What is Dementia?

First, what dementia is not…

Dementia is not normal aging.  It is quite natural to lose some mental sharpness as we get older. An older person might walk into a room and forget why. Mom might not be quite as good with mental math as she used to be. This is a slow decline and may at times be frustrating. However, the cognitive loss associated with normal aging doesn’t impair day to day functioning.

Dementia is not a disease.  It is a syndrome or a set of symptoms. It can be caused by a number of different diseases and conditions. In fact, over one hundred different things  cause dementia, from alcoholism to head trauma. And, of course, Alzheimer’s disease.

Dementia is not Alzheimer’s. This may be the most confusing of all. Alzheimer’s disease (AD) is just one of the many causes of dementia. Until quite recently people used used the terms almost interchangeably; indeed, they sometimes still do. Fortunately, Alzheimer’s and dementia are such hot topics now that general understanding is improving. It’s much better today than it was even 15 years ago, when I started writing about the syndrome. However, I still see the title, “The 7 Stages of Dementia” on blogs that I would think should know better. Let’s clear that up: There are seven stages of Alzheimer’s disease. Other forms of dementia do not progress in the same way.

So, What Is Dementia?

According to the National Institute of Health:

Dementia is the loss of cognitive functioning—the ability to think, remember, or reason—to such an extent that it interferes with a person’s daily life and activities. These functions include memory, language skills, visual perception, problem solving, self-management, and the ability to focus and pay attention. 

So dementia is not just memory loss, though memory problems are a part of most types of dementia. Depending on the cause, dementia can affect every part of the brain, and every brain function. Although normal aging may impair any of the cognitive functions listed in this definition. It is only when impairment is so severe that it “interferes with a person’s daily life and activities” that it becomes dementia.

Dementia vs Alzheimer’s

In Auguste Dieter’s brain (after her death) Alois Alzheimer found the first plaques and tangles – hallmarks of Alzheimer’s disease.

The big reason that Alzheimer’s and dementia are often confused is that Alzheimer’s disease is the leading cause of dementia. In fact, by some estimates, AD accounts for as much as 60% of all cases. Other common forms of dementia include:

• Lewy body dementia
• Parkinson’s dementia
• frontotemporal dementia
• vascular dementia

Other less well known causes are

• Creutzfeldt-Jakob disease
• Huntington’s disease
• Niemann-Pick disease

Some more recent definitions I have seen include the qualifications that dementia is incurable and will eventually result in death. This leaves out conditions termed “curable dementia.” 

Curable dementia is a condition that mimics dementia symptoms but can be treated, including things as simple as nutritional deficiencies. Vitamin B1 and B12  deficiencies, for example, can present symptoms similar to dementia. Some others include:

• Lyme disease
• Urinary tract infection (UTI) and other infections
• Depression
• Vitamin B12 deficiency
• Normal pressure hydrocephalus
• Drug side-effects and interactions
• Dehydration
• Hearing and vision impairment

As you can see, all of these ailments are treatable. Most are curable. 

2 real world examples of misdiagnosed dementia

“The Punky QB” Jim McMahon quarterbacked the best team ever to play the football – The 1985 Chicago Bears.

For example, Jim McMahon, quarterback for the 1985 World Champion Chicago Bears, was diagnosed with younger onset dementia in 2012. Several years later, his doctors recognized his condition  as normal pressure hydrocephalus. 

Similarly, Singer/songwriter Kris Kristofferson was diagnosed with and began treatment for dementia in 2015. It turned out that his symptoms were from Lyme disease, not Alzheimer’s. When treated for the right condition he showed almost immediate improvement.

Whether you call them cases of curable dementia or conditions that mimics dementia symptoms, these real-life events illustrate the importance of an accurate diagnosis if dementia is suspected.