Five common myths about dementia – and the reality

Having trouble with cognitive issues is difficult, but it only gets harder if you’re dealing with misinformation.

Mathew Pulicken, MD, a neurologist at Neurologists of Cape Cod in Hyannis, addressed some myths and realities that families might face.

Myth one: Dementia and Alzheimer's disease are the same thing.

“Dementia is an old term that we don't use too much anymore,” he said. “Now, we use ‘neurocognitive disorder,’ which encompasses all kinds of dementia. Many people associate dementia with Alzheimer's, which is only one subtype of dementia. Alzheimer's dementia is the most common kind of dementia and about 70 percent of all kinds of dementia, would be from an Alzheimer's pathology."

“Based on some of the clinical features, you can distinguish between Alzheimer's dementia from other kinds of dementia like frontal temporal dementia versus Lewy body dementia. You can only diagnose with one hundred percent certainty with a biopsy or a tissue sample, following an autopsy. But the FDA recently approved a new test that can diagnose Alzheimer's pathology to some certainty by measuring certain proteins in the spinal fluid.”

Myth two: Neurocognitive disorders cannot be treated.

“Once the damage from a neurocognitive disorder starts kicking in, you cannot reverse it. But we do have a few medicines that are FDA-approved and when used can slow the disease progression. Any delay in disease progression would be welcome, as it gives more time with better quality of life. Your doctor can try to find you a good option."

“Any time you have concern about memory loss or other cognitive issues, or if your family is noticing issues, bring it up with your primary care physician during your routine physical examination. They can do lab tests to rule out any contributing causes, schedule a formal memory assessment and/or send you to a neurologist for further evaluation.”

Myth three: Memory loss in older adults is not normal

“Just like any part of your body, your brain will undergo degeneration over time. If you look at your skin, or bones or other tissues, there will be degeneration over time. Some cognitive changes can be part of the normal aging process.”

“The tricky part is trying to distinguish is this normal for my age or is there something more going on? Memory is just one aspect of your overall neurocognitive function. If you’re forgetting some things now and then, that is not a big deal, but if you're noticing changes in your routine activities, forgetting to pay your bills or things you used to do before, or family is noticing a lot of repetition or other changes, it would be a good idea to be evaluated for any additional neurodegenerative pathology.”

Myth four: Forgetfulness is the only early sign of dementia.

“That’s not necessarily true, although it is the most common sign. For some patients, the biggest challenge is with language, word finding difficulty and the memory part comes in later. For Lewy body dementia, you can have behavioral changes that can be more prevalent than memory loss. Memory loss is the most common symptom and with Alzheimer's pathology, it's the earliest sign that gets noticed the most.”

Myth five: People living with dementia are all the same.

“This is not true as depending on the pathology of the neurodegeneration, the diagnosis and the stage of the disease, the symptoms and difficulty can vary a great deal. Depending on which kind of abnormal protein is being deposited or what kind of chemical is being lost in the brain, will dictate the clinical presentation."

“And even with the same pathology, different people manifest with varying degree of symptoms. With advanced disease, there will be similarity with clinical symptoms based of which kind of dementia, but each person is different when it comes to rate of progression and the kinds of symptoms.”