Alzheimer’s disease causes up to 75 percent of dementia cases — but even though the two conditions are often associated, dementia is not always related to Alzheimer’s disease.
“Dementia is just a fancy word for memory loss,” says Raj C. Shah, MD, medical director of the Rush Memory Center at Rush University Medical Center in Chicago. “It doesn’t tell you what the cause is.” In addition to memory loss, dementia also causes difficulty with thinking, reasoning, and decision making.
A dementia diagnosis is based on the presence of certain symptoms, which are then categorized to determine the stage of dementia and the appropriate dementia treatment. There is no cure for dementia, which is by definition a fatal, progressive disease, meaning dementia symptoms will only get worse over time. Dementia treatment, however, can help slow the progression of symptoms in some cases.
 
Possible Causes of Dementia
If someone is diagnosed with dementia, the possible causes include:
  • Alzheimer’s disease
  • Creutzfeldt-Jakob disease, a rare brain disorder sometimes referred to as mad cow disease that kills most patients within a year
  • Frontotemporal dementia, a condition in which parts of the brain shrink, affecting either behavior or speech
  • Strokes, in which cause brain cells die because their oxygen supply has been cut off or from bleeding in the brain, sometimes resulting in a condition called vascular dementia
  • Traumatic brain injury
  • Lewy body dementia, a common type in which Lewy bodies, a type of protein, build up in the brain, causing cognitive and other types of problems
  • Parkinson’s disease, which occurs when nerve cells in the brain lose the ability to make a chemical transmitter called dopamine, causing difficulties with movement, as well as dementia
The Worst Form of Dementia? Because Alzheimer’s disease is the most common cause and the most often studied, people may believe it to be the “worst” form of dementia.
“In general, for anybody with dementia, it’s just horrible — for the person and the caregivers,” says Dr. Shah. He explains that there has been limited research on which types of dementia consistently progress faster or more severely, so there is no objective standard of what might be the worst type of dementia. Whichever one you are dealing with is likely to feel like the worst.
 
How Dementia Is Treated
Even if Alzheimer’s disease is not the cause of the dementia, treatment is likely to be the same.
“We use the same treatment mechanisms for everybody,” says Shah. “Ten percent is medications; 90 percent is education and community support.”
The medications that are available to help control dementia symptoms have primarily been tested in Alzheimer’s disease patients and are generally approved for use in Alzheimer’s disease — which means that if they are used for a patient with vascular dementia or Parkinson’s disease, that is technically an “off-label” use.
This may not change the outcome of treatment, but Shah emphasizes that it is important for doctors, patients, and their families to be clear about off-label uses of dementia medications.
Most dementia treatment involves developing an individualized care plan, says Shah. That means creating a web of care with the patient in the middle, surrounded by family and caregivers, and building a network of support that involves the medical team, as well as community and social services.
However, if your form of dementia is caused by something other than Alzheimer’s, you may have additional treatments that are specific to your underlying condition.
Even if you do have Alzheimer’s, your doctor may want to prevent complicating factors that could add to your dementia, such as strokes, so you could also be started on treatments that are new to you, such as blood pressure and cholesterol medication.
 
Are All Dementias Made Equal?
Regardless of the cause of dementia, you can expect the disease to progress through the same stages, as defined by worsening symptoms, although at different speeds. If you are concerned that a diagnosis of Parkinson’s disease or frontotemporal dementia means you will one day have Alzheimer’s, know that one cause of dementia does not automatically become another type of dementia.
Understanding the differences among the different causes of dementia — and what they mean for dementia treatment and quality of life — is challenging. Research and consultation with your medical team are an important part of coming to grips with what this news means for your health and your family.