Differentiating Alzheimer's disease from other diseases: Difference between revisions
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[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Alzheimer%27s_disease]] | |||
{{CMG}}; {{AE}} {{HK}} | {{CMG}}; {{AE}} {{HK}} | ||
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| style="padding: 5px 5px; background: #F5F5F5;" | +++ | | style="padding: 5px 5px; background: #F5F5F5;" | +++ | ||
(Slow cognitive and functional decline with early loss of awareness) | (Slow [[cognitive]] and functional decline with early loss of awareness) | ||
|<nowiki>+++</nowiki> | |<nowiki>+++</nowiki> | ||
|Not helpful | |Not helpful | ||
| Line 48: | Line 48: | ||
|<nowiki>++</nowiki> | |<nowiki>++</nowiki> | ||
| | | | ||
* Focal neurological signs absent during early stage (may develop later) | * [[Focal neurologic signs|Focal neurological signs]] absent during early stage (may develop later) | ||
* Mild | * Mild [[extrapyramidal]] signs | ||
|Has the following clinical stages: | |Has the following clinical stages: | ||
* Pre-clinical | * Pre-clinical | ||
* Mild cognitive impairment | * [[Mild cognitive impairment]] | ||
* Advanced dementia (full blown dementia) | * Advanced [[dementia]] (full blown dementia) | ||
| | | | ||
* Neurofibrillary tangles | * [[Neurofibrillary tangle|Neurofibrillary tangles]] | ||
* Senile (neuritic) plaques | * [[Senile plaques|Senile (neuritic) plaques]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Lewy body dementia]] | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Lewy body dementia]] | ||
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* Focal neurological signs present in majority | * Focal neurological signs present in majority | ||
* Strongly associated with | * Strongly associated with [[extrapyramidal]] signs | ||
* Autonomic changes | * [[Autonomic]] changes | ||
| | | | ||
* Early visual hallucinations | * Early [[visual hallucinations]] | ||
* Muscle rigidity | * [[Muscle rigidity]] | ||
* Sleep disturbance | * [[Sleep disturbance]] | ||
| | | | ||
* α-synuclein deposits present in neurons | * [[Alpha-synuclein|α-synuclein]] deposits present in [[Neuron|neurons]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Frontotemporal lobar degeneration]] | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Frontotemporal lobar degeneration]] | ||
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|<nowiki>-</nowiki> | |<nowiki>-</nowiki> | ||
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* Focal neurological signs present (motor neuron disease) | * [[Focal neurologic signs|Focal neurological signs]] present ([[motor neuron disease]]) | ||
* | * [[Extrapyramidal|Extrapyramidal signs]] present (familial [[Frontotemporal lobar degenerations|frontotemporal lobar degeneration]]) | ||
* Onset in young age | * Onset in young age | ||
* Strong familial association | * Strong [[familial]] association | ||
* Focal atrophy of frontal and temporal lobes | * Focal [[atrophy]] of [[Frontal lobe|frontal]] and [[temporal lobes]] | ||
* Knife-edge atrophy noted on MRI | * Knife-edge [[atrophy]] noted on [[Magnetic resonance imaging|MRI]] | ||
* Personality and behavioral changes | * [[Personality changes|Personality]] and behavioral changes | ||
* Language impairment | * Language impairment | ||
| | | | ||
* Two major variants: | * Two major variants: | ||
** Progressive nonfluent aphasia | ** Progressive nonfluent [[aphasia]] | ||
** Semantic variant | ** [[Semantic Dementia|Semantic]] variant | ||
* Progressive supranuclear palsy | * [[Progressive supranuclear palsy]] | ||
| | | | ||
* Pick bodies | * [[Pick bodies]] | ||
* Corticobasal degeneration | * [[Corticobasal degeneration]] | ||
* Ubiquitinated inclusions | * [[Ubiquitination|Ubiquitinated]] inclusions | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Vascular dementia]] | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Vascular dementia]] | ||
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|<nowiki>+</nowiki> | |<nowiki>+</nowiki> | ||
| | | | ||
* Focal neurological signs present typically | * [[Focal neurologic signs|Focal neurological signs]] present typically | ||
* Mild | * Mild [[extrapyramidal]] signs | ||
* Depression | * [[Depression]] | ||
* Mild motor signs in subcortical vascular dementia | * Mild [[Motor disorders|motor signs]] in subcortical [[vascular dementia]] | ||
* Slowed processing speed | * Slowed processing speed | ||
* Presentation might be similar to Alzheimer's disease | * Presentation might be similar to Alzheimer's disease | ||
| | | | ||
* Stepwise progression and focal neurologic signs (also known as multi-infarct dementia or poststroke dementia) | * Stepwise progression and focal neurologic signs (also known as [[multi-infarct dementia]] or poststroke [[dementia]]) | ||
| | | | ||
* Multifocal and/or diffuse lesions (lacunes and microinfarcts) | * Multifocal and/or diffuse lesions (lacunes and microinfarcts) | ||
* The following brain areas may be involved: | * The following [[brain]] areas may be involved: | ||
** Subcortical area | ** [[Subcortical|Subcortical area]] | ||
** Thalamus | ** [[Thalamus]] | ||
** Frontobasal | ** Frontobasal[[limbic system]] | ||
** White matter lesions | ** [[White matter]] lesions | ||
** Hippocampal sclerosis | ** [[Hippocampal sclerosis]] | ||
** Diffuse post-ischemic lesions | ** Diffuse post-ischemic lesions | ||
|} | |} | ||
Latest revision as of 18:51, 15 October 2019
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]
Overview
Alzheimer's disease must be differentiated from other causes of dementia which may share common characteristics of cognitive impairment. The differentials include, vascular dementia, Lewy body dementia and frontotemporal dementia.
