Knowledge and Mythbusting Series -1
Vascular vs Alzheimer’s dementia
A common misconception that you would come across often is, dementia is a disease. Friends, let’s get the basics Right!
Alzheimer’s is a disease BUT dementia is a symptom or condition contributing to the disease.
There are four COMMON types of dementia- Alzheimer’s, vascular, frontotemporal and Lewy body dementia. Each have their own distinctive biomarkers and etiology (the cause of a disease). Yet they share a common features/ symptom that classifies them under the umbrella of “Dementia” – the cognitive and executive dysfunction i.e having memory loss, being unable to execute day to day task independently, feeling insecured or experiencing seizures.
Of the four types of dementia, Alzheimer’s dementia is the most common with profound knowledge available on it; followed by the less known and the second most common Vascular dementia. So, how are they similar or different?
Hence, this post will focus primarily give a contrasting perspective between Alzheimer’s dementia ( AD) and Vascular dementia ( VaD)
AD and VaD are often confused to be the same due to their similarities in their symptoms- primarily memory loss, the inability of performing day to day task independently and occasional seizures (Llewellyn et al., 2010). However, the etiology between both the conditions are different.
AD is often associated with an accumulation of amyloid-beta proteins and formation of neurofibrillary Tau protein tangles (Iadecola, 2010). Unlike AD, VaD is a multifactorial and heterogenous vascular disease. It is a consequence of decreased blood flow and deprivation of oxygen and nutrients to the brain due to an acute brain injury or chronic multiple cerebral infarcts (Iadecola, 2010). As a result, an alteration in the neuronal and dendro-synapses lead to the defects in cognition and executive dysfunction (Kalaria, 2018).
VaD is often accompanied by the severe impairments onto more than one cognitive domain (Smith, 2017). It can occur due to sudden brain damage or gradual symptomatic ischemic stroke (Ravona-Springer, Davidson, & Noy, 2003). On the other hand, AD is more likely a gradual process due to lack of physical and mental activity (Ravona-Springer et al., 2003).
Iadecola, C. (2010). The overlap between neurodegenerative and vascular factors in the pathogenesis of dementia. Acta Neuropathologica, 120(3), 287–296. https://doi.org/10.1007/s00401-010-0718-6
Kalaria, R. N. (2018). The pathology and pathophysiology of vascular dementia. Neuropharmacology, 134, 226–239. https://doi.org/10.1016/J.NEUROPHARM.2017.12.030
Llewellyn, D. J., Lang, I. A., Matthews, F. E., Plassman, B. L., Rogers, M. A., Morgenstern, L. B., … Langa, K. M. (2010). Vascular health, diabetes, APOE and dementia: the Aging, Demographics, and Memory Study. Alzheimer’s Research & Therapy, 2(3), 19. https://doi.org/10.1186/alzrt43
Ravona-Springer, R., Davidson, M., & Noy, S. (2003). Is the distinction between Alzheimer’s disease and vascular dementia possible and relevant? Dialogues in Clinical Neuroscience, 5(1), 7–15. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22033677
Smith, E. E. (2017). Clinical presentations and epidemiology of vascular dementia. Clinical Science (London, England : 1979), 131(11), 1059–1068. https://doi.org/10.1042/CS20160607
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