Dementia vs. Altzheimer's. What's the difference?

[babylonsister]

Estelle Getty died of dementia. I didn't need to know that, but what IS the difference? Does anyone know?

[dflprincess]

1. Alzheimer's is a specific form of dementia

There are many causes and kinds of dementia. For example, one of my grandmothers had some dementia, but hers was caused by having many small strokes it was not considered Alzheimer's.

[azul]

27. Right. But maybe try to differentiate JCD (madcow) from Alzheimers

and see where you end up. Pathologists don't want to diagnose Jacob-Creutzfeldt disease because there is no known practical way to sterilize the instruments and lab if found at autopsy.

AD and JCD both cause brain destruction by protein tangles leading to increasing dementia and death. The proteins in JCD, however, somehow form into about the toughest biological structures ever encountered: prions. Astonishingly, they cannot be broken down by chemicals -or even by normal methods of combustion. And they are transmissible somehow.


My feeble attempt at jocularity, because it is a twisted and scary subject, that most people don't quite get is,

Q: What did the Mars lander find?
A: Prions.

[dflprincess]

37. True

I have a friend whose mother had JCD and another whose mom had Alzheimer's (both finally diagnosed at autopsy). The only difference any of us could see was that the one who had JCD seemed to develop the confusion suddenly went downhill very quickly while the one with Alzheimer's was a much slower process. We could look back and realize the "odd" behavior we'd seen a few years before it became obvious was probably the early warning signs, but with the mom who had JDC not even with hindsight could anyone see any warning signs.

[entanglement]

38. IIRC, JCD is quite different from Alzheimers...spongiform appearance post mortem in JCD vs plaques

in Alzheimers

[bdamomma]

2. I think Dementia and Alzheimers are basically the same

terrible disease, my mom died of it. :-(

[malaise]

4. We buried my cousin's husband two weeks ago

A once brilliant family doctor just self destructed in less than a year. In the last four or five months, he didn't even recognize his wife or children. He was 87 and it was painful to watch. I'd rather die young.

[babylonsister]

9. He was 87 and 'destructed' in less than a year, and died?

Try a 63-yr old mom-watching her die from cancer for 2 and a half years, slowly. That doc's family suffered, but it could have been a lot worse.

[malaise]

14. And we're very thankful

but the deterioration was mind blowing.

[babylonsister]

21. I understand. So hard any which way when you love someone. nt

[awoke_in_2003]

29. My father use to take care

of Altzheimers patients. He told me if he ever got it to shoot him. It is a terrible way to die, for the victim and the family.

[Warpy]

24. No, they're not. They have different causes and different disease

profiles.

Dementia can be caused by poor circulation, by multiple small strokes, by some medications, and even by chronic electrolyte imbalance. Alzheimer's is caused by plaques within the brain, disrupting electrical signals within the brain.

My dad was always paranoid about Alzheimer's as his father had mild dementia by the time he died. I told him dementia was losing track of where you were in life and what you were supposed to be doing. Alzheimer's was when you went out the front door for the morning paper and then couldn't remember where you lived.

Patients with dementia generally don't lose their personalities. Patients with Alzheimer's lose everything, eventually forgetting how to eat. That's the signal they've had enough, and that comfort measures are necessary.

[babylonsister]

34. Thanks, Warpy. I recall you have dwelled in the medical field, so

do trust your definitions.

[lapislzi]

35. Warpy, have I told you lately that you're brilliant?

That is one of the best definitions (and differentiations) that I have read.

[Warpy]

36. Oh, great, now I have to go puncture my head

Thanks for the kind words!

[Hekate]

32. They are different medical descriptions. My MIL had a bunch of small strokes before the big one...

... that paralyzed her and robbed her of speech. My mother experienced a drastic change after her heart bypass, and that was probably due to microthrombi -- teensy clots that can be filtered out by your lungs, but not by the heart-lung machine they put you on for the surgery-- it can affect the brain in some people.

As far as dementia goes, my MIL was often confused the past several years (she's 95 now), and now we can't tell if anyone's home at all. My mother ended up with full-blown paranoia, and every negative aspect of her character was magnified. She passed away two years after her heart surgery, convinced her best friend was "stalking" her, hating me, dividing the family.

