Dementia is not just Alzheimer’s disease

Alzheimer’s disease, vascular dementia, Dementia with Lewy Bodies, mixed dementia, Parkinson’s disease, the list goes on and on. Which diseases of the brain are considered dementia, and what does dementia really mean?

The misconceptions that surround dementia stems from misunderstanding the word dementia. Once people understand what dementia means, we will be able to better understand the different diseases that fall under that general term.

Understanding dementia

First, dementia is a general term that providers can use to define an acquired, sustained decline in someone’s ability to function. It really is a decline from one’s previous level of baseline functioning, interfering with work or activities of daily living.

Next, dementia is usually defined as a decline in two or more cognitive domains of your brain. The main cognitive domains that may lose function, leading to dementia include:

• Memory—ability to learn and recall information
• Language – ability to comprehend or express
• Visuospatial – ability to interpret non-verbal, graphic or geographic information
• Executive – ability to plan, reason and solve problems
• Attention – ability to focus awareness on a given stimulus or task, and shift awareness if appropriate

Different dementia diseases

As you can see, dementia is not just about memory loss. The symptoms of dementia can range from a decline in memory or thinking to personality or behavior changes. The neurodegeneration in different areas of your brain can make it difficult to diagnose.

For example, a person may have abnormalities of more than one type of dementia. There may be some changes hinting to Alzheimer’s disease as well as vascular changes. Dementia with Lewy bodies may have a mixed dementia picture. Someone with Parkinson’s disease, a chronic progressive movement disorder, may suffer from another form of dementia later on in the disease course.

For any patient, a dementia diagnosis is very hard and challenging to navigate. It can be devastating. When it comes to the different types of dementia, providers are able to do structural and functional imaging in order to put the entire picture together. Experts analyze the symptoms of each type of dementia and use the images to look for any volume loss, atrophy or any other abnormalities in the brain. They also look at which cognitive domain is being affected and the time course of symptoms.

Moving forward with dementia

Knowing more about your specific type of dementia is vital, especially for future research and clinical trials.

Claudia R. Padilla, MD, recently joined the Baylor AT&T Memory Center as the Medical Director for Research. Part of her role is evaluating new findings and communicating this information to patients and the public.

There has been an increase in news reports surrounding dementia, including claims that women decline faster than men and information about younger onset patients.

One area of focus for Dr. Padilla is treating younger onset patients. Patients in their 50s or 60s will come in and visit with her and when they hear dementia or Alzheimer’s disease, they tend to think of someone in their elderly years unable to function normally. Alzheimer’s disease is not just a disease of old age. For a younger patient, it can be a very focal disease process affecting one area of cognition.

For anyone who is fighting dementia or trying to prevent dementia, Dr. Padilla always suggests staying physically active, mentally active and socially active.

• Physically active—walk 20 to 30 minutes a day, run, or do an activity you enjoy doing to keep your body and your brain healthy. Remember to keep your diet in check as well for optimal brain function.
• Mentally active—if you’re retired and not as busy mentally, do something to keep your brain engaged. There are different apps or programs if you enjoy those, but find something mentally stimulating that will keep your brain sharp.
• Music therapy—Dr. Padilla has also found that music therapy really helps. There have been a lot of studies that suggest when patients listen to music from their childhood or familiar music, it can bring back positive, happy memories. At UCLA they recently collected old mp3 players to donate to patients in nursing homes to help improve patients’ quality of life.
• Socially active—it is important to avoid isolation and to stay engaged in social events with your friends and family. Dr. Padilla suggests some patients get a large calendar so they can keep track of the days of the week and look forward to future events.

Some physicians haven’t had experience recognizing these specific dementias affecting younger patients and the types can be hard to separate. Understanding these distinctions will help providers diagnose and treat dementia in the most effective way possible.

Information in this post was provided and approved by Claudia R. Padilla, MD, a behavioral neurologist on the medical staff at Baylor AT&T Memory Center. Dr. Padilla is a board certified behavioral neurologist specializing in the diagnosis and management of progressive cognitive and behavioral impairments and is on the medical staff at Baylor University Medical Center at Dallas.