Why is Alzheimer's disease confused with other dementias?

Alzheimer disease (AD) is the most common cause of dementia. The cardinal manifestation of AD is progressive loss of memory. However, there are some nonamnestic presentations of AD, also called atypical AD. Symptoms of AD can sometimes start suddenly. In the presence of atypical symptoms or sudden onset, it may be difficult to distinguish AD from other dementias. We would like to discuss the confusing features of atypical AD that mimic other dementias. In this review, the literature associated with confusing features of AD, suggesting other dementia syndromes, is reviewed. In addition, a case of semantic dementia (SD) with the complaint of forgetfulness previously diagnosed as AD is presented together with clinical and radiological clues of the differential diagnosis of dementia syndromes. As in our representative SD case, a careful clinical history, a detailed mental evaluation, and neuroimaging will overcome this difficulty in diagnosis.

Why is Alzheimer's disease confused with other dementias?

Alzheimer disease (AD) is the most common cause of dementia. The cardinal manifestation of AD is progressive loss of memory. However, there are some nonamnestic presentations of AD, also called atypical AD. Symptoms of AD can sometimes start suddenly. In the presence of atypical symptoms or sudden onset, it may be difficult to distinguish AD from other dementias. We would like to discuss the confusing features of atypical AD that mimic other dementias. In this review, the literature associated with confusing features of AD, suggesting other dementia syndromes, is reviewed. In addition, a case of semantic dementia (SD) with the complaint of forgetfulness previously diagnosed as AD is presented together with clinical and radiological clues of the differential diagnosis of dementia syndromes. As in our representative SD case, a careful clinical history, a detailed mental evaluation, and neuroimaging will overcome this difficulty in diagnosis.

