Dementia Risks

Research

It's Not Always Dementia: Common Misdiagnoses

As one gets older, it is common to experience some cognitive decline with typical brain aging, such as subtle changes in memory, thinking, and  reasoning, explains the U.S. Centers for Disease Control and Prevention (CDC). However, dementia is not an inevitable part of typical brain aging, the CDC adds.

Many treatable conditions present symptoms that are similar to Alzheimer’s disease or another form of dementia, which refers to the loss of cognitive functioning — thinking, remembering, and reasoning.

Dementia can be challenging to diagnose – and differentiate from other conditions, explains Raphi Wald, Psy.D., a board-certified neuropsychologist with Marcus Neuroscience Institute at Boca Raton Regional Hospital, part of Baptist Health.

Raphael Wald, Psy.D., a neuropsychologist with Marcus Neuroscience Institute at Boca Raton Regional Hospital.

 

A standard medical workup for dementia, or Alzheimer's, often includes structural imaging with magnetic resonance imaging (MRI) or computed tomography (CT). These tests are primarily used to rule out other conditions that may cause symptoms similar to dementia but require different treatments. Structural imaging can reveal tumors, evidence of small or large strokes, damage from severe head trauma, or a buildup of fluid in the brain – all of which can produce dementia-like symptoms.

“Unfortunately, nothing fits neatly into a container where everything looks exactly the same way,” said Dr. Wald. “We have many patients that realize they have memory problems and they may have dementia. And we have many patients who don't realize they have memory problems and have vascular dementia. Many times the patient realizes there's an issue, but sometimes they have difficulty seeing it. So, there really is a range of appearances and levels of insight that people can bring to their doctor.”

Vascular dementia is caused by different conditions that interrupt the flow of blood and oxygen supply to the brain and damage blood vessels in the brain. There is no cure for vascular dementia, but treatments can help slow down the progression of the condition and prevent further brain damage

According to the National Institutes of Health (NIH), other conditions that cause dementia or dementia-like symptoms include:

  • Normal pressure hydrocephalus, an abnormal buildup of cerebrospinal fluid in the brain;
  • Creutzfeldt-Jakob disease, a rare brain disorder;
  • Huntington's disease, an inherited, progressive brain disease;
  • Chronic traumatic encephalopathy, caused by repeated traumatic brain injury;
  • HIV-associated dementia, a rare disease that occurs when the HIV virus spreads to the brain;
  • Heavy alcohol use over a long period of time;
  • Head injury, such as a concussion from a fall or accident;
  • Emotional problems, such as stress, anxiety, and depression;
  • Delirium, a sudden state of confusion and disorientation.

Another important point about dementia and Alzheimer’s, which is the most common form of the disease: There are several modifiable risk factors that seem to be mounting as new clinical studies emerge. Alzheimer's disease accounts for 60 to 80 percent of dementia cases.

Researchers estimate that 40 percent of dementia cases are linked to 14 risk factors. Those factors included: People having a lower level of education, hearing problems, high blood pressure, smoking, obesity, depression, physical inactivity, diabetes, high cholesterol, excessive drinking, traumatic brain injury, air pollution, untreated vision loss, and social isolation.

“That's why you need a doctor in order to help determine what is going on because maybe it's depression or maybe it's a first symptom of Alzheimer's disease,” explains Dr. Wald. “When a patient comes in, a 70-year-old man for example, and asks me: ‘How do I know whether it’s dementia or not when I have problems coming up with a word or remembering where I put my car keys.’

“I tell them that you probably can't throw a baseball as far as you could when you were 30-years-old. So, your brain is not going to work as well as it did when you were 30. So, some decline is normal. Our bodies don't work the same way they did 40, 50 years ago. But the question is: Is the aging happening at a rate that we expect or is it happening faster than we would like it to?”

Learn about our Memory Disorders Program.

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