Rodger Marion

Coming from a non-clinical background and working around health care providers forces one to learn medical terminology whether one wants to or not.  I am often forced to look up terms, so that I can understand what is going on. This week, I wanted to know what the difference between dementia and Alzheimer’s? A simple question right? Well, not as simple as you might think.

Let’s start with Dementia. Dementia is not a specific disease but a term used to describe a wide range of symptoms associated with a decline in memory or other mental skills (Alzheimer’s Association, 2013; Dementia, 2013). It is not just the usual forgetfulness of walking into a room and forgetting what you went in there for (did that) or not being able to recall what you ate yesterday for dinner (that one too). “Dementia is a symptom of brain dysfunction” and is severe enough to impact one’s ability to perform everyday activities (Alzheimer’s Association, 2013; Morris, 1996). For example, having trouble doing things that take planning, like making a list and going shopping, using or understanding common words, or getting lost in places you know well. These are signs of dementia (WebMD, 2013).

Dementia affects people in different ways and has various stages. Unfortunately there is no single test for dementia. Physicians use multiple strategies to determine the severity including a physical exam, asking questions about recent and past experiences (relying heavily on friends and family to check details). conducting simple memory tests and brain scans. For example, a health care provider may ask a patient to repeat a series of words or draw a clock face. There are over 70 different causes of dementia, including Lewy body disease, Huntington’s disease, infections that can affect the brain (such as HIV/AIDS), and Alzheimer’s (which is the most common cause of dementia for persons over 65) (Alzheimer’s Foundation of America, 2013; Morris, 1996).

Alzheimer’s is a progressive, degenerative disease that attacks the brain’s nerve cells “resulting in loss of memory, thinking, language skills and behavioral changes,” which are also symptoms associated with dementia (Alzheimer’s Foundation of America, 2013). The term “Alzheimer’s” dates back to 1906 after Dr. Alois Alzheimer, a German physician, who presented the first case history of a 51-year-old woman. “A brain autopsy identified plaques and tangles that today characterize Alzheimer’s disease” (Alzheimer’s Foundation of America, 2013). Although clinicians can now diagnose Alzheimer’s with up to 90% accuracy (using methods similar to diagnosing dementia), Alzheimer’s can only be “confirmed” through autopsy, when pathologists look for the characteristic plaques and tangles in brain tissue.  “In the absence of a biological marker for Alzheimer’s… diagnosis remains in the hands of the clinician” (Morris, 1996).

Columnist Rick Nauert (PsychCentral, 2011), says that “misdiagnosis of Alzheimer’s disease and other dementing illnesses appears to be relatively common,” as “diagnosing specific dementias in people who are very old is complex.”  In a study conducted in Honolulu, Hawaii, researchers autopsied 426 residents and found that about half of those diagnosed with Alzheimer’s disease did not have sufficient numbers of brain lesions for that diagnosis and most of those who were not previously diagnosed with Alzheimer’s had sufficient brain lesions to explain the dementia.  After finding this information and reading about the many other complexities surrounding dementia (symptoms) and Alzheimer’s (a disease that can cause dementia), I realized that I was not the only one confused (Gardner, 2011).

My cliff notes explanation, dementia is a syndrome (group of disabling symptoms) that has multiple causes and Alzheimer’s is a disease, that can cause dementia (Dementia.org, 2012).

Guest blogger: Regina Knox, MPH, CHES, Special Projects Coordinator, Texas AHEC East

References

1. About Alzheimer’s. (2013). Alzheimer’s Foundation of America. Retrieved on March 12, 2013 from http://www.alzfdn.org/AboutAlzheimers/definition.html
2. Dementia – Topic Overview. (2013). WebMD. Retrieved on March 12, 2013 from http://www.webmd.com/alzheimers/tc/dementia-topic-overview
3. The Difference Between Alzheimer’s and Dementia. (2012). Dementia.org. Retrieved on March 12, 2013  from http://www.dementia.org/types/the-difference-between-alzheimers-and-dementia
4. Gardner, A. (2011). Health Magazine. Half of Alzheimer’s Cases Misdiagnosed. Retrieved on March 12, 2013 from http://news.health.com/2011/02/23/alzheimers-misdiagnosis/.
5. Mark, JC. (1996). Classification of dementia and Alzheimer’s Disease. Acta Neurologica Scandinavica. Supplement 165:41-50.
6. Nauert, R. (2011). Alzheimer’s, Dementia Often Misdiagnosed. Psych Central. Retrieved on March 12, 2013, from http://psychcentral.com/news/2011/02/25/alzheimers-dementia-often-misdiagnosed/23898.html
7. What is Dementia? (2013). Alzheimer’s Association. Retrieved on March 12, 2013 from http://www.alz.org/what-is-dementia.asp

Join us for a real-time discussion about questions raised by this essay on Wednesday from 12:00 p.m. to 12:45 p.m. See Discussion and SL tabs above for details. Link to the virtual meeting room: http://tinyurl.com/cjfx9ag.