What is Dementia?

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“Dementia” is the term that is now used by many instead of the more out-of-date word, “senility.” It refers to a group of symptoms, including memory difficulties and problems in at least one other area of cognitive functioning (e.g., language, attention, problem solving, spatial skills, judgment, planning, organization), with these problems being severe enough to get in the way of normal daily living (e.g., social and occupational functioning). A good analogy to the term, dementia, is “fever.” Fever refers to an elevated temperature, indicating that the person is sick. But, it doesn’t give any information about what is causing the sickness. In the same way, dementia means that there is something wrong with the person’s brain, but doesn’t provide any information about what is causing the memory and other cognitive difficulties. Dementia is not a disease; it is the clinical presentation of a disease.

What is the Difference between Dementia and Alzheimer's?

There are many possible causes of dementia. Some of these causes are reversible, such as certain thyroid conditions or vitamin deficiencies. If these underlying problems are treated then the dementia reverses and the person can return to normal functioning. However, most causes of dementia are not
reversible. Rather, they are progressive, degenerative diseases of the brain. Alzheimer’s disease is one of these degenerative causes of dementia. In fact, it is the most common cause of dementia, accounting for 70- 80% of all cases of dementia. There are other less common degenerative causes of dementia, such as vascular dementia (also referred to as multi-infarct dementia), fronto-temporal dementia, Lewy Body disease, and Chronic Traumatic Encephalopathy. But, again, the most common cause of dementia, accounting for approximately three quarters of all dementias is Alzheimer’s disease. And, this disease is all too common, with approximately 5.3 million Americans currently living with Alzheimer’s disease. And, with increasing age, the prevalence of the disease increases, such that approximately 50% of people age 85 and older have the disease. It is important to note, however, that, although Alzheimer’s disease is extremely common in later years, it is not part of normal aging. And, for that matter, dementia is not part of normal aging. If someone has dementia (from whatever underlying cause) it represents an important problem in need of appropriate diagnosis and treatment by a well-trained health care provider.

In a nutshell: dementia is a symptom; Alzheimer’s disease is the cause of the symptom. So, when someone is told they have dementia, it means that they have significant memory problems as well as other cognitive difficulties, and that these problems are severe enough to get in the way of daily living. Most of the time, dementia is caused by the specific brain disease, Alzheimer’s. Contrary to what some people may think, dementia is not a less severe problem, with Alzheimer’s disease a more severe problem. There is not a continuum with dementia on one side and Alzheimer’s at the extreme. Rather, there can be early or mild stages of Alzheimer’s disease, which then progress to moderate and then severe stages of the disease.

To read the full essay by Dr. Robert Stern, click here