Alzheimer's disease is characterized not by strokes but by what they call plaques and tangles in the brain.

Dementia can be caused by a lot of different things, including head injuries, tumors, and diseases such as Parkinson's or untreated syphilis. Some of these things can be treated and cured, and some can be managed and mitigated, which is why it's important to differentiate them.

I'm really sorry about your mom. It's very hard to lose a loved one while they are still alive and in front of you. :hug:

Hekate

[elocs]

3. I am not sure, but I think Alzheimer's can only be definitively diagnosed with an autopsy.

Could be wrong. My mother has been in a nursing home with dementia for 12 years now. It's kind of 6 of one and a half dozen of another.

[babylonsister]

12. Give her a hug from us both; my mom died in 1990, and I sure

do wish I could hug her.

But my grandmother had dementia, I think. The last time I saw her, she didn't recognize me. The time before that, with all grandkids present (all 5 of us, and spouses), 'the lovely strangers' took her out to lunch, in her pajamas. Mimi had lost her sartorial splendor, but she was a great lady.

:hug:

[elocs]

13. My mom hasn't recognized me in years.

After 12 years in the nursing home she is an oldtimer there, having been there longer than many of the workers and having outlived most of the other people there. She lives in the big now which is collapsing onto itself. The spark that made her unique has gone out and now she really does not live, but simply exists.

[blonndee]

15. ...

Sorry to butt in, but I just wanted to say I'm sorry that you're going through this. I can't think of much more difficult than what you and your mom are experiencing (especially you, at this stage). My grandfather suffered for several years from Alzheimer's...it was a long and ugly process and I know exactly what you're talking about. I hope someday no families will have to live through such a painful ordeal. :hug:

[elocs]

17. I have really hoped with the size of the Baby Boomer generation and how old we are getting

would give us a strong incentive to find a cure for dementia by whatever name.

[babylonsister]

19. OK.

That's sad. For both of you.

[bdamomma]

20. terrible disease, it truly robs a person of their whole being.

and is equally as bad for family members. :hug:

[emilyg]

18. My step-dad was diagnosed with Alzheimers

I watched him go downhill for over 3 years. Very sad disease.

[Jackpine Radical]

5. Alzheimer's is one type of dementia.

There are many types, all characterized by a loss of function associated with some sort of brain damage. Damage from many little strokes is called "multi-infarct dementia," which can be highly variable in its effects, depending on exactly which brain areas are stricken. There is another type called Pick's Disease, often associated with alcoholism, that mostly damages the frontal lobes, and therefore affects the person's judgment, impulse control, etc. Alzheimer's is typified by a sort of global "withering" of the cortex, with declines im many areas of function, usually first becoming apparent in memory and judgment problems. Often the specific type of dementia is not known until an autopsy is performed.

Hope this helps.

[babylonsister]

8. I was just curious but you explained it perfectly so I can understand. Thanks. nt

[goclark]

23. The Dr. said my Mom has Simmons, a form of Alzheimer's

She now has good days and bad days but I am with her all the time.

[Thirtieschild]

6. We had two neighbors, one with dementia and the other with Alzheimer's

The difference? The eyes. The one with Alzheimers was gone, her eyes were empty. The one with dementia mentally out of it, but you could see the same personality in her eyes. She would have occasional - very occasional - rational moments. This is my uneducated diagnosis, based on a big difference in their eyes.

[ruggerson]

7. She died of Lewy Body disease

It's when clumps of alpha synuclein build up in the brain.

http://en.wikipedia.org/wiki/Lewy_body

[Kceres]

10. Dementia is not a disease.

It is a symptom of another process such as Alzheimer's, multi-infarct (strokes), etc. You can also become demented from narcotics, alcohol abuse, blood sugar irregularities, hydrocephalus, fever, clinical depression, manic episodes; the list is long. The swallowing reflex is just about the last thing to go during end-stage Alzheimer's, causing aspiration and, in turn, pneumonia. "Death from Alzheimer's" is usually a result of pneumonia. Horrible.