Differentiating Alzheimer's Disease from other Diseases
Alzheimer's disease may be differentiated from other causes of dementia which may share common characteristics of cognitive impairment. The following table outlines the common differentials:[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]
| 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:
|
|
| Lewy body dementia | ++ | - | Helpful | +++ | + | + | +++ | + | +++ | +++ | +++ |
|
| |
| Frontotemporal lobar degeneration | +/- | - | Helpful | +++ | + | - | +++ | +++ | ++ | +++ | - |
|
|
|
| Vascular dementia | + (Dysexecutive syndrome) | - | Helpful | + | + | + | ++ | - | ++ | +++ | + |
|
|
|
References
- ↑ Jellinger KA (2008). "The pathology of "vascular dementia": a critical update". J. Alzheimers Dis. 14 (1): 107–23. PMID 18525132.
- ↑ Murayama S (2008). "[Neuropathology of frontotemporal dementia]". Rinsho Shinkeigaku (in Japanese). 48 (11): 998. PMID 19198143.
- ↑ Hodges JR, Patterson K (1996). "Nonfluent progressive aphasia and semantic dementia: a comparative neuropsychological study". J Int Neuropsychol Soc. 2 (6): 511–24. PMID 9375155.
- ↑ Hodges JR, Patterson K, Oxbury S, Funnell E (1992). "Semantic dementia. Progressive fluent aphasia with temporal lobe atrophy". Brain. 115 ( Pt 6): 1783–806. PMID 1486461.
- ↑ "Dementia, Globalization and Contemporary Art".
- ↑ Helkala EL, Laulumaa V, Soininen H, Riekkinen PJ (1988). "Recall and recognition memory in patients with Alzheimer's and Parkinson's diseases". Ann. Neurol. 24 (2): 214–7. doi:10.1002/ana.410240207. PMID 3178177.
- ↑ Weintraub S, Wicklund AH, Salmon DP (2012). "The neuropsychological profile of Alzheimer disease". Cold Spring Harb Perspect Med. 2 (4): a006171. doi:10.1101/cshperspect.a006171. PMC 3312395. PMID 22474609.
- ↑ Goldman JG, Williams-Gray C, Barker RA, Duda JE, Galvin JE (2014). "The spectrum of cognitive impairment in Lewy body diseases". Mov. Disord. 29 (5): 608–21. doi:10.1002/mds.25866. PMC 4126402. PMID 24757110.
- ↑ Metzler-Baddeley C (2007). "A review of cognitive impairments in dementia with Lewy bodies relative to Alzheimer's disease and Parkinson's disease with dementia". Cortex. 43 (5): 583–600. PMID 17715794.
- ↑ Uversky VN (2008). "Alpha-synuclein misfolding and neurodegenerative diseases". Curr. Protein Pept. Sci. 9 (5): 507–40. PMID 18855701.
- ↑ Bennett DA, Schneider JA, Wilson RS, Bienias JL, Arnold SE (2004). "Neurofibrillary tangles mediate the association of amyloid load with clinical Alzheimer disease and level of cognitive function". Arch. Neurol. 61 (3): 378–84. doi:10.1001/archneur.61.3.378. PMID 15023815.
- ↑ Brion JP (1998). "Neurofibrillary tangles and Alzheimer's disease". Eur. Neurol. 40 (3): 130–40. PMID 9748670.
- ↑ Lee JS, Jung NY, Jang YK, Kim HJ, Seo SW, Lee J, Kim YJ, Lee JH, Kim BC, Park KW, Yoon SJ, Jeong JH, Kim SY, Kim SH, Kim EJ, Park KC, Knopman DS, Na DL (2017). "Prognosis of Patients with Behavioral Variant Frontotemporal Dementia Who have Focal Versus Diffuse Frontal Atrophy". J Clin Neurol. 13 (3): 234–242. doi:10.3988/jcn.2017.13.3.234. PMC 5532319. PMID 28748674.
- ↑ Pao WC, Dickson DW, Crook JE, Finch NA, Rademakers R, Graff-Radford NR (2011). "Hippocampal sclerosis in the elderly: genetic and pathologic findings, some mimicking Alzheimer disease clinically". Alzheimer Dis Assoc Disord. 25 (4): 364–8. doi:10.1097/WAD.0b013e31820f8f50. PMC 3107353. PMID 21346515.
- ↑ Tsolaki M, Kokarida K, Iakovidou V, Stilopoulos E, Meimaris J, Kazis A (2001). "Extrapyramidal symptoms and signs in Alzheimer's disease: prevalence and correlation with the first symptom". Am J Alzheimers Dis Other Demen. 16 (5): 268–78. doi:10.1177/153331750101600512. PMID 11603162.
- ↑ McGuinness B, Barrett SL, Craig D, Lawson J, Passmore AP (2010). "Executive functioning in Alzheimer's disease and vascular dementia". Int J Geriatr Psychiatry. 25 (6): 562–8. doi:10.1002/gps.2375. PMID 19810010.