms generally don’t surface until after age 65. It is the most common type of dementia. 

Symptoms of Alzheimer’s

There are stages to the progressive symptoms of Alzheimer’s disease. The most common early symptom of Alzheimer’s is difficulty retaining new information. This is because the disease damages the learning part of the brain first. During the early stage, symptoms are not life-changing. A patient is aware of their condition and only needs minimal assistance. During the middle stage, symptoms become more noticeable, and some assistance is necessary. The late stage happens when your loved one becomes unable to communicate or take care of the activities of daily living. Apathy and depression may be noticeable.  At the end of life, the cognitive decline will require 24-hour care. Eventually, speaking, swallowing, and walking become difficult for patients. 

The Alzheimer’s Association offers a helpful and detailed list of the 10 most common signs and symptoms of Alzheimer’s on its website. 

Causes of Alzheimer’s Disease

In people with Alzheimer’s disease, brain cells die, and connections between brain cells break down. In advanced Alzheimer’s, the brain actually shrinks. Changes in the brain may occur a decade or more before symptoms start. One specific difference between Alzheimer’s and other dementia conditions is that the entire brain is usually affected with Alzheimer’s, while only certain areas of the brain are affected in other conditions. 

Medical professionals don’t think there is only one cause of Alzheimer’s disease. They believe it develops through many factors, including environment, lifestyle, and genetics. Some factors like age, family history, and heredity can’t be changed. However, new studies suggest there are other causes we can influence, like healthy life choices. 

Risk Factors for Alzheimer’s

There are two sets of genes that can cause disease: deterministic genes and risk genes. Alzheimer’s can be found in both types, but less than 1% of Alzheimer’s cases are caused by deterministic genes. Head trauma could be a risk as well. There are also interesting studies that connect Alzheimer’s with heart disease, depression, and even air pollution. 

Treatment of Alzheimer’s 

There is no cure for Alzheimer’s but doctors can manage symptoms with medication like antipsychotics for behavior issues, cholinesterase inhibitors for memory loss, and medications for sleep changes and depression. 

There is a relatively new drug called Aducanumab that changes the progression of Alzheimer’s and improves both cognition and function. It is the first treatment that reduces beta-amyloid plaques, one of the most common characteristics of Alzheimer’s disease. As with all medicines, patients should contact their doctor to discuss the possibility of taking this medication. 

Dementia & Alzhemer’s Resources for Caregivers in Colorado

Many families decide to care for their loved ones with dementia at home instead of in a memory care facility. A 2017 study reported that more than four times as many people with dementia live in traditional community settings (like their own home) than in nursing homes or residential care facilities. This decision could be due to finances or to minimize the disruption that could cause further damage to their loved ones. 

In most cases, patients with dementia need more extensive care than other diseases or conditions. That care can be extremely expensive and difficult to manage for family members. Family caregivers need resources to keep not only their loved ones safe but also themselves. Caregivers of people with dementia are twice as likely to be diagnosed with depression than other caregivers. Caregivers’ physical health is often negatively affected as well.

All caregivers need support. The Alzheimer’s Association and AARP have created a very helpful website to find location-based in-home health and personal care services, disease information, and referrals to medical professionals, respite care, and end-of-life specialists including attorneys and financial advisors. The Alzheimer’s Association’s Colorado website is also a wonderful resource for local community support groups, caregivers’ training and classes, programs for patients, and care support.  

The memory issues we all face as we age can be scary. But not all memory issues are caused by dementia. Dementia is a name for a severe decline in mental ability, not associated with the typical aging process. Dementia is a syndrome. Alzheimer’s is one type of dementia. Learning about these differences can inform and empower older adults living with memory issues and their caregivers.

Visit www.agewisecolorado.org for more information.