[ZombieHorde]

11. Dictionary.com

Dementia:
severe impairment or loss of intellectual capacity and personality integration, due to the loss of or damage to neurons in the brain.
http://dictionary.reference.com/browse/dementia

Alzheimer's:
a progressive form of presenile dementia that is similar to senile dementia except that it usually starts in the 40s or 50s; first symptoms are impaired memory which is followed by impaired thought and speech and finally complete helplessness
http://dictionary.reference.com/search?r=2&q=Alzheimer%27s

[bdamomma]

22. and the longer we are alive our risk is greater.

if there is history of it in the family, I hope I never suffer from it.

[DailyGrind51]

16. Dementia can be a consequence of stroke.

" Dementia

Also called: Senility

Dementia is a word for a group of symptoms caused by disorders that affect the brain. It is not a specific disease. People with dementia may not be able to think well enough to do normal activities, such as getting dressed or eating. They may lose their ability to solve problems or control their emotions. Their personalities may change. They may become agitated or see things that are not there.

Memory loss is a common symptom of dementia. However, memory loss by itself does not mean you have dementia. People with dementia have serious problems with two or more brain functions, such as memory and language.

Many different diseases can cause dementia, including Alzheimer's disease and stroke. Drugs are available to treat some of these diseases. While these drugs cannot cure dementia or repair brain damage, they may improve symptoms or slow down the disease.

National Institute of Neurological Disorders and Stroke"

http://www.nlm.nih.gov/medlineplus/dementia.html

[Rosa Luxemburg]

25. ICD classification of Dementia (there are many types!)

http://www.who.int/classifications/apps/icd/icd10online/

Chapter V

--------------------------------------------------------------------------------
Mental and behavioural disorders
(F00-F99)
Organic, including symptomatic, mental disorders
(F00-F09)

This block comprises a range of mental disorders grouped together on the basis of their having in common a demonstrable etiology in cerebral disease, brain injury, or other insult leading to cerebral dysfunction. The dysfunction may be primary, as in diseases, injuries, and insults that affect the brain directly and selectively; or secondary, as in systemic diseases and disorders that attack the brain only as one of the multiple organs or systems of the body that are involved.

Dementia (F00-F03) is a syndrome due to disease of the brain, usually of a chronic or progressive nature, in which there is disturbance of multiple higher cortical functions, including memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement. Consciousness is not clouded. The impairments of cognitive function are commonly accompanied, and occasionally preceded, by deterioration in emotional control, social behaviour, or motivation. This syndrome occurs in Alzheimer's disease, in cerebrovascular disease, and in other conditions primarily or secondarily affecting the brain.

Use additional code, if desired, to identify the underlying disease.



F00* Dementia in Alzheimer's disease ( G30.-+ )
Alzheimer's disease is a primary degenerative cerebral disease of unknown etiology with characteristic neuropathological and neurochemical features. The disorder is usually insidious in onset and develops slowly but steadily over a period of several years.
F00.0* Dementia in Alzheimer's disease with early onset ( G30.0+ )
Dementia in Alzheimer's disease with onset before the age of 65, with a relatively rapid deteriorating course and with marked multiple disorders of the higher cortical functions.
Alzheimer's disease, type 2
Presenile dementia, Alzheimer's type
Primary degenerative dementia of the Alzheimer's type, presenile onset

F00.1* Dementia in Alzheimer's disease with late onset ( G30.1+ )
Dementia in Alzheimer's disease with onset after the age of 65, usually in the late 70s or thereafter, with a slow progression, and with memory impairment as the principal feature.
Alzheimer's disease, type 1
Primary degenerative dementia of the Alzheimer's type, senile onset
Senile dementia, Alzheimer's type

F00.2* Dementia in Alzheimer's disease, atypical or mixed type ( G30.8+ )
Atypical dementia, Alzheimer's type

F00.9* Dementia in Alzheimer's disease, unspecified ( G30.9+ )



F01 Vascular dementia
Vascular dementia is the result of infarction of the brain due to vascular disease, including hypertensive cerebrovascular disease. The infarcts are usually small but cumulative in their effect. Onset is usually in later life.
Includes: arteriosclerotic dementia

