When your loved one receives a diagnosis involving memory and cognitive problems, you might hear both "dementia" and "Alzheimer's disease" used in the same conversation. Are these the same thing? Different conditions? Is one worse than the other? The terminology can feel confusing, especially when you're already overwhelmed by the diagnosis itself.
The simple answer:
Dementia is an umbrella term for a group of symptoms affecting memory, thinking, and daily functioning. Alzheimer's disease is the most common specific disease that causes dementia, accounting for 60-80% of all dementia cases.
Think of it this way: dementia is the symptom, Alzheimer's is one of several possible diseases that cause those symptoms. It's similar to how "fever" is a symptom that can be caused by the flu, infection, or other illnesses.
Why understanding the difference matters:
Knowing which specific type of dementia your loved one has affects treatment options, understanding progression patterns, anticipating specific symptoms, planning for care needs, and connecting with appropriate support resources. Different dementia types require different management approaches, so accurate diagnosis matters beyond just understanding terminology.
What you'll learn in this guide:
- The precise relationship between Alzheimer's and dementia
- How Alzheimer's differs from other types of dementia
- Specific symptoms and progression patterns unique to Alzheimer's
- Other common causes of dementia and their characteristics
- Why accurate diagnosis matters for treatment and care planning
- Questions to ask your doctor about your loved one's specific diagnosis
Dementia: The Umbrella Term
Dementia is not a specific disease. It's a clinical syndrome, which means a collection of symptoms that occur together and affect daily life.
Core dementia symptoms include:
- Memory loss that disrupts daily life
- Difficulty with planning, reasoning, or problem-solving
- Challenges completing familiar tasks
- Confusion about time or place
- Problems with words, speaking, or writing
- Changes in mood, personality, or behavior
- Withdrawal from social activities
Key point: To be classified as dementia, these symptoms must be severe enough to interfere with independence and daily functioning. Occasional forgetfulness or mild age-related cognitive changes don't qualify as dementia. For more on this distinction, see our guide on early signs of dementia vs normal aging.
What causes dementia:
Many different brain diseases and conditions cause dementia symptoms:
- Alzheimer's disease (60-80% of dementia cases)
- Vascular dementia (10-20% of cases)
- Lewy body dementia (5-10% of cases)
- Frontotemporal dementia (5-10% of cases)
- Mixed dementia (combination of multiple types)
- Parkinson's disease dementia
- Huntington's disease
- Creutzfeldt-Jakob disease
- Normal pressure hydrocephalus
- Traumatic brain injury
- Chronic substance abuse
- Other conditions
Dementia is a description, not a diagnosis
When a doctor says "your mother has dementia," that describes her symptoms but doesn't identify the underlying cause. It's like saying "your mother has a fever" without identifying whether it's caused by the flu, infection, or something else. The next step should be determining which specific disease is causing the dementia symptoms.
Alzheimer's Disease: The Most Common Cause
Alzheimer's disease is a specific, progressive brain disease that causes dementia. It's the leading cause of dementia worldwide.
What happens in Alzheimer's disease:
Alzheimer's involves specific changes in the brain:
- Amyloid plaques: Abnormal protein deposits (beta-amyloid) build up between brain cells
- Neurofibrillary tangles: Twisted protein fibers (tau) form inside brain cells
- Brain cell death: These abnormal proteins damage and kill brain cells
- Brain shrinkage: Over time, affected areas of the brain shrink significantly
These changes typically begin in areas of the brain crucial for forming new memories (the hippocampus) and gradually spread to other brain regions responsible for language, reasoning, and social behavior.
