Alzheimer's vs Dementia: What’s the Difference?

When a loved one begins to forget names, repeat questions or struggle with daily tasks, it can feel overwhelming and uncertain. You might hear terms like Alzheimer’s and dementia used interchangeably, adding to the confusion. But here’s the important distinction: dementia is a syndrome—a collection of symptoms affecting memory, thinking and behavior—while Alzheimer’s is a specific disease and the most common cause of dementia.

Understanding the difference isn’t purely semantics. It’s about gaining clarity in a confusing time, finding the right care and ensuring your loved one gets the support they need. Whether you’re trying to make sense of a diagnosis or noticing early signs of cognitive decline, knowing what sets Alzheimer’s apart from other forms of dementia can empower you to act confidently.

Let’s explore the nuances between Alzheimer’s and dementia. We will unravel the science, symptoms and causes, and guide you through the steps to seek help. This is critical because when it comes to memory-related challenges, the right information can make all the difference for you and your family.

Dementia is a broad term that describes a decline in cognitive abilities severe enough to interfere with daily life. It is an umbrella term that covers a variety of conditions affecting memory, thinking, problem-solving, language and behavior. Dementia results from injury to brain cells, impairing their ability to function effectively.

While common in older adults, dementia is not a normal part of aging. Understanding its characteristics and causes can provide clarity for individuals and families grappling with cognitive changes.

• Not a Disease: Dementia is a syndrome caused by different underlying conditions that damage the brain.
• Progressive in Most Cases: Over time, symptoms tend to worsen, though the speed of progression varies depending on the cause.
• Diverse Symptoms: Memory loss is a hallmark sign, but dementia also affects reasoning, language, mood and behavior.
• Risk Increases With Age: While age is a major risk factor, dementia can occur in younger individuals, known as early-onset dementia.

Alzheimer’s disease is a specific, progressive form of dementia that accounts for approximately 60-80% of all dementia cases. It is a neurodegenerative disorder that gradually impairs a person's memory, thinking skills and ability to perform everyday tasks. Unlike normal age-related memory loss, Alzheimer’s disease disrupts cognitive function in a way that impacts daily life and one’s ability to maintain independence.

As the most common cause of dementia, Alzheimer's disease is often misunderstood. It’s not just about forgetfulness; it’s a disease that affects the brain’s structure and function, causing irreversible changes that worsen over time. While scientists have made considerable progress in understanding Alzheimer’s, there is still much to learn about the disease’s causes and how best to treat it.

Dementia is not a single condition but a collection of symptoms caused by various underlying diseases. These diseases and conditions result in damage to brain cells, leading to memory loss, cognitive decline and changes in behavior. The specific type of dementia a person has depends on which areas of the brain are affected and the underlying cause. Here are some of the most common types of dementia:

Vascular dementia is the second most common form of dementia, caused by reduced blood flow to the brain. This lack of oxygen and nutrients to brain cells can occur due to stroke, small vessel disease or other cardiovascular issues. The symptoms often emerge suddenly or in a stepwise pattern, with cognitive abilities declining rapidly after a stroke or series of strokes.

Key Symptoms:

• Sudden onset of cognitive difficulties, such as poor attention or decision-making.
• Challenges with problem-solving and planning tasks.
• Mood changes, such as depression or irritability.
• Potential memory loss, though less pronounced in the early stages compared to Alzheimer’s.

Lewy body dementia is caused by the accumulation of abnormal protein deposits called Lewy bodies in the brain, particularly in areas involved in thinking, movement and emotions. It is a progressive condition that can significantly impair cognitive function.

Key Symptoms:

• Visual hallucinations (seeing things that aren’t there) are a hallmark symptom
• Fluctuating alertness and attention.
• Movement issues similar to Parkinson's disease, including tremors, stiffness and difficulty walking.
• Sleep disturbances, including acting out dreams (REM sleep behavior disorder).

Frontotemporal dementia primarily affects the frontal and temporal lobes of the brain, which are responsible for regulating behavior, personality and language. Unlike Alzheimer’s disease, memory loss isn’t always the first symptom to appear.

Key Symptoms:

• Impulsive or socially inappropriate behavior, apathy or lack of empathy (behavioral variant FTD).
• Difficulty with speech and understanding language (primary progressive aphasia).
• Muscle weakness or movement disorders in some cases.
• Younger onset: FTD often affects people at a younger age, typically in their 50s and 60s.

Huntington's disease is a hereditary neurodegenerative disorder that causes progressive cognitive decline, along with motor dysfunction and psychiatric symptoms. It is caused by a mutation in the Huntington gene, which leads to the gradual degeneration of nerve cells in the brain.

Key Symptoms:

• Involuntary movements, called chorea, which may include jerking or writhing movements.
• Cognitive decline, which affects memory, reasoning and judgment.
• Emotional and psychiatric symptoms, such as depression, irritability and mood swings.

Creutzfeldt-Jakob disease is a rare, rapidly progressing form of dementia caused by prions—misfolded proteins that damage brain tissue. CJD typically leads to rapid cognitive decline, and it is fatal, often within a year of diagnosis.

Key Symptoms:

• Rapid onset of dementia, often within weeks to months.
• Severe memory loss, confusion, and difficulty with motor coordination.
• Muscle stiffness and spasms.
• Vision problems and personality changes.

Wernicke-Korsakoff syndrome is a type of brain disorder caused by a deficiency in thiamine (vitamin B1), often related to chronic alcohol abuse or malnutrition. It is actually two conditions: Wernicke’s encephalopathy (an acute phase) and Korsakoff syndrome (a chronic phase).

