Types of Dementia in The Elderly

Dementia has been around for more than 100 years without a cure. Today, there are ten well-known types of Dementia consuming the elderly population.

1. Alzheimer’s Disease
2. Frontotemporal Dementia
3. Lewy Body Dementia
4. Vascular Dementia
5. Mixed Dementia
6. Normal Pressure Hydrocephalus
7. Creutzfeldt-Jakob Disease
8. Parkinson’s Disease
9. Huntington’s Disease
10. Wernicke-Korsakoff Syndrome

Alzheimer’s Disease

Alzheimer’s Disease was named after Dr. Alois Alzheimer’s who first discovered it in 1906. Dr. Alzheimer examined the brain of a female that he thought had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior.

Alzheimer’s Disease and Dementia are words that are routinely used,
interchangeably, for an elderly person experiencing symptoms of
Dementia. Definitively, there are not the same. Alzheimer’s Disease happens to be one type of Dementia. Not all people suffering from Dementia has Alzheimer’s. It is believed that 60% – 80% of people with Dementia is due to Alzheimer’s. It would be safe to say that Alzheimer’s is the most common cause of Dementia. Alzheimer’s Disease most often progresses to Dementia. It is not usually the other way around, Dementia does not progress to Alzheimer’s. A person with late-stage Alzheimer’s may present with symptoms of Dementia. He or she may lose the ability to properly communicate even the most basic needs.

Alzheimer’s Disease is an irreversible progressive brain disorder
that slowly destroys memory and thinking skills and eventually the
ability to carry out the simplest task. Alzheimer’s Disease, sometimes
called Senile Dementia, is very common. Symptoms usually develop slowly
and get worse over time.

Alzheimer’s Disease is currently rank as the sixth leading cause of death in the United States.

Frontotemporal Dementia

Frontotemporal Dementia is a disorder or a group of disorders caused by progressive nerve cell damage, or nerve cells loss, in the brains frontal lobes or its temporal lobes. The damage or loss of brain cells in these regions leads to loss of function which eventually leads to personality changes, language disturbances, or an alteration in muscle or motor functions

Pick’s Disease (a more familiar term) is the most common form of Frontotemporal Dementia. Pick’s Disease affects an individual’s personality significantly. Unlike other types of Dementia, Pick’s Disease typically results in behavior and personality changes, manifesting before memory loss and speech problems.

Another very interesting piece of information about frontotemporal is that the onset is much earlier than typical Dementia. Frontotemporal Dementia may occur in individuals as early as age 40, again unlike the typical Dementia which usually occurs after the age of 65.

Altered Mental Status changes in an individual 40 – 65 years would not usually point in the direction of Dementia. Neither would behavior and personality changes without memory loss and speech problems cause a clinician to think Dementia may be involved. These two reasons alone can be the cause of misdiagnosis in cases of Frontotemporal Dementia.

From personal experience, confrontation with a person suffering from Frontotemporal Dementia can be an experience that you will never forget. The words “Socially Inappropriateness” does nothing to prepare you for some things you may hear or see from that individual. It is like all the filters are removed. You will hear anything that comes to mind. Even for trained clinicians, the experience can be jarring.

There are at least six key differences between Frontotemporal Dementia and Alzheimer’s

1. Age at time of diagnosis is significant. Most people with Frontotemporal Dementia are diagnosed between 40 – 65 years. Alzheimer’s, on the other hand, usually shows up after 65.
2. Memory loss tends to be more of an issue in early Alzheimer’s than in Frontotemporal Dementia.
3. In Frontotemporal Dementia, Behavior changes are often the first noticeable symptoms. In Alzheimer’s Disease, Behavior changes are common but they tend to occur later in the disease.
4. Getting lost in familiar places is more common in Alzheimer’s than in Frontotemporal Dementia.
5. Hallucinations and Delusions are relatively common in Alzheimer’s as it progresses, but it is uncommon in Frontotemporal Dementia.
6. People with Alzheimer’s may have trouble thinking of the right word or remembering names but they tend to have less difficulty than the individual with Frontotemporal Dementia, making sense when they speak or understanding the speech of others.

Lewy Body Dementia

Lewy Body Dementia is a brain abnormality that was named after Frederich H. Lewy, M.D., a neurologist who discovered it while working in Dr. Alois Alzheimer’s laboratory during the early 1900s.

Lewy Body Dementia is believed to be the third most common cause of Dementia after Alzheimer’s Disease and Vascular Dementia. It accounts for 10 – 25% of the cases. It is characterized by abnormal protein deposits called Lewy Bodies which appear in the nerve cells in the brain stem. Dementia with Lewy Bodies is a progressive dementia that leads to a decline in thinking, reasoning, and independent functioning. Individuals with Lewy Bodies also experience movement symptoms, such as hunched posture, rigid muscles, a shuffling walk and trouble initiating movement. An individual with Lewy Bodies may experience visual hallucinations.