Alzheimer's symptoms and progression:
Early stage Alzheimer's (2-4 years typically):
- Forgetting recent conversations or events
- Difficulty remembering names of new people or places
- Problems finding the right words
- Trouble planning or organizing
- Misplacing items
- Mild personality changes or withdrawal
Middle stage Alzheimer's (2-10 years typically):
- Significant memory loss, including important personal history
- Confusion about time, place, or events
- Increased difficulty with communication
- Changes in sleep patterns
- Wandering or getting lost
- Personality and behavioral changes (suspicion, repetitive behaviors)
- Needing help with daily activities like dressing and bathing
Late stage Alzheimer's (1-5 years typically):
- Severe memory loss and inability to recognize family
- Loss of ability to communicate
- Needing extensive help with all personal care
- Physical decline including difficulty walking, swallowing, and controlling bladder/bowel
- Increased vulnerability to infections, especially pneumonia
Characteristic pattern: Alzheimer's typically begins with memory problems and gradually affects other cognitive abilities. The progression is usually slow and steady, though rates vary significantly between individuals.
How Alzheimer's is diagnosed:
No single test definitively diagnoses Alzheimer's in living patients (definitive diagnosis requires brain examination after death). Doctors diagnose "probable Alzheimer's" based on:
- Medical history and symptom pattern
- Cognitive and memory testing
- Brain imaging (MRI or CT) to rule out other causes
- Lab tests to eliminate reversible causes
- Sometimes specialized scans (PET scans) or spinal fluid tests
For more information about what to expect, read our guide on early stage dementia what to expect.
Other Major Types of Dementia
Understanding how Alzheimer's differs from other dementia types helps clarify why accurate diagnosis matters.
Vascular dementia
What it is: Dementia caused by reduced blood flow to the brain, typically from strokes (large or small) or other blood vessel damage.
How it differs from Alzheimer's:
- Often has sudden onset or step-wise progression rather than gradual decline
- May affect judgment and planning more prominently than memory in early stages
- Physical symptoms like weakness or difficulty walking may be more pronounced
- Often associated with history of stroke, heart disease, or high blood pressure
Key symptoms:
- Difficulty with planning, organizing, and decision-making
- Slowed thinking
- Problems with attention and concentration
- Memory problems (but may be less prominent than in Alzheimer's)
- Physical symptoms like weakness on one side of body
Lewy body dementia (LBD)
What it is: Dementia caused by abnormal protein deposits (Lewy bodies) in areas of the brain involved in thinking, memory, and movement.
How it differs from Alzheimer's:
- Visual hallucinations are common and often occur early
- Movement problems similar to Parkinson's disease
- Fluctuating cognition where alertness changes dramatically day to day
- REM sleep behavior disorder (acting out dreams)
- Extreme sensitivity to antipsychotic medications
Key symptoms:
- Detailed visual hallucinations
- Parkinson-like movement problems
- Dramatic fluctuations in alertness and attention
- Memory problems (but may be less severe in early stages)
- Sleep disturbances
Frontotemporal dementia (FTD)
What it is: A group of disorders caused by progressive damage to the frontal and temporal lobes controlling personality, behavior, and language.
How it differs from Alzheimer's:
- Often begins at younger age (typically 45-65)
- Personality and behavior changes typically more prominent than memory problems
- Language difficulties may be the first noticeable symptom
- Memory often relatively preserved in early stages
- Different brain regions affected
Key symptoms:
- Significant personality changes (loss of empathy, impulsivity)
- Decline in social skills and manners
- Apathy or loss of motivation
- Compulsive or ritualistic behaviors
- Language problems (difficulty speaking or understanding)
- Memory relatively intact in early stages
For comprehensive guidance on FTD, see our article on caregiving for frontotemporal dementia.
Mixed dementia
What it is: When someone has brain changes from more than one type of dementia simultaneously, most commonly Alzheimer's disease combined with vascular dementia.
How it differs from single-type dementia:
- Symptoms may not fit neatly into one dementia type's pattern
- May have characteristics of multiple dementia types
- More common in older individuals (age 80+)
- May progress differently than either condition alone
Why the Specific Type Matters
Accurate diagnosis beyond "dementia" affects multiple aspects of care.
