Alzheimer’s vs. Dementia
Dementia is an impairment of thinking and memory that interferes with a person’s ability to do things which he or she previously was able to do. In this regard, dementia is an umbrella term for anything that can cause issues with brain functioning such as confusion, memory loss, or loss of problem solving ability.
Alzheimer’s disease is a progressive disease that destroys memory and other important mental functions. It’s the most common cause of dementia — a group of brain disorders that results in the loss of intellectual and social skills. These changes are severe enough to interfere with day-to-day life.
Distinguishing Alzheimer’s disease from other causes of dementia is not always as easy and straightforward as defining these terms. In practice, people and their disorders of behavior are far more complex than simple definitions sometimes commonly imply.
Medical Conditions That Can Mimic Dementia
(Taken from: BrightFocus Foundation) Below are a few of the many medical disorders that can interfere with cognition and mimic dementia. The systems and organs of the body are so dependent upon each other that it will not surprise you to learn that many different kinds of disorders can present with real or apparent memory disturbances.
Starting at the top of the body, head injury tops the list because of the risk of trauma to the brain. A fall, even one that seemed less serious, can be followed by significant cognitive problems. When this is due to a concussion, symptoms usually improve over time with supportive care. A limited post-traumatic bleed inside the skull can interfere with cognitive functioning by leading to a collection of blood called a subdural hematoma.
Normal Pressure Hydrocephalus
Another condition that can create cognitive impairment is normal pressure hydrocephalus (NPH), a disorder in which cerebrospinal fluid accumulates in the ventricles (cavities) of the brain and interferes with thinking, memory, walking, and control of urination.
Problems with Vision and Hearing
Sensory limitations, too, can create a picture like cognitive impairment that worsens as the affected person becomes increasingly isolated as a result of hearing or vision problems.
Disorders of the Heart and Lungs
The heart and lungs provide the brain with oxygen and nutrients that are necessary for proper functioning. Age is often accompanied by vascular (blood vessel) disease that interferes with cardiac output or lung disease that interferes with the delivery of oxygen to the brain. These underlying diseases can cause MaND as well as what’s commonly known as vascular dementia (which can sometimes occur along with Alzheimer’s-related dementia). They can also affect alertness, memory, and executive function.
Liver and Kidney Disease
Diseases of the kidney or liver can result in an accumulation of toxic metabolic waste products in the blood, dulling the mind or poisoning mental activity and sometimes resulting in MaND.
Disorders of the endocrine organs, responsible for making hormones that are transported through the bloodstream in order to control many metabolic activities, are additional causes of MaND-like symptoms. An excess or deficiency of thyroid hormone interferes with thinking. Disturbances in the regulatory effects of insulin, a hallmark of diabetes mellitus, harm cognition along with other bodily functions.
Some infections produce a prolonged change in mental functioning that lacks signs clearly linked with delirium. Lyme disease, syphilis, or HIV for example, are capable of mimicking MaND.
Heavy metal toxicity, too, can create more stable changes that could go unrecognized without specific testing.
Cancers of various types can affect cognition through brain tissue destruction, increased pressure within the head, or sometimes even through producing chemicals that travel from various parts of the body through the blood stream to the brain where they create havoc.
How Doctors Make an Accurate Diagnosis
Fortunately, many of these medical conditions are treatable and some are even curable. An assessment for MaND should always include tests to look for these treatable conditions so that no patient has to suffer needlessly from an untreated and debilitating condition. The mental status examination should give clues to the presence of a delirium or certain other medical disturbances, and this examination is followed up by physical examination and tests of the blood and urine.
Blood count, thyroid tests, kidney functions, liver enzymes, metabolic screening, and urinalysis are routine elements of the MaND diagnostic workup. Lyme or syphilis tests, lumbar puncture, heavy metal screen, urine culture, chest X-ray, EEG, or neuroimaging with MRI and/or PET scanning may be appropriate tests for patients whose symptoms suggest the need for these additional, more costly, and sometimes more invasive tests.
BrightFocus Foundation is a nonprofit organization supporting research and public education to help eradicate brain and eye diseases, including Alzheimer’s disease, macular degeneration and glaucoma. For more information, call 1-800-437-2423.