One of the most frequent questions I am asked is “What is the difference between Alzheimer’s disease and dementia?” Dementia is a general term that is often misunderstood. Dementia refers to mental deterioration to the point that one can no longer do higher level mental tasks like balancing a checkbook, using a computer, or preparing a meal. In more severe forms of dementia, one may no longer be able to tend to personal needs such as bathing, toileting, or dressing. In other words, dementia refers to mental decline where one can no longer function independently (i.e., needs at least some level of external care). Dementia refers to the severity of the mental deterioration.

Dementia is caused by a loss of skills that used to work well (e.g., finding your way around, paying bills, dressing). There are many possible causes of dementia. For example, the most frequent cause of dementia stems from a heavy burden of abnormal proteins named amyloid (i.e., plaques) and tau (i.e., tangles) that interferes with brain functions. When these proteins are the cause of the decline the condition is diagnosed as Alzheimer’s disease. Dementia is the general term for decline and Alzheimer’s disease is one of many possible causes of decline known as primary progressive dementia.

There are many causes of dementia other than Alzheimer’s disease. For example, when stroke causes the decline, the diagnosis would be vascular dementia. When a head injury causes the decline, the diagnosis would be dementia due to traumatic brain injury. If the frontal lobes (the part of the brain that plans and judge, interacts in socially appropriate ways, expresses oneself) decline the diagnosis would be a frontotemporal dementia. Progressive loss of expressive language is diagnosed as a primary progressive aphasia. There is a progressive dementia in some with Parkinson’s disease. There is another rather common progressive dementia caused by Lewy bodies called diffuse Lewy body disease. These conditions (as well as others) are all irreversible declines in ability. Some dementias are progressive (meaning they get worse over time) whereas others may be develop suddenly then stabilize or even improve over time (such as those caused by a stroke or a brain injury).

We often hear of so called “treatable dementias.” This is a poor choice of words. The term dementia should refer to irreversible conditions. There are some medical conditions that may cause temporary mental deterioration. With appropriate treatment or over time, there is a recovery to normal or near normal. Medical conditions such as thyroid disorder, metabolic disorders, certain vitamin deficiencies, tumors, severe depression, normal pressure hydrocephalus (if discovered and treated early enough), reactions to medications, untreated sleep apnea, “brain fog” from chemotherapy, acute illnesses (e.g., urinary tract infections, high fever) may cause temporary (may last hours to days to weeks) inability to function. These possibilities need to be evaluated in anyone showing decline.

In short, dementia is an irreversible and severe decline of mental abilities that interferes with independence. If properly managed, those with dementia can have a good quality of life.

Dr. Beckwith will present “Engagement Therapy for Memory Loss” on July 27 sponsored by Arden Courts in Fort Myers (call 454-1277 to register) and a three hour workshop (fee $100 per person/$150 per couple with limited seating) in Naples on August 8 (call 591-6226 to register).