Treatment differences
Medications:
- Cholinesterase inhibitors are approved specifically for Alzheimer's and may help with symptoms
- Different medications work for behavioral symptoms in different dementia types
- Some medications used in Alzheimer's can be dangerous in Lewy body dementia
- Vascular dementia treatment emphasizes cardiovascular medications
Behavioral management:
- Strategies that work for Alzheimer's behavioral symptoms may not work for FTD
- Understanding that LBD causes hallucinations prevents inappropriate treatment
- Knowing progression patterns helps anticipate and prepare for specific challenges
Progression patterns
Different dementia types progress at different rates and in different patterns:
- Alzheimer's typically shows gradual, steady decline
- Vascular dementia may have sudden drops followed by periods of stability
- FTD often progresses faster in younger individuals
- LBD may have more variable day-to-day functioning
Understanding your loved one's specific type helps set realistic expectations and plan appropriately.
Care planning implications
Different types require different approaches:
- Someone with LBD needs careful medication management and movement support
- FTD behavioral symptoms may require different safety precautions than Alzheimer's memory problems
- Vascular dementia requires aggressive management of cardiovascular health
- Knowing the specific type helps you connect with specialized support groups and resources
Common Misconceptions About Alzheimer's and Dementia
Myth: Alzheimer's and dementia are the same thing
Reality: Dementia is the syndrome (collection of symptoms). Alzheimer's is one specific disease that causes dementia. Not all dementia is Alzheimer's.
Myth: Dementia is a normal part of aging
Reality: While some mild cognitive changes are normal with aging, dementia is not. Dementia involves cognitive decline severe enough to interfere with independence. Most older adults never develop dementia.
Myth: If you have dementia, it must be Alzheimer's
Reality: While Alzheimer's is the most common cause, 20-40% of dementia cases are caused by other conditions. Proper diagnosis matters.
Myth: Memory loss always means dementia
Reality: Many conditions cause memory problems, including depression, medication side effects, vitamin deficiencies, thyroid problems, and normal aging. Medical evaluation distinguishes dementia from other causes.
Myth: Nothing can be done about Alzheimer's, so diagnosis doesn't matter
Reality: While there's no cure, medications may help manage symptoms. More importantly, diagnosis enables legal planning, safety modifications, family preparation, and access to support services. Early diagnosis provides more time to make informed decisions.
Questions to Ask If Your Loved One Has Been Diagnosed
If your loved one has been told they have "dementia," make sure you understand the specifics.
About the diagnosis:
- What specific type of dementia does my loved one have?
- How confident are you in this diagnosis?
- What tests or evidence led to this conclusion?
- Could it be more than one type (mixed dementia)?
About progression:
- How does this type typically progress?
- What symptoms should we expect to develop?
- What's the usual timeline for this type?
- What signs indicate progression to the next stage?
About treatment:
- What medications or treatments are appropriate for this specific type?
- Are there treatments we should avoid based on this diagnosis?
- What non-medication approaches might help?
- Are there clinical trials for this specific type of dementia?
For a comprehensive list of questions, see our guide on questions to ask doctor after dementia diagnosis.
How CareThru Helps Manage Different Dementia Types
Regardless of whether your loved one has Alzheimer's or another dementia type, coordinating care and tracking symptoms becomes essential.
Tracking type-specific symptoms: For Alzheimer's, log memory lapses and orientation problems. For LBD, track hallucinations and fluctuations. For FTD, document behavioral changes. For vascular dementia, note sudden changes versus gradual decline.
Medication management: Different dementia types require different medications. Track which medications are prescribed, when they're taken, and whether they seem to help.
Sharing diagnosis information: Once you have a specific diagnosis, share it with all family members so everyone understands what type of dementia they're dealing with.
Connecting symptoms to diagnosis: As new symptoms emerge, log them and note whether they're typical for your loved one's specific dementia type.
Preparing for appointments: Pull up logged symptoms and patterns to share with doctors, helping them assess progression specific to your loved one's dementia type.
Frequently Asked Questions About Alzheimer's and Dementia
Can you have dementia without having Alzheimer's?
