Types of Dementia other than Alzheimer’s Disease

Cognitive decline is often due to Alzheimer’s disease, but not always. Other causes of cognitive decline include Lewy Body disease (LBD), Parkinson’s (PD), Vascular dementia, Frontal Temporal Lobe dysfunction, Chronic traumatic encephalopathy, Creutzfeldt Jacob disease, Limbic encephalitis, Toxic encephalopathy, Normal pressure hydrocephalus Post concussion syndrome and Thyroid disease. We will briefly describe these.

1. Lewy Body disease
Lewy Body disease is like Alzheimer’s Type 4 in that toxins are commonly involved, and it is frequently seen in conjunction with Alzheimer’s. In this disease abnormal proteins called alpha-synucleins, are deposited in the brain where they affect brain chemicals that are essential for thinking, movement, and mood. It is a progressive disease with mild symptoms in the early stages. Progression speed varies from person to person, depending on overall health, however, cognitive decline precedes motor decline.

Typical symptoms include: a late sleeping pattern (a change in sleep pattern involving sleep until 11:00 am), visual hallucinations, periods of alertness versus poor alertness, mumbling speech, and REM sleep disturbance. Some symptoms are similar to Parkinson’s disease such as eye blinking, decreased facial expression, resting tremor, a wheeling forward type gait, and slowed movements. These patients can be hypersensitive to medications.

Treatment includes identifying toxins and removing them, supporting mitochondria, reducing inflammation, optimizing hormones and nutrition, and treating any chronic infections.

2. Parkinson’s Associated dementia
Parkinson’s disease (PD) is a neurodegenerative disorder that affects motor regions of the brain. Symptoms become more severe as the disease advances. Symptoms include tremors, difficulty walking and standing straight, changed facial expression, balance issues, and slowed movements.

PD is receiving increased attention in the press lately because this once rare disease is becoming so commonthat some are calling it a pandemic. It has been considered a genetically linked disease but the rapid increase in prevalence is not explained by genetics. Researchers have identified an association with environmental toxins and a pathologic gut microbe that is present in high levels in patients with PD.

Cognitive decline can be a feature of advanced PD.It is often preceded by a loss of the sense of smell, constipation, and REM sleep disturbance. Like Lewy Body disease, Parkinson’s associated dementia is associated with toxins. These patients may not detox well and may have a history of glyphosate and pesticide exposures. There can be a history of antibiotic use with gut dysfunction due to an altered gut microflora in many of these patients.

3. Vascular dementia
Vascular dementia is a condition caused by a compromised blood supply which results in insufficient oxygen and nutrient delivery to the brain. It causes problems with reasoning, planning, judgment, and memory.

Traditionally vascular dementia has been considered distinct from Alzheimer’s disease. The modern view is that vascular disease is one of the first manifestations of Alzheimer’s. In only 5% to 10% of cases, vascular dementia is a separate entity with no amyloid plaques or Tau tangles that are characteristic of Alzheimer’s.

Symptoms of vascular dementia include movement changes such as paralysis, weakness, loss of muscle control, increased or decreased muscle tone, or movements a person cannot control such as tremor, sensation changes such as numbness or decreased sensation, and speech difficulties.

Treatment is aimed at optimizing lipids, blood pressure, delivering oxygen to the tissues and resolving inflammation.

4. Frontal temporal dementia
Frontal temporal dementia is a term for a group of brain disorders that affect the frontal and temporal lobes of the brain. The areas affected are associated with personality, behavior, and language. The frontal and temporal areas atrophy or shrink in size.

Symptoms vary depending on the part of the brain that is affected. Some people have dramatic changes in their personality and become socially inappropriate, apathetic, impulsive or lose the ability to use language properly. Frontal temporal dementia tends to occur at a younger age than Alzheimer’s. Currently there is no effective treatment.

5. LATE(Limbic predominant age-related associated TDP-43 Encephalopathy)
Limbic-predominant age-related TDP-43 encephalopathy (LATE) is a type of dementia that causes problems with memory and thinking, like Alzheimer’s disease, but with different underlying causes. It is characterized by abnormal clusters of a protein called TDP-43 in the brain, especially in the memory centers. It usually occurs in people over age 75 years. LATE can coexist with Alzheimer’s. There is no known cause or treatment.

6. Creutzfeldt Jacob Disease (CJD)
CDJ, also known as mad cow disease, is a rare prion disease. A prion is a misfolded protein, and misfolded proteins don’t function properly. CJD causes rapidly worsening brain dysfunction and affects muscle coordination, thinking, and memory. Symptoms include involuntary muscle jerks, seizures, behavior changes, balance issues, depression, anxiety, insomnia, unusual sensations, and changes in vision.

7. Limbic Encephalitis
The term ‘limbic encephalitis’ (LE) describes the condition when limbic areas of the brain are inflamed (swollen) and consequently not functioning properly. The limbic areas of the brain control many functions including memory, learning, and emotions such as aggression. In addition, some of these limbic areas are susceptible to seizures, which are a common feature of limbic encephalitis. Most forms of LE fall into two main categories: infectious encephalitis and autoimmune encephalitis.

The symptoms of LE include memory loss, seizures, confusion, disturbances of sleep and psychological problems such as altered personality or behavior.

8. Chronic Traumatic Encephalopathy (CTE) and Post Concussion Syndrome
CTE is brain degeneration due to repetitive head traumas which cause concussions, short-term memory loss, impulsive behavior, and depression. Amyloids may, in some cases, increase after injury, but they can be cleared.  Symptoms include aggression, dementia, and depression. Oxygen therapy can be beneficial.

Concussion head injuries can have long term effects that may include brain fog, decrease in cognitive abilities, headache and neck pain, dizziness, and personality changes. New research suggests that perineural injection therapy and oxygen therapy may be beneficial.

9. Normal pressure hydrocephalus
Normal pressure hydrocephalus (NPH) is a condition that is caused by an abnormal buildup of cerebrospinal fluid (CSF) in the ventricles (cavities or spaces) of the brain. This condition is marked by gait disturbance, cognitive decline, and urinary incontinence or urgency. On MRI the cerebral ventricles appear enlarged. Symptoms usually improve after spinal fluid is removed.

10. Progressive Supranuclear Paralysis (PSP)
PSP is a neurodegenerative condition that causes problems with balance, vision, speech, gait, movement, and swallowing. It presents like Parkinson’s but does not respond to treatment. Some patients present with cognitive decline. A classic sign is difficulty looking up or down.