Alzheimer's and Dementia-What's the Difference?

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St. Alphonsus Hospital

For more information about the author, click to view their website: https://www.saintalphonsus.org/location/saint-alphonsus-regional-medical-center-boise-1

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Jan 04, 2024

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Idaho - Boise and the Treasure Valley

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

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

Alzheimer’s is one of many types of dementia. In fact, it is the most common type of dementia. Dementia is the umbrella term for diseases that present as a decline in memory and/or thinking skills resulting in impairment of daily functioning observed over six or more months. Dementia, also called major neurocognitive disorder, can be caused by many different medical and neurological conditions.  Other types of dementia include but are not limited to vascular dementia, Lewy Body dementia, frontotemporal dementia and Parkinson’s dementia.

Alzheimer’s dementia is due to amyloid plaques and tau tangles in the brain that cause cell dysfunction and death eventually resulting in loss of daily function. It develops over more than 20 years before it starts to cause symptoms. People often first notice trouble with short term memory. While all of us can experience some difficulty with short term memory as we age, memory loss is worrisome for possible dementia 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 so they can explore this with you further.  Your health care provider may be able to identify reversible or 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 some blood tests and conduct head imaging (brain scan) to further understand cause(s) of your memory loss.

Aside from brain autopsy we do not have one definitive, widely available 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, cerebral spinal fluid tests and head imaging that help us with the diagnosis of Alzheimer’s dementia, but these are not often covered by insurance. These tests will likely 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 Alzheimer’s dementia, none of which cure the disease. These medications are only thought to slow the cognitive decline in select group of individuals. One group of therapies are called acetylcholine esterase inhibitors such as donepezil (Aricept) or rivastigmine (Exelon) The other class is NMDA receptor blocker called memantine (Namenda). These two classes of drugs have been around a long time 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 which did demonstrate a reduction of amyloid in the brain but studies resulted in no clinical data to support that it provides any observable benefit to the patient. The other medication 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 but they may be covered in the future.  Veterans Administration does currently cover lecanemab for veterans who meet specific criteria.  There are many more anti-amyloid and anti-tau drugs in the clinical trials, and I suspect we will see more diagnostic tests and treatments for Alzheimer’s gain FDA approval over the next several years.

Most importantly, everyone should know that 40% of all dementias can be prevented or the onset delayed by adopting a healthy lifestyle and addressing potentially modifiable risk factors (e.g., hypertension, diabetes, hearing loss).  There is scientific evidence to support that the following are effective ways to reduce your risk of developing dementia; regular exercise, a healthy Mediterranean diet, weight loss, treating heart disease especially hypertension, getting restorative sleep, quitting smoking, avoid excessive alcohol use, early treatment of hearing loss, and stay socially and intellectually engaged.

By the end of 2023 Saint Alphonsus will be starting a new 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 our comprehensive Brain Health Program. For more information, please continue to check this website. You can however see one of geriatrics teams today for a memory assessment as well. Please ask your primary care provider for a referral to Saint Alphonsus Geriatrics Consult Clinic.

By Kara Kuntz, MD, Geriatrician, Saint Alphonsus

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