Dementia

EXTRA INFORMATION

Understanding the difference between dementias

WHAT WE KNOW

Alzheimer’s disease. In people age 65 and older, Alzheimer’s disease is the most common cause of dementia. Alzheimer’s disease is a progressive, degenerative brain disease and the most common form of dementia. Alzheimer’s disease affects about 1 in 15 people over 65 years, and almost 1 in 4 people over 85 years.

At present, we don’t know what causes Alzheimer’s disease. We do know that people with this illness have abnormal material that builds up in their brain. These protein ‘tangles’ and ‘plaques’ disrupt communication between brain cells and lead to eventual cell death and brain shrinkage. There is currently no cure for Alzheimer’s disease. Available treatments only target symptoms, not the underlying biological cause of the disease.

Vascular dementia. Vascular dementia, the second most common type of dementia, occurs as a result of brain damage due to reduced or blocked blood flow in blood vessels leading to your brain.

Blood vessel problems may be caused by stroke, infection of a heart valve (endocarditis) or other blood vessel (vascular) conditions.

Symptoms usually start suddenly and often occur in people with high blood pressure or people who have had strokes or heart attacks in the past.

Several different types of vascular dementia exist, and the types have different causes and symptoms. Alzheimer’s disease and other dementias also may be present at the same time as this dementia.

Lewy body dementia. Lewy body dementia (LBD) affects approximately 10 percent of people with dementia, making it one of the most common types of dementia. Lewy body dementia becomes more common with age.

Like Parkinson Disease, people with LBD get slowed movements, stooped unsteady shuffling gait, loss of facial expression, and tendency to fall. Additionally, people with LBD also develop significant changes to memory and thinking. Commonly, they will have major fluctuations in their attention and awareness, which can last for significant periods of the day, or can be momentary. This may manifest as staring spells, spending most of the day sitting or sleeping, or difficulty following events. Oftentimes, the types of thinking changes will look like psychiatric disease like major depression, odd false beliefs (delusions) or seeing things that are not there (visual hallucinations).

Frontotemporal dementia. Frontotemporal dementia is the second most common degenerative disease causing dementia in younger adults.

The age of onset is typically in the 50s or 60s but can be as young as 30. The disease is sometimes called frontotemporal lobar degeneration and was first described 100 years ago by Arnold Pick and was previously referred to as Pick’s disease.

Damage to brain cells begins in the frontal and/or temporal lobes of the brain. When the initial damage is in the frontal lobe (called behavioural-variant FTD) the main changes are in personality and behaviour. Individuals with damage predominantly in the temporal lobe (either progressive non-fluent aphasia or semantic dementia) lose the ability to speak or understand language.

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