F01.0 Vascular dementia of acute onset
Usually develops rapidly after a succession of strokes from cerebrovascular thrombosis, embolism or haemorrhage. In rare cases, a single large infarction may be the cause.
F01.1 Multi-infarct dementia
Gradual in onset, following a number of transient ischaemic episodes which produce an accumulation of infarcts in the cerebral parenchyma.
Predominantly cortical dementia

F01.2 Subcortical vascular dementia
Includes cases with a history of hypertension and foci of ischaemic destruction in the deep white matter of the cerebral hemispheres. The cerebral cortex is usually preserved and this contrasts with the clinical picture which may closely resemble that of dementia in Alzheimer's disease.
F01.3 Mixed cortical and subcortical vascular dementia
F01.8 Other vascular dementia
F01.9 Vascular dementia, unspecified



F02* Dementia in other diseases classified elsewhere
Cases of dementia due, or presumed to be due, to causes other than Alzheimer's disease or cerebrovascular disease. Onset may be at any time in life, though rarely in old age.
F02.0* Dementia in Pick's disease ( G31.0+ )
A progressive dementia, commencing in middle age, characterized by early, slowly progressing changes of character and social deterioration, followed by impairment of intellect, memory, and language functions, with apathy, euphoria and, occasionally, extrapyramidal phenomena.
F02.1* Dementia in Creutzfeldt-Jakob disease ( A81.0+ )
A progressive dementia with extensive neurological signs, due to specific neuropathological changes that are presumed to be caused by a transmissible agent. Onset is usually in middle or later life, but may be at any adult age. The course is subacute, leading to death within one to two years.
F02.2* Dementia in Huntington's disease ( G10+ )
A dementia occurring as part of a widespread degeneration of the brain. The disorder is transmitted by a single autosomal dominant gene. Symptoms typically emerge in the third and fourth decade. Progression is slow, leading to death usually within 10 to 15 years.
Dementia in Huntington's chorea

F02.3* Dementia in Parkinson's disease ( G20+ )
A dementia developing in the course of established Parkinson's disease. No particular distinguishing clinical features have yet been demonstrated.
Dementia in:
· paralysis agitans
· parkinsonism

F02.4* Dementia in human immunodeficiency virus disease ( B22.0+ )
Dementia developing in the course of HIV disease, in the absence of a concurrent illness or condition other than HIV infection that could explain the clinical features.
F02.8* Dementia in other specified diseases classified elsewhere
Dementia in:
· cerebral lipidosis ( E75.-+ )
· epilepsy ( G40.-+ )
· hepatolenticular degeneration ( E83.0+ )
· hypercalcaemia ( E83.5+ )
· hypothyroidism, acquired ( E01.-+ , E03.-+ )
· intoxications ( T36-T65+ )
· multiple sclerosis ( G35+ )
· neurosyphilis ( A52.1+ )
· niacin deficiency ( E52+ )
· polyarteritis nodosa ( M30.0+ )
· systemic lupus erythematosus ( M32.-+ )
· trypanosomiasis ( B56.-+ , B57.-+ )
· vitamin B 12 deficiency ( E53.8+ )




F03 Unspecified dementia
Presenile:
· dementia NOS
· psychosis NOS
Primary degenerative dementia NOS
Senile:
· dementia:
· NOS
· depressed or paranoid type
· psychosis NOS

Excludes: senile dementia with delirium or acute confusional state ( F05.1 )
senility NOS ( R54 )




F04 Organic amnesic syndrome, not induced by alcohol and other psychoactive substances
A syndrome of prominent impairment of recent and remote memory while immediate recall is preserved, with reduced ability to learn new material and disorientation in time. Confabulation may be a marked feature, but perception and other cognitive functions, including the intellect, are usually intact. The prognosis depends on the course of the underlying lesion.
Korsakov's psychosis or syndrome, nonalcoholic

Excludes: amnesia:
· NOS ( R41.3 )
· anterograde ( R41.1 )
· dissociative ( F44.0 )
· retrograde ( R41.2 )
Korsakov's syndrome:
· alcohol-induced or unspecified ( F10.6 )
· induced by other psychoactive substances ( F11-F19 with common fourth character .6)




