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Wait, what's the difference between Alzheimer's and dementia, anyway?

I hear that question a lot. Doctors also hear a variation of this confusion. “It looks like dementia,” they might tell a patient, and he or she (or a family member) replies with relief, “Whew! At least it’s not Alzheimer’s!”

Alzheimer’s IS dementia. Other things can be dementia, too. Dementia is an umbrella term used to describe a group of symptoms and behaviors caused by brain changes that interfere with daily life. Alzheimer's is by far its leading cause. Think of it like this: Just as dogs are one type of pet, Alzheimer's is one type of dementia. So you can describe someone who has Alzheimer's also as having dementia, just the way if you have a dog, it can also be said that you have a pet. But others have other types of pet, like cats or birds (or in the case of dementia, a different form of dementia from Alzheimer's, like vascular dementia or Parkinson's dementia).

What’s in a name, anyway? Does it matter what we call this brain-wreck of a disease?


And often not as much as you might think.

Millions of us never find out exactly what’s causing Mom to start cursing or a diligent husband to forget to pay bills. Even after memory loss and cognitive glitches become impossible to ignore, families don’t always seek (or receive) an official diagnosis. We just deal with the effects.

Here's what really matters in the dementia name game:

First distinguish between “normal aging” and “something’s not quite right here.”

When he was younger, my son misheard “Alzheimer’s disease” as "old timer’s disease." He's not alone. Nearly 60% of people in a 2014 Alzheimer's Association survey mistakenly thought Alzheimer's is a natural result of aging.

It’s true your odds of Alzheimer’s do increase with age. It’s also true that thinking skills can slow in some ways with age. But it's not inevitable; not everyone develops dementia no matter how long they live. The biomarkers associated with Alzheimer's seem distinct from normal brain aging. So if there are curious symptoms going on, something's not right.

Definitely explore the cause of worrisome symptoms.

In some ways, it’s as important to know what the problem isn’t, in order to rule out or treat possible causes that we know how to fix today. For example, dementia symptoms that are caused by delirium, dehydration, vitamin deficiencies, and even some brain tumors resolve when the underlying problem is addressed. Among older adults, especially those who live alone, depression often leads to cognitive impairment.

There's yet no single test to diagnose Alzheimer's disease or the other major types of nonreversible, degenerative dementia, which include vascular dementia, frontotemporal dementia, and dementia with Lewy bodies. Confirmation with 100 percent certainty can only be made by examination of brain tissue after death. But by using tools including taking an extensive history, tests of cognition and function, and process of elimination, doctors currently claim high accuracy rates in making a clinical diagnosis (95 percent accuracy for "probable Alzheimer's").

Be aware that knowing exactly which degenerative dementia it is won't lead you to a cure.

Beyond these basic diagnostics, some families, mine included, never go the exhaustive (and often expensive) neuro-testing route for older loved ones.

It's an individual question. But whether your mom has Alzheimer’s or another type of irreversible dementia, there are no nutritional cures to be had. No medicines yet reverse the course of disease. Existing therapies can improve some functioning and quality of life, for awhile.

But knowing the precise diagnosis isn’t going to make Dad remember how to pull on his pants or keep your wife from wandering away from home and getting lost.

Exception: Researchers (rightly) care about names