What’s the Difference Between Alzheimer’s Disease and Dementia?
Alzheimer’s Disease and dementia. You hear these terms batted around seemingly interchangeably, especially during November, which is National Alzheimer’s Disease Awareness Month. Most know they both relate to memory loss, but is there a discernible difference between them?
“Dementia is the umbrella term and encompasses all types of cognitive impairment,” says Kevin Overbeck, DO, a geriatrician and Physician Educator at Rowan University’s New Jersey Institute for Successfully Aging. “So Alzheimer’s is the most common type of dementia.”
Other varieties include Lewy Body and Vascular dementia, which have different root causes and associated symptoms, but ultimately lead to the same place: memory loss.
Dr. Overbeck says there’s been considerable debate about the possible causes of Alzheimer’s, but that he anticipates we’ll learn in the future that each of the varieties of dementia overlap enough to be considered mostly the same.
“The differences are just in how they affect you, what the mechanisms are, and what parts of your brain are affected more,” Dr. Overbeck says.
He cites research by Robert Nagele, Ph.D, also of Rowan University, which has examined the disease’s pathology and led to a theory about a breakdown of the blood-brain barrier. What is that, exactly? Dr. Overbeck explains:
“It’s so important that our brain is protected and separated from the things that are in our bloodstream. So when there’s a breakdown in that barrier, there are blood elements, like antibodies, that get in there and don’t recognize the neurons they interact with to be ours. They recognize them as something foreign, and sets up a cascade of events that leads to neuron breakdowns [which lead to memory loss].”
This theory isn’t widely agreed upon just yet, but Dr. Overbeck says it has great support within the medical community. He cites the short-term cognitive impairment known to happen after anesthesia as possible supporting evidence, as there is a mechanism which interacts with anesthesia that also opens up the blood-brain barrier.
Alzheimer’s in particular pertains to short term memory loss, while long term memory, Dr. Overbeck says, typically remains intact. For instance, a patient may be able to easily remember what the weather was like on their wedding day, but will forget the content of a conversation from five minutes ago. But he says it’s also important, as relatives or friends get older, for loved ones to be aware of the less obvious signs of memory loss.
“Tracking weight is really important,” Dr. Overbeck says. “When people have memory loss, they start eating less, preparing meals less, they’re sort of not hungry so they forget to eat meals. Many older adults are driven by what time of day it is rather than hunger, so that’s one way memory loss can be demonstrated more subtly.”
Sometimes, he says, it can be hard for families to come to terms with an older relative experiencing memory loss. Relatives will often write off demonstrated memory loss as a function of hearing loss or say things like, “they’re pretty good for their age.” However, untreated dementia can lead to falls, hospitalizations, and other complications that exacerbate and accelerate the condition.
Memory loss can also impact the ability to stay on a medication plan. So, Dr. Overbeck says, if other health problems like high blood pressure aren’t getting solved as quickly as they could or should be, it may be that a patient is unable to follow recommendations because they can’t remember that they need to follow them.
Geriatricians like Dr. Overbeck are well-trained to help patients make simple interventions to improve or preserve memory, like prescribing medication, improving hearing, or even treating depression if it’s applicable. And while it’s rare, sometimes there are simple fixes, like addressing Vitamin B12 deficiency, folic deficiency, or other simple vitamin deficiencies that can cause memory problems. In many cases, though, taking care of a patient with memory loss requires outside assistance.
Dr. Overbeck says that even having someone available to help with medication oversight can greatly help reduce common events like the aforementioned hospitalizations or falls. But regardless of the severity of visible symptoms, he says families should always err on the side of caution and make sure their loved ones with memory loss are treated early on.
“I think one of the most important things that makes us human is our memories and minds,” Dr. Overbeck says. “When we talk about memory, we’re also talking about our life experiences, which form our personality. Going to a doctor and being evaluated for memory loss is not something to avoid. It’s literally about preserving who you are.”