Key Symptoms:

• Wernicke’s encephalopathy: Symptoms include confusion, difficulty with coordination and balance, and eye movement problems.
• Korsakoff syndrome: Characterized by memory problems, particularly short-term memory and confabulation (making up stories to fill in memory gaps).
• This condition is treatable if caught early by correction of  thiamine deficiency 

Mixed dementia refers to a condition in which a person has more than one type of dementia. The most common combination is Alzheimer's disease and vascular dementia, but other combinations can also occur. Mixed dementia often presents with a wider range of symptoms, and diagnosis can be more challenging.

Symptoms:

• A combination of symptoms from different forms of dementia, such as memory loss (Alzheimer’s), movement issues (Parkinson’s or Lewy body dementia) and mood swings (vascular dementia).
• Diagnosis requires careful evaluation as the symptoms can overlap with other types of dementia.
• Treatment often focuses on managing the symptoms of each contributing condition.

Diagnosing dementia can be a complex process because the symptoms of dementia often overlap with other conditions, and there are many different types of dementia, each presenting unique symptoms. However, a timely and accurate diagnosis is crucial for managing the condition, accessing appropriate treatment and planning for future care.

If you or a loved one are experiencing memory loss, confusion or other cognitive issues, it’s important to see a health care provider who specializes in dementia. The diagnostic process generally involves a combination of medical history reviews, physical and neurological exams, and cognitive testing.

• Family history: Is there a family history of dementia or other neurological diseases? Genetics can play a role in the development of certain types of dementia, including Alzheimer’s disease.
• Current health: What other medical conditions or medications is the individual taking? Conditions like diabetes, hypertension and depression can influence cognitive function.
• Lifestyle factors: Habits like alcohol use, smoking and exercise levels can affect brain health and cognitive decline.

• Reflexes and coordination: How well the person can move and respond to physical stimuli.
• Balance and gait: Walking, standing and general coordination to rule out other physical conditions that might impact brain function.
• Sensory perception: Testing vision, hearing and touch to determine if there are other sensory impairments.

• Mini-mental state examination (MMSE): A series of questions and tasks that evaluate memory, orientation, and cognitive abilities.
• Montreal cognitive assessment (MoCA): A brief test that looks at memory, attention, language, and executive function.
• Clock drawing test: A task where the person is asked to draw a clock face with the hands set at a certain time, which helps evaluate their spatial awareness and ability to follow instructions.

• Magnetic Resonance Imaging (MRI): MRI scans can detect brain shrinkage, structural damage, or the presence of strokes, tumors or other conditions that might cause dementia-like symptoms.
• Positron Emission Tomography (PET): PET scans can detect amyloid plaques, a hallmark of Alzheimer’s disease, or other abnormalities like reduced blood flow that can help diagnose specific types of dementia.
• Computed Tomography (CT) scan: A CT scan can also help identify physical brain changes, such as a stroke or tumor, that could be causing cognitive problems.

Blood tests may be performed to rule out other potential causes of cognitive decline, such as vitamin deficiencies (e.g., vitamin B12), thyroid problems or infections. Blood tests can also help assess overall health and check for conditions like diabetes or liver disease, which could contribute to memory loss or confusion.

While blood tests can’t diagnose dementia, they play an important role in ensuring that no other treatable conditions are causing or contributing to cognitive issues.

• Depression: Often referred to as “pseudodementia,” depression can cause symptoms like memory problems and difficulty concentrating, but it’s treatable with therapy or medication.
• Sleep disorders: Conditions like sleep apnea can lead to daytime cognitive issues due to poor sleep quality.
• Infections or drug side effects: Certain infections, medications or even substance abuse can cause confusion or memory loss, which may resolve once the underlying issue is treated.

While there is currently no cure for dementia, several treatments can help manage symptoms, slow progression and improve quality of life for individuals living with the condition. Treatment options vary depending on the type of dementia and its stage.

• Medications: In some cases, medications like cholinesterase inhibitors (donepezil, rivastigmine) are prescribed to help improve memory and cognitive function in Alzheimer's disease. Medications like memantine may also be used to regulate glutamate and help with cognitive symptoms.
• Managing underlying conditions: For certain types of dementia, such as vascular dementia, managing underlying health issues like high blood pressure, diabetes or heart disease can help prevent further cognitive decline.
• Therapies: Cognitive stimulation therapy, occupational therapy and speech therapy can help maintain cognitive function, improve communication and support daily living activities.
• Lifestyle changes: Regular physical exercise, a balanced diet, mental stimulation and social engagement are important for overall brain health and may help slow the progression of symptoms.
• Supportive care: In addition to medical treatment, families and caregivers often benefit from support groups, counseling and respite care to help manage the emotional and physical challenges of caring for someone with dementia.

While treatments can’t cure dementia, they can provide significant benefits in managing symptoms, maintaining independence and improving quality of life. It’s important for individuals with dementia and their families to work closely with health care providers to find the best care plan.

While Alzheimer’s and dementia can be challenging, understanding the differences and taking proactive steps can make a world of difference. If you or a loved one are experiencing memory loss or cognitive difficulties, don’t wait to seek help. Early intervention is key to improving quality of life.

At CHI Saint Joseph Health, you’re never alone on this journey. We’re here to provide expert care, education and compassion every step of the way.

If you have questions or need support, don’t hesitate to contact us or schedule an appointment. Together, we’ll find the best path forward.