F05 Delirium, not induced by alcohol and other psychoactive substances
An etiologically nonspecific organic cerebral syndrome characterized by concurrent disturbances of consciousness and attention, perception, thinking, memory, psychomotor behaviour, emotion, and the sleep-wake schedule. The duration is variable and the degree of severity ranges from mild to very severe.
Includes: acute or subacute:
· brain syndrome
· confusional state (nonalcoholic)
· infective psychosis
· organic reaction
· psycho-organic syndrome

Excludes: delirium tremens, alcohol-induced or unspecified ( F10.4 )

F05.0 Delirium not superimposed on dementia, so described
F05.1 Delirium superimposed on dementia
Conditions meeting the above criteria but developing in the course of a dementia (F00-F03).

F05.8 Other delirium
Delirium of mixed origin

F05.9 Delirium, unspecified



F06 Other mental disorders due to brain damage and dysfunction and to physical disease
Includes miscellaneous conditions causally related to brain disorder due to primary cerebral disease, to systemic disease affecting the brain secondarily, to exogenous toxic substances or hormones, to endocrine disorders, or to other somatic illnesses.
Excludes: associated with:
· delirium ( F05.- )
· dementia as classified in F00-F03
resulting from use of alcohol and other psychoactive substances ( F10-F19 )

F06.0 Organic hallucinosis
A disorder of persistent or recurrent hallucinations, usually visual or auditory, that occur in clear consciousness and may or may not be recognized by the subject as such. Delusional elaboration of the hallucinations may occur, but delusions do not dominate the clinical picture; insight may be preserved.
Organic hallucinatory state (nonalcoholic)

Excludes: alcoholic hallucinosis ( F10.5 )
schizophrenia ( F20.- )

F06.1 Organic catatonic disorder
A disorder of diminished (stupor) or increased (excitement) psychomotor activity associated with catatonic symptoms. The extremes of psychomotor disturbance may alternate.
Excludes: catatonic schizophrenia ( F20.2 )
stupor:
· NOS ( R40.1 )
· dissociative ( F44.2 )

F06.2 Organic delusional disorder
A disorder in which persistent or recurrent delusions dominate the clinical picture. The delusions may be accompanied by hallucinations. Some features suggestive of schizophrenia, such as bizarre hallucinations or thought disorder, may be present.
Paranoid and paranoid-hallucinatory organic states
Schizophrenia-like psychosis in epilepsy

Excludes: disorder:
· acute and transient psychotic ( F23.- )
· persistent delusional ( F22.- )
· psychotic drug-induced ( F11-F19 with common fourth character .5)
schizophrenia ( F20.- )

F06.3 Organic mood disorders
Disorders characterized by a change in mood or affect, usually accompanied by a change in the overall level of activity, depressive, hypomanic, manic or bipolar (see F30-F38), but arising as a consequence of an organic disorder.
Excludes: mood disorders, nonorganic or unspecified ( F30-F39 )

F06.4 Organic anxiety disorder
A disorder characterized by the essential descriptive features of a generalized anxiety disorder (F41.1), a panic disorder (F41.0), or a combination of both, but arising as a consequence of an organic disorder.
Excludes: anxiety disorders, nonorganic or unspecified ( F41.- )

F06.5 Organic dissociative disorder
A disorder characterized by a partial or complete loss of the normal integration between memories of the past, awareness of identity and immediate sensations, and control of bodily movements (see F44.-), but arising as a consequence of an organic disorder.
Excludes: dissociative disorders, nonorganic or unspecified ( F44.- )

F06.6 Organic emotionally labile disorder
A disorder characterized by emotional incontinence or lability, fatigability, and a variety of unpleasant physical sensations (e.g. dizziness) and pains, but arising as a consequence of an organic disorder.
Excludes: somatoform disorders, nonorganic or unspecified ( F45.- )

