You’ve likely heard of them before. Their most distinctive feature is a severe and progressive decline in memory, reasoning, and other primary cognitive abilities. Their diagnoses get easily mistaken for one another, and the two terms are often used interchangeably.
Are dementia and Alzheimer’s the same thing? The short answer is no, they are not. Although tightly intertwined, they are remarkably different.
How so? Well, this may come as a surprise. Alzheimer’s is a disease. Dementia is not. Technically, dementia is a syndrome or a collection of symptoms associated with a specific disorder. In other words, it’s not the cause, it’s the effect. Think of it as the tip of the iceberg, the most apparent signal of some underlying conditions that need addressing. Alzheimer’s is one of them.
It’s probably the most well-known and common one. In fact, according to the Alzheimer’s Association’s latest report, it accounts for about 60-80% of recorded cases. And yet, it’s only one of the many possible causes. Creutzfeldt-Jakob disease, Huntington’s disease, Parkinson’s disease, HIV, traumatic brain injury, vascular cognitive impairment, frontotemporal and Lewy body dementia, along with several others, all can set it off.
That is, not everyone diagnosed with dementia has Alzheimer’s. The root cause might be something else.
Let’s dig a bit deeper.
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What is dementia, exactly?
While its current diagnostic name is “major neurocognitive disorder,” the umbrella term dementia is still universally used—mostly in the lay language—to describe a wide array of symptoms resulting from a variety of brain pathologies and injuries. Loss of memory together with impairment in thinking, reasoning, learning, and language skills; intense mood swings; behavioral and emotional issues; and difficulties carrying out simple daily tasks all fall under its rubric.
If you are wondering what the symptoms look like in action, Shakespeare’s King Lear (1606), one of the greatest tragedies in English literature, can give you quite an in-depth and faithful portrait. The 80-year-old King of Britain could have suffered from Lewy Body dementia, experts suggest. The signs are woven throughout the play: from irrational thinking, paranoia, and hallucinations, to sudden mood changes, and eventually, the inability to recognize people he knows.
King Lear’s “madness,” dementia, gets its name from two Latin words joined together: de, meaning “away from,” and mens, mentis, meaning “mind, reason, intellect.” It’s usually translated as “being out of one’s mind.”
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First recorded in The Etymologies, an encyclopedia compiled around ad 600 by the archbishop of Seville, Saint Isidore (ad 560–636), the term dementia referred to all kinds of mental and neurological diseases.
That said, the concept of dementia has been around since early civilizations, long before it was named. Greek and Roman thinkers and philosophers regarded it as a natural and inevitable consequence of aging—which it is not, by the way. Neither is Alzheimer’s.
The Middle Ages twisted dementia into a punishment from God for sins committed, and soon after into a supernatural phenomenon, evidence of demon-possession, or involvement with witchcraft. Oftentimes, those who fell victim to the witch-hunt were simply suffering from some kind of brain condition, such as schizophrenia, epilepsy, or senile dementia. Today, the word still carries lots of fear and social stigma, somewhat like a modern-day Scarlet Letter.
Within the medical community, many advocate for a more sensitive term to describe dementia, such as cognitive and neurocognitive impairment. Along the same lines, the Diagnostic and Statistical Manual of Mental Disorders (DSM 5) now classifies dementia as major neurocognitive disorder, which is its current clinical term.
Even if the word dementia might not be going away soon, its days seem to be numbered.
What is Alzheimer’s disease?
Alzheimer’s disease was named after German neuropathologist Alois Alzheimer, who in 1906 reported to the academic world the peculiar case of a 51-year-old woman who died of pneumonia after suffering from an “unusual mental illness.” She became the first patient with Alzheimer’s disease, a degenerative and irreversible disorder of the brain that can develop in mid-to-late adulthood, with no cure or known cause, as yet.
Alzheimer’s slowly steals the mind of its victims, robbing them of their story, their memories, and at last, their lives. The onset of dementia typically occurs in the final stage. That’s when impaired memory, speech, and judgment; confusion and disorientation; personality changes; or emotional instability start to show up, worsening over time.
On a physical level, the hallmarks of Alzheimer’s are two microscopic structures known as plaques, clusters of beta-amyloid proteins found between neurons, and tangles, twisted threads of tau proteins found inside them (inside neurons). These tiny deposits, unique to the disease, were the German physician Alzheimer’s groundbreaking discoveries. They gradually build up on the brain tissue, disrupting the way neurons work and communicate with each other, eventually resulting in the death of nerve cells and neural connections.
However, panic not. Let’s stress this point again. Neither Alzheimer’s nor dementia are a normal part of aging. Being forgetful doesn’t necessarily mean that something is wrong.
Is this just a “senior moment” or something else?
Have you ever spent the whole morning looking for your keys? Or forgotten the reason for walking to another room? Rest assured, you are not alone. It happens to everyone and at any age. Countless factors could be to blame, including stress, poor sleep patterns, and even some medications.
Nevertheless, it tends to happen more often as you age. Why? Your brain grows older as you do. It’s called cognitive aging. Some areas of the brain shrink and its processing speed slows down, so memory lapses become more frequent and problem-solving and multitasking take more effort.
These kinds of age-related difficulties are far less intrusive than that associated with Alzheimer’s or other neurological pathologies.
Also, it doesn’t come together with other warning signs, like repeating questions or getting lost in familiar places, trouble handling money, paying bills, and completing habitual tasks, or sudden changes in mood and personality. These, instead, should all raise a red flag.
The good news is, your genetics, diet, and overall lifestyle all seem to play an important role not only in the age of your brain—which doesn’t depend much on the number of years you have lived—but also in the risk of developing diseases and disorders.
So, let’s live well, address any concerns, and keep our health in check. While research makes progress and changes the games.
