Alzheimer’s and Dementia: What’s the Difference?

Dementia is the umbrella term for diseases that cause a decline in memory and/or thinking skills

People often ask, what is the difference between Alzheimer’s and dementia?

Dementia, also called Major Neurocognitive Disorder, can be caused by many medical and neurological conditions. Types include but are not limited to vascular dementia, Lewy Body dementia, frontotemporal dementia, and Parkinson’s dementia.

Alzheimer’s is a type of dementia, and the most common type. Dementia is the umbrella term for diseases that cause a decline in memory and/or thinking skills. This results in an impairment of daily functioning that is observed over six or more months.

Alzheimer’s is due to amyloid plaques and tau tangles in the brain that cause cell dysfunction. This results in loss of daily function and eventually, death. It develops more than 20 years before it starts to cause symptoms. People often first notice trouble with short term memory. While all of us may experience some difficulty with short term memory as we age, memory loss is worrisome when it interferes with the ability to complete routine daily tasks such as managing finances, medications, driving, or cooking.

You should see a health care provider if you are worried about memory loss. They may be able to identify treatable causes of memory loss that are not dementia such as depression, a sleep disorder, or medication side effects. Your provider may choose to run blood tests and head imaging (brain scan) to further understand cause(s) of your memory loss. They then may find methods to reverse the symptoms.

Aside from a brain autopsy we do not have one definitive test for Alzheimer’s disease. This means a health care provider will do a series of tests to determine the most likely cause of your symptoms. There are some recent advancements in blood tests and head imaging that help us with the diagnosis of Alzheimer’s dementia, but these are often not covered by insurance. They may be covered by insurance in the future once we have more effective treatment options for the disease.

Currently, there are only a few treatment options for dementia, none of which cure the disease. These medications slow the cognitive decline in a select group of people. One group of therapies is called Acetylcholine Esterase Inhibitors such as Donepezil (Aricept) or Rivastigmine (Exelon). The other class is an NMDA receptor blocker called Memantine (Namenda). These two classes of drugs have been around a while with limited benefit.

Recently a new class of Alzheimer’s drugs have been approved. Anti-amyloid Monoclonal Antibody Infusion Therapies; Aducanumab and Lecanemab. Aducanumab was the first to be approved and it showed a reduction of amyloid in the brain. However, studies resulted in no clinical data to support that it provides any observable benefit to the patient. Lecanemab reduced amyloid in the brain as well and demonstrated minimal to moderate slowing of cognitive decline in clinical trials. Neither of these two newer drugs are covered by insurance. There are many more anti-amyloid and anti-tau drugs in the clinical trials. I suspect we will see more diagnostic tests and treatments for Alzheimer’s gain Food and Drug Administration approval over the next several years.

40% of all dementias can be prevented or delayed by adopting a healthy lifestyle. There is scientific evidence to support that there are effective ways to reduce your risk of developing dementia. These include regular exercise, a healthy Mediterranean diet, weight loss, treating heart disease (especially hypertension), getting restorative sleep, not smoking, avoiding excessive alcohol use, early treatment of hearing loss, and being socially and intellectually engaged.

We now have a state-of-the-art Memory Center where we will provide a thorough multidisciplinary assessment of memory loss, explore access to the latest tests and treatments, and offer you enrollment in a comprehensive Brain Health Program. For more information, please continue to check this website. You can see our geriatrics team today for a memory assessment as well. Please ask your primary care provider for a referral to the Saint Alphonsus Geriatrics Consult Clinic.

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