Yes, absolutely. About 20-40% of people with dementia have types other than Alzheimer's, including vascular dementia, Lewy body dementia, frontotemporal dementia, or other causes. Dementia is the symptom, and Alzheimer's is just one of many possible causes.
Can you have Alzheimer's without having dementia?
Not really, with one exception. By definition, Alzheimer's disease causes progressive cognitive decline. However, researchers have identified "preclinical Alzheimer's" where brain changes are present but the person hasn't yet developed noticeable symptoms. This preclinical stage can last years before dementia symptoms appear.
Is Alzheimer's worse than other types of dementia?
Not necessarily. All progressive dementia types are serious and eventually fatal. Different types cause different challenges. Alzheimer's may progress more slowly on average than FTD. LBD has particular medication sensitivities. Vascular dementia progression can be less predictable. "Worse" depends on how you measure severity, speed, specific symptoms, and individual experience.
If someone is diagnosed with dementia, will they eventually be told it's Alzheimer's?
Not always. Some people receive a "dementia" diagnosis without specific type identification, either because evaluation wasn't thorough enough or because the clinical picture doesn't clearly fit one specific type. If your loved one has been diagnosed with dementia but you don't know the type, ask for more specific diagnosis or request specialist evaluation.
Can the type of dementia change over time?
The underlying diagnosis doesn't typically change, but understanding of the diagnosis might. Sometimes what initially looks like one type is later recognized as another as more characteristic symptoms develop. Additionally, people can develop mixed dementia, where a second type develops alongside the first.
Is memory loss worse in Alzheimer's than other dementias?
Generally yes, especially in early stages. Alzheimer's typically affects memory formation first and most prominently because it begins in the hippocampus (brain's memory center). Other dementia types may affect behavior, language, or executive function more than memory in early stages. However, as all dementia types progress, severe memory impairment eventually occurs regardless of type.
Does knowing the specific type change the outcome?
It doesn't change the underlying disease, but it does change management, treatment approaches, symptom anticipation, and care planning. Accurate diagnosis allows for type-specific medications, avoidance of dangerous medications (especially important in LBD), connection to appropriate support resources, and realistic expectation-setting about progression.
Can dementia be reversed or cured?
Most common types (Alzheimer's, vascular, Lewy body, frontotemporal) are currently incurable and progressive. However, some causes of dementia symptoms are treatable or reversible, including vitamin B12 deficiency, normal pressure hydrocephalus, brain tumors, depression, medication side effects, and thyroid problems. This is why thorough medical evaluation is crucial when dementia symptoms appear.
Disclaimer: This article provides general information about Alzheimer's disease and dementia and is not a substitute for professional medical advice, diagnosis, or treatment. Every person's situation is unique. Always consult with qualified healthcare providers about your loved one's specific diagnosis, treatment options, and care planning needs.
Sources
- Alzheimer's Association. (2024). "What Is Dementia?" Available at: https://www.alz.org/alzheimers-dementia/what-is-dementia
- Alzheimer's Association. (2024). "What Is Alzheimer's Disease?" Available at: https://www.alz.org/alzheimers-dementia/what-is-alzheimers
- National Institute on Aging. (2024). "Alzheimer's Disease Fact Sheet." Available at: https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet
- National Institute on Aging. (2024). "What Is Dementia? Symptoms, Types, and Diagnosis." Available at: https://www.nia.nih.gov/health/what-dementia-symptoms-types-and-diagnosis
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- Alzheimer's Society (UK). (2024). "Types of Dementia." Available at: https://www.alzheimers.org.uk/about-dementia/types-dementia
- Lewy Body Dementia Association. (2024). "What Is LBD?" Available at: https://www.lbda.org/what-is-lbd
- The Association for Frontotemporal Degeneration. (2024). "What Is FTD?" Available at: https://www.theaftd.org/what-is-ftd
- Bang, J., Spina, S., & Miller, B. L. (2015). "Frontotemporal Dementia." The Lancet, 386(10004), 1672-1682.
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