It's not as simple as just diagnosing one or the other.

By Samantha Lauriello
January 08, 2019

When someone goes to the doctor concerned about memory loss—maybe they’ve started to regularly misplace things or get lost while driving through familiar areas—it’s not uncommon for the patient or their loved ones to ask, “So doc, do you think it’s Alzheimer’s or dementia?” What many don’t realize, however, is that a person won’t necessarily have one or the other.

That's because dementia isn’t a disease. Rather, it’s an umbrella term used to describe a group of symptoms related to decline in memory, social abilities, and everyday function, says Kristin Addison-Brown, PhD, dementia specialist and owner of NEA Neuropsychology in Arkansas. We asked Addison-Brown how she explains the difference to patients. Here's what we learned.

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Alzheimer’s disease is the most common cause of dementia, though there are many conditions that can bring about this group of symptoms. Others include Parkinson’s disease, Huntington's disease, traumatic brain injury, and damage to the vessels that supply blood to the brain, which can be the result of stroke or other conditions.

Depending on the cause, dementia can manifest in different ways, Addison-Brown says, and the earliest signs can be easily overlooked. Early-stage dementia symptoms include things like forgetting recent conversations, getting lost in familiar places, and personality changes, like being uncharacteristically impatient.

As dementia progresses, cognitive symptoms can include difficulty communicating, planning, reasoning, problem solving, and, of course, remembering, according to the Mayo Clinic. Psychological symptoms include agitation, inappropriate behavior, paranoia, hallucinations, anxiety, depression, and more. At its worst, dementia can cause a person to forget who their loved ones are and make them completely unable to care for themselves.

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The cause of the dementia—whether it be Alzheimer's, Parkinson's, or something else—will not only affect how the symptoms present themselves, but also “treatment, outcome, planning, and implications for the family members,” Addison-Brown says.

Alzheimer’s disease is an irreversible, progressive brain disorder that causes brain cells to waste away and die, slowly destroying memory and thinking skills. A person living with Alzheimer’s will likely show typical dementia symptoms like a decline in memory, social abilities, and everyday function, in addition to confusion, wandering, aggressiveness, loss of inhibitions, changes in sleeping habits, distrust in others, and social withdrawal.

The exact cause of Alzheimer’s itself isn’t completely understood. Researchers believe it’s the result of a combination of genetic, lifestyle, and environmental factors that affect the brain over time and cause specific proteins to malfunction. There’s no cure for Alzheimer’s, but there are options to help manage the symptoms, such as antipsychotic and memory loss medication. But before prescribing treatment, doctors will investigate whether or not a person truly has Alzheimer’s disease—or if there's another cause of their cognitive decline.

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This typically involves neuropsychological testing, Addison-Brown says, but early symptoms can also provide clues. For example, patients with dementia caused by Parkinson’s disease are more likely to experience involuntary movements in the early stages of the disease, while those with Lewy body dementia are more likely to experience visual hallucinations early on.

It’s also possible for a person to have more than one condition contributing to the dementia at the same time, Addison-Brown says. “Usually a person will have just one type of dementia, but it’s certainly not unheard of for someone to have something like Alzheimer’s disease and vascular dementia at the same time. When those co-occur, we call that mixed dementia.”

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That might leave you wondering: Are some types of dementia more or less serious than others? Unfortunately, Addison-Brown says they’re all serious in their own ways. Alzheimer’s isn’t any more or less distressing than other types, such as Parkinson’s or vascular disease. There isn’t one cause of dementia that’s necessarily less aggressive than any of the others. Of course, every case of dementia is different and will progress at different speeds, but all cases need serious attention and care.

If there’s a chance you or someone you know could be struggling with dementia, it’s crucial to see a doctor as soon as possible. Early treatment may be able to slow the process and help the patient go about their normal life for as long as they can. Be aware of early symptoms, and make proper care a priority.

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