Lewy Body Dementia is not reversible and has no known cure.

Vascular Dementia

Vascular Dementia is the second most common form of Dementia. It is caused by poor blood flow to the brain. Vascular Dementia can be caused by any number of conditions that narrow the blood vessels. This deprives the brain cells of the nutrients and oxygen they need to function normally.

Unlike Alzheimer’s Disease, which usually begins with memory problems, Vascular Dementia usually begins with poor judgment or trouble planning, organizing, and making decisions.

Mixed Dementia

Mixed Dementia is a condition in which abnormalities characteristic of more than one type of Dementia occurs simultaneously. The most common form of mixed Dementia is caused by both Alzheimer’s Disease and Vascular Dementia. In some cases, an individual may have brain changes linked to Alzheimer’s Disease, Vascular Dementia, and Dementia with Lewy Bodies.

Normal Pressure Hydrocephalus

Normal Pressure Hydrocephalus is caused by an accumulation build-up of fluids in the brain. Impaired drainage of this fluid leads to added pressure in the brain. Individuals with Dementia caused by Normal Pressure Hydrocephalus often experience problems with ambulation, balance and bladder control, in addition to cognitive impairments.

Creutzfeldt-Jakob Disease

Creutzfeldt-Jakob Disease is the most common human form of a group of rare, fatal brain disorders known as Prion diseases. Prion diseases occur when prion protein in the brain begins folding into an abnormal three-dimensional shape. One type of prion disease found in human is similar to Mad Cow Disease found in wild deer, elk, and moose.

The Centers for Disease Control has no evidence so far to suggest that the disease has been transmitted to humans

Creutzfeldt-Jakob Disease causes a rare type of Dementia which only occurs in about one in every one million people annually, worldwide. Unlike most other forms of Dementia, that progresses slowly, Creutzfeldt-Jakob Disease progresses at a much quicker rate.

Parkinson’s Disease Dementia

Parkinson’s Disease Dementia is a decline in thinking and reasoning that develops in someone diagnosed with Parkinson’s Disease at least one year earlier.

According to the Alzheimer’s Association, Parkinson’s Disease is a fairly common neurological disorder in older adults, estimated to affect nearly 2% of those older than age 65. The Parkinson’s Foundation estimates that about one million Americans have Parkinson’s Disease and that 50 – 80% of those with Parkinson’s eventually develop Parkinson’s Disease Dementia. The average time from the onset of Parkinson’s to developing Dementia is about ten years.

Huntington’s Disease

Huntington’s Disease, also known as Huntington’s Chorea, is an inherited disorder that results in the death of brain cells. Usually, symptoms begin around age 30 to 50 years but it can happen at any age, from infancy to the elderly. About 8% of Huntington’s cases start before the age of 20.

Early symptoms of Huntington’s are often problems with mood or mental abilities, followed by a lack of coordination and an unsteady gait. Uncoordinated, jerky body movements become more apparent as the disease progresses. A person’s physical abilities gradually worsen until coordinated movements become difficult and the person may lose his or her ability to speak. Mental abilities generally decline into dementia.

The first likely description of this disease was in 1841 by Charles Oscar Waters. It was later described in greater detail in 1872 by the physician George Huntington’s after whom it was named.

Wernicke-Korsakoff Syndrome

Korsakoff Syndrome is a chronic memory disorder caused by a severe deficiency of thiamine. Thiamine helps brain cells produce energy from sugar. When Thiamine levels fall too low, brain cells are not able to generate enough energy to function properly. Korsakoff Syndrome may develop as a result.

Korsakoff syndrome is most commonly caused by alcohol misuse but can be associated with other conditions such as AIDS, chronic infection, poor nutrition, and others. This syndrome is often, but not always, preceded by an episode of Wernicke encephalopathy and because of that, the disorder is sometimes called Wernicke-Korsakoff Syndrome.

Wernicke Encephalopathy is an acute brain reaction, to a severe lack of thiamine. It is a medical emergency that causes life-threatening brain disruption, confusion, staggering and stumbling, lack of coordination, and abnormal involuntary eye movement. Unlike most other forms of Dementia, memory problems may be strikingly severe but the thinking and social skills remain intact. Individuals with Korsakoff Syndrome may confabulate (make up information to take the place of what they can’t remember). They are not intentionally lying, experts think that they may actually believe their own made up stories.

Article Sources

Alzheimer’s Association

https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia

Caring.com

https://www.caring.com/articles/types-of-dementia

WebMD.

https://www.webmd.com/alzheimers/guide/alzheimers-dementia

National Institute on Aging.

https://www.nia.nih.gov/health/what-lewy-body-dementia

https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet

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