Differentiating Alzheimer's disease from other diseases

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Alzheimer's disease may be differentiated from other causes of dementia based on characteristic clinical and cognitive features.

Differentiating Alzheimer's disease from other Diseases

  • Alzheimer's disease may be differentiated from other causes of dementia based on characteristic clinical and cognitive features:
Cause of dementia Clinical features Associated features Nature of progression Histopathological findings
Cognitive impairment
Recall Recollection Cue requirement for recall Infirngement of thoughts Semantic memory Procedural memory Working memory Awareness Attention Executive functioning issues Visuo-spatial skills
Alzheimer's disease +++

(Slow cognitive and functional decline with early loss of awareness)

+++ Not helpful +++ ++ - ++ +++ ++ ++ ++ Has the following clinical stages:
  • Pre-clinical
  • Mild cognitive impairment
  • Advanced dementia (full blown dementia)
Lewy body dementia ++ - Helpful +++ + + +++ + +++ +++ +++
  • Early visual hallucinations
  • Muscle rigidity
  • Sleep disturbance
  • Autonomic changes
  • α-synuclein deposits present in neurons
Frontotemporal lobar degeneration +/- - Helpful +++ + - +++ +++ ++ +++ -
  • Onset in young age
  • Strong familial association
  • Focal atrophy of frontal and temporal lobes
  • Knife-edge atrophy noted on MRI
  • Personality and behavioral changes
  • Language impairment
Vascular dementia + (Dysexecutive syndrome) - Helpful + + + ++ - ++ +++ +
  • Depression
  • Mild motor signs in subcortical vascular dementia
  • Slowed processing speed
  • Presentation might be similar to Alzheimer's disease
  • Stepwise progression and focal neurologic signs (also known as multi-infarct dementia or poststroke dementia)

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