Conditions With Symptoms Similar To Alzheimer's That Could Cause A Misdiagnosis

There are many disorders that can cause or imitate dementia, which can lead to the misdiagnosis of Alzheimer's disease.

Alzheimer's disease (AD) is one of several diseases that can cause or imitate dementia. Dementia is a group of symptoms associated with the deterioration of cognitive skills and accompanies particular disorders or physical conditions. Generally, the symptoms of dementia include memory loss, impairment of reasoning or judgment abilities, confusion, learning difficulties, personality changes, behavioral problems, and loss of language skills. Since dementia is common in several disorders, AD can be misdiagnosed. Some types of dementia are reversible or controlled with the correct therapy.

Multi-infarct dementia (MID), occurs when a person experiences multiple strokes in the brain. Sometimes "ministrokes" is used to describe this occurrence. The strokes result when small blood vessels of the brain become blocked, causing insufficient blood supply to the brain, destroying brain tissue. A decline in mental abilities follows. With symptoms similar to AD, MID is sometimes misdiagnosed. These include confusion, memory loss, incontinence, and behavioral changes. AD and MID may also be present together. Brain biopsy is the only way to distinguish MID from AD.

Some patients with Parkinson's disease (PD) may later develop dementia and some AD patients experience PD symptoms. In PD, brain cells that produce dopamine deteriorate, causing the inability to control movements normally. Patients often experience tremor, stiffness of the limbs, and slow movement. Changes are subtle, occurring gradually over time.

Huntington's disease (HD), an inherited illness, may be mistaken for AD. Unlike AD, however, a genetic test can confirm HD. HD is a degenerative brain disease, and symptoms may include involuntary movements, depression, personality changes, memory loss, and impaired decision-making abilities.

An uncommon brain disorder, Creutzfeldt-Jakob disease (CJD), results in quickly progressing dementia, with many patients dying within a year. This terminal disease is caused by an infection, however, in extremely rare cases, it may be inherited. Like AD, CJD can only be definitively diagnosed at autopsy. Patients experience a number of symptoms similar to AD, such as memory loss, behavioral changes, and uncoordinated movement.

In the elderly, depression is easily mistaken for dementia, especially since patients with dementia often present with depressive symptoms. With depression, however, language and motor skills are not diminished, unlike AD. Depressed patients experience sadness, hopelessness, inactivity, inattentiveness and thinking problems. Patients with severe depression may also have memory loss. Unlike AD, depression can be reversed, if diagnosed properly.

Normal pressure hydrocephalus, or NPH, may also cause dementia. In this rare disease, the flow of spinal fluid is blocked, causing fluid to accumulate within ventricles in the brain, compressing brain tissue. Symptoms often depend on where these ventricles are compressing brain tissue; however, in general, patients experience symptoms similar to AD, including problems with movement and memory loss. NPH can be confirmed or excluded through a CT or MRI scan, and it may be corrected through surgery in most patients.

With symptoms akin to AD, Pick's disease may be misdiagnosed as well. Pick's disease is a rare disorder, in which patients present with abnormal bodies, called Pick's bodies that affect nerve cells in the brain. The onset of disease usually occurs between 40 and 60 years of age. Since the disease may be inherited, the initial diagnosis focuses on family history; however, like AD, a definitive diagnosis can only be obtained at autopsy. With Pick's disease, patients usually experience memory loss, changes in personality, confusion, and difficulties with movements and language.

A different form of dementia is Lewy Body Dementia, or LBD. With LBD, the brain has abnormal protein deposits referred to as Lewy bodies. Currently, researchers do not know if LBD is a separate entity or is a variant of AD and PD, since the construction of the Lewy bodies as well as the symptoms are a combination of AD and PD. Symptoms of dementia, such as confusion, memory loss, and language problems, usually present at the start, and then are followed by symptoms of PD, such as abnormal movement.

Binswanger's disease is still another rare type of dementia, referred to as subcortical dementia. With this disorder, patients have lesions in the deep white-matter of the brain, resulting in memory loss and personality changes. Patients usually have abnormal blood pressure as well as signs of stroke and heart disease.

Other causes of dementia include nutritional deficiencies, as in the case of Wernicke-Korsakoff syndrome. With this brain disorder, patients have insufficient levels of thiamine, or B1, which can be a result of alcohol abuse, eating disorders, or as a side effect of chemotherapy. Patients usually present with confusion, memory problems, hypotension, and stupor. Another nutritional deficiency associated with dementia is vitamin B12.

Some medications can induce dementia, and this is the most common cause of reversible dementia. Other reversible types of dementia include thyroid problems and infection.

Brain tumors may also induce dementia symptoms. These can be confirmed or excluded through a CT or MRI scan.

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