About Non-Alzheimer Dementias

Dementia with Lewy Bodies or "DLB"

Dementia with Lewy Bodies, or DLB, is a condition in which symptoms of Alzheimer's disease and Parkinson's disease are simultaneously present. Specifically, patients with DLB can have a general slowing of their movements as well as visual hallucinations or delusions early in the course of the illness, and a mental status that fluctuates markedly over time such as episodes of confusion or sleepiness. Persons with DLB may demonstrate extreme, sometimes violent movements during sleep suggestive of dream-enactment behavior. DLB is an important condition to diagnose as it has been shown that persons affected by the disorder can be extremely sensitive to the side effects of medications, particularly to the antipsychotic drugs frequently used to treat hallucinations. As the brains of persons with DLB usually also demonstrate the changes of Alzheimer's disease, it is thought by some to represent a sub-type of Alzheimer's disease and has also been referred to as the "Lewy Body variant of Alzheimer's disease."

Vascular / "Multi-Infarct" Dementia

Another common type of dementia is vascular, or "multi-infarct" dementia (MID) in which strokes either contribute to the cognitive impairment or more rarely, are the sole cause of the dementia. Persons with vascular dementia may be known to have had strokes or may have had them without having had any stroke symptoms. Vascular dementia is more common in persons with risk factors for heart disease and stroke such as high blood pressure, diabetes, elevated cholesterol levels, and smoking. Vascular dementia is commonly, but not always, associated with focal neurological symptoms (for example, weakness on one side of the body), problems with walking, or difficulty with urinary incontinence. Persons diagnosed with vascular dementia frequently also have the changes of Alzheimer's disease in their brains when studied at autopsy. During life, imaging studies such as MRIs can help identify the strokes.

Frontotemporal Dementia or "FTD"

Frontotemporal dementia (FTD) and other focal dementias are an important group of brain disorders that result in behavioral, cognitive, or language changes. Although far less is known about FTD than about Alzheimer’s disease (AD), research during the last ten years has greatly increased our understanding of these disorders. Researchers at UCLA and elsewhere continue to make new discoveries about FTD, formerly known as Pick’s disease, and other brain-behavior syndromes. FTD occurs most frequently in persons under the age of 65 and is rare among persons over 75. As discussed, the symptoms of FTD differ from typical memory impairments of Alzheimer’s disease. Not surprisingly, these changes in cognition and behavior are brought about by pathological changes in the brain that are also quite different from those of AD. FTD seems to be caused by more focal changes in specific brain regions, as a result of alternate protein changes. FTD brains show the deposit of Pick bodies and balloon neurons. These inclusions occur mostly in the frontal and temporal (side) parts of the brain, and some patients will experience very focal changes in these regions. For example, patients experience focal losses on the left side of the brain, where the regions that control language abilities are found. Other patients experience more frontal changes, resulting in social behavior symptoms such as unusual speaking to or touching strangers.

Symptoms of FTD (Pick’s Disease)

• Changes in personality
• Lack of interest for usual activities or family and friends
• Socially embarrassing behavior
• Unusual compulsive or rigid behavior
• Unusual eating behavior
• Difficulty with speaking or finding or understanding words
• Apathy
• Emotional disengagement
• Social disinhibition (e.g. talking to or touching strangers in public)

How is FTD Different from Alzheimer's Disease?

Although FTD and AD present with different symptoms, both are likely to affect reason and other forms of cognition. There are many substantial differences that exist between these disorders, however. While AD is most common in persons over the age of 65 (and increasing in likelihood as individuals get older), FTD occurs most frequently in persons under the age of 65 and is rare among persons over 75. As discussed, the symptoms of FTD differ from typical memory impairments of AD. Not surprisingly, these changes in cognition and behavior are brought about by pathological changes in the brain that are also quite different from those of AD. Whereas AD involves the deposit of plaques and tangles and the eventual loss of the much of the cerebral cortex, FTD seems to be caused by more focal changes in specific brain regions, as a result of alternate protein changes. Instead of plaques and tangles, FTD brains show the deposit of Pick bodies and balloon neurons. These inclusions occur mostly in the frontal and temporal (side) parts of the brain, and some patients will experience very focal changes in these regions. For example, patients experience focal losses on the left side of the brain, where the regions that control language abilities are found. Other patients experience more frontal changes, resulting in social behavior symptoms such as unusual speaking to or touching strangers. The UCLA Behavioral Neurology Program is focused on better understanding these and other changes in patients, as well as developing new treatments for this category of dementia.

Other Focal Neurobehavioral Disorders

• Primary Progressive Aphasia and Semantic Dementia - speaking and word finding problems.
• Posterior Cortical Atrophy - seeing and reading problems.
• Corticobasal Degeneration and Progressive Supranuclear Palsy - Problems with movement or motor coordination of arms or eyes.
• Other progressive problems with cognition, reading, writing, spatial abilities, reasoning, judgment, or mathematics.