F06.7 Mild cognitive disorder
A disorder characterized by impairment of memory, learning difficulties, and reduced ability to concentrate on a task for more than brief periods. There is often a marked feeling of mental fatigue when mental tasks are attempted, and new learning is found to be subjectively difficult even when objectively successful. None of these symptoms is so severe that a diagnosis of either dementia (F00-F03) or delirium (F05.-) can be made. This diagnosis should be made only in association with a specified physical disorder, and should not be made in the presence of any of the mental or behavioural disorders classified to F10-F99. The disorder may precede, accompany, or follow a wide variety of infections and physical disorders, both cerebral and systemic, but direct evidence of cerebral involvement is not necessarily present. It can be differentiated from postencephalitic syndrome (F07.1) and postconcussional syndrome (F07.2) by its different etiology, more restricted range of generally milder symptoms, and usually shorter duration.
F06.8 Other specified mental disorders due to brain damage and dysfunction and to physical disease
Epileptic psychosis NOS

F06.9 Unspecified mental disorder due to brain damage and dysfunction and to physical disease
Organic:
· brain syndrome NOS
· mental disorder NOS




F07 Personality and behavioural disorders due to brain disease, damage and dysfunction
Alteration of personality and behaviour can be a residual or concomitant disorder of brain disease, damage or dysfunction.
F07.0 Organic personality disorder
A disorder characterized by a significant alteration of the habitual patterns of behaviour displayed by the subject premorbidly, involving the expression of emotions, needs and impulses. Impairment of cognitive and thought functions, and altered sexuality may also be part of the clinical picture.
Organic:
· pseudopsychopathic personality
· pseudoretarded personality
Syndrome:
· frontal lobe
· limbic epilepsy personality
· lobotomy
· postleucotomy

Excludes: enduring personality change after:
· catastrophic experience ( F62.0 )
· psychiatric illness ( F62.1 )
postconcussional syndrome ( F07.2 )
postencephalitic syndrome ( F07.1 )
specific personality disorder ( F60.- )

F07.1 Postencephalitic syndrome
Residual nonspecific and variable behavioural change following recovery from either viral or bacterial encephalitis. The principal difference between this disorder and the organic personality disorders is that it is reversible.
Excludes: organic personality disorder ( F07.0 )

F07.2 Postconcussional syndrome
A syndrome that occurs following head trauma (usually sufficiently severe to result in loss of consciousness) and includes a number of disparate symptoms such as headache, dizziness, fatigue, irritability, difficulty in concentration and performing mental tasks, impairment of memory, insomnia, and reduced tolerance to stress, emotional excitement, or alcohol.
Postcontusional syndrome (encephalopathy)
Post-traumatic brain syndrome, nonpsychotic

F07.8 Other organic personality and behavioural disorders due to brain disease, damage and dysfunction
Right hemispheric organic affective disorder

F07.9 Unspecified organic personality and behavioural disorder due to brain disease, damage and dysfunction
Organic psychosyndrome




F09 Unspecified organic or symptomatic mental disorder
Psychosis:
· organic NOS
· symptomatic NOS

Excludes: psychosis NOS ( F29 )

[Manifestor_of_Light]

26. I've known several people with Alzheimer's.

My mother and father were both diagnosed in 1995 by a neurologist. Mom still remembered who we were, but she was not paying her bills, not eating enough, and she got extremely nasty with everyone. She even got her lawyer after me. She was 81.

Dad stayed in good physical shape, and still recognized us, and only sometimes got nasty. He was almost 89.

It's been eight years today.

RIP Dad 8-26-1911 - 7-23-2000

:cry:

[babylonsister]

28. Thank you for sharing. nt

[Manifestor_of_Light]

31. Thank you for giving a damn.

Mom didn't take care of herself physically. She never got exercise, and ate too much. So when she passed at 81 she was in bad shape physically and mentally. I think the nastiness was there anyway, it was just more suppressed when she was younger.

Dad, OTOH, was active and in good shape until he got cancer and decided not to fight it, and was almost 89 when he passed.

The difference in their physical conditions as they aged was more and more apparent. I'm determined not to vege out.

I really miss Dad. He was a very wise man.

[lonestarnot]

30. One the brain shrinks, the other the brain gets holey.

:P lonestarnotdictionary.com

[LeftishBrit]

33. Alzheimers is one form of dementia

There are other forms (e.g. multi-infarct dementia). So all with Alzheimers have dementia, but not all with dementia have Alzheimers.