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  • Fratiglioni L, Winblad B, Strauss E. Prevention of Alzheimer’s disease and dementia. Major findings from the Kungsholmen Project. Physiol Behav 2007; 92: 98–104. 2. Querfurth HW, LaFerla FM. Alzheimer’s disease. N Engl J Med 2010; 362: 329–344.
  • de Souza LC, Bertoux M, Funkiewiez A, Samri D, Azuar C, Habert MO, Kas A, Lamari F, Sarazin M, Dubois B. Frontal presentation of Alzheimer’s disease. Dement Neuropsychol 2013; 7: 66–74.
  • Maurer K, Volk S, Gerbaldo H. Auguste D and Alzheimer’s disease. Lancet 1997; 349: 1546–1549. 5. Harciarek M, Kertesz A. Primary progressive aphasias and their contribution to the contemporary knowledge about the brain- language relationship. Neuropsychol Rev 2011; 21: 271–287.
  • Graham A, Davies R, Xuereb J, Halliday G, Kril J, Creasey H, Graham K, Hodges J. Pathologically proven frontotemporal dementia presenting with severe amnesia. Brain 2005; 128: 597–605.
  • La Joie R, Landeau B, Perrotin A, Bejanin A, Egret S, Pélerin A,  Mézenge F,  Belliard S,  de La Sayette V,  Eustache F et al. Intrinsic connectivity identifies the hippocampus as a main crossroad between Alzheimer’s and semantic dementia- targeted networks. Neuron 2014; 81: 1417–1428.
  • von Gunten A, Bouras C, Kövari E, Giannakopoulos P, Hof PR. Neural substrates of cognitive and behavioral deficits in atypical Alzheimer’s disease. Brain Res Rev 2006; 51: 176–211.
  • McKhann GM, Knopman DS, Chertkow H, Hyman BT, Jack CR Jr, Kawas CH, Klunk WE, Koroshetz WJ, Manly JJ, Mayeux R et al. The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging- Alzheimer’s Association workgroups on diagnostic guide lines for Alzheimer’s disease. Alzheimers Dement 2011; 7: 263–269.
  • Dubois B, Feldman HH, Jacova C, Dekosky ST, Barberger- Gateau P, Cummings J, Delacourte A, Galasko D, Gauthier S, Jicha G et al. Research criteria for the diagnosis of Alzheimer’s disease: revising the NINCDS-ADRDA criteria. Lancet Neurol 2007; 6: 734–746.
  • Blennow K, de Leon MJ, Zetterberg H. Alzheimer’s disease. Lancet 2006; 368: 387–403.
  • Qiu C, Kivipelto M, von Strauss E. Epidemiology of Alzheimer’s disease: occurrence, determinants and strategies toward intervention. Dialogues Clin Neurosci 2009; 11: 111–128.
  • Mendez MF. Early-onset Alzheimer’s disease: nonamnestic subtypes and type 2 AD. Arch Med Res 2012; 43: 677–685.
  • Duker AP, Espay AJ, Wszolek ZK, Rademakers R, Dickson DW, Kelley BJ. Atypical motor and behavioral presentations of Alzheimer disease: a case-based approach. Neurologist 2012; 18: 266–272.
  • Kertesz A, Jesso S, Harciarek M, Blair M, McMonagle P. What is semantic dementia?: a cohort study of diagnostic features and clinical boundaries. Arch Neurol 2010; 67: 483–489.
  • Neary D, Snowden JS, Gustafson L, Passant U, Stuss D, Black S, Freedman M, Kertesz A, Robert PH, Albert M et al. Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology 1998; 51: 1546–1554.
  • Irish M, Addis DR, Hodges JR, Piguet O. Considering the role of semantic memory in episodic future thinking: evidence from semantic dementia. Brain 2012; 135: 2178–2191.
  • Matuszewski V, Piolino P, Belliard S, de la Sayette V, Laisney M, Lalevée C, Pélerin A, Viader F, Eustache F, Desgranges B. Patterns of autobiographical memory impairment according to disease severity in semantic dementia. Cortex 2009; 45: 456– 472.
  • Diehl J, Grimmer T, Drzezga A, Riemenschneider M, Förstl H, Kurz A. Cerebral metabolic patterns at early stages of frontotemporal dementia and semantic dementia. A PET study. Neurobiol Aging 2004; 25: 1051–1056.
  • Mion  M,  Patterson  K,  Acosta-Cabronero J,  Pengas G, Izquierdo-Garcia D, Hong YT, Fryer TD, Williams GB, Hodges JR, Nestor PJ. What the left and right anterior fusiform gyri tell us about semantic memory. Brain 2010; 133: 3256–3268.
  • Helzner EP, Scarmeas N, Cosentino S, Tang MX, Schupf N, Stern Y. Survival in Alzheimer disease: a multiethnic, population-based study of incident cases. Neurology 2008; 71: 1489–1495.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

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Alzheimer disease, inflammation, and novel inflammatory marker: resistin

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The value of FDG-PET/CT by using 3-dimensional stereotactic surface projection software analysis in the differential diagnosis of dementia

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Forensic medicine evaluation of Alzheimer patients: a series from Ankara, Turkey

MEHMET CAVLAK, RAMAZAN AKÇAN, ALİ RIZA TÜMER, AYSUN BALSEVEN ODABAŞI, AYKUT LALE, MAHMUT ŞERİF YILDIRIM, EYUP RUŞEN HEYBET

A comparison of hair and serum trace elements in patients with Alzheimer disease and healthy participants

EMİNE RABİA KOÇ, ATİLLA İLHAN, ZÜBEYDE AYTÜRK, BURCU ACAR, MUKADDES GÜRLER, AYNUR ALTUNTAŞ, MUSTAFA KARAPİRLİ, ABDURRAHMAN SAİD BODUR

Why is Alzheimer disease confused with other dementias?

İbrahim Levent GÜNGÖR, Dursun AYGÜN

COGNITIVE PROBLEMS RELATED TO VERTEBRO-BASILAR CIRCULATION

ABDULKADİR KOÇER

Why is Alzheimer's disease confused with other dementias?

DURSUN AYGÜN, İBRAHİM LEVENT GÜNGÖR