There are a lot of causes of dementia other than Alzheimer's disease although Alzheimer's disease probably counts for anywhere from 40 to 60% of the cases of dementia. Other things that we see very commonly are disease processes called vascular dementia, for instance, Lewy body dementia and sometimes, things like normal pressure hydrocephalus and frontotemporal dementia. The most common one behind Alzheimer's disease is vascular dementia. Vascular dementia occurs in a setting of high blood pressure, elevated cholesterol, other cardiovascular diseases. It seems to be a little different from Alzheimer's disease. Alzheimer's disease is a very slowly progressive loss of function whereas vascular dementia folks tend to lose their abilities to remember and think in a step wise progression.
What makes it more complicated now though is that we think we see a lot of what we refer to as mixed dementia. These are folks who probably are on their way to developing Alzheimer's disease but have enough vascular risk factors that they have that is a component as well. Lewy body dementia is an interesting and distinctive one. When folks have Lewy body dementia, they often will start with visual hallucinations. They may have some movement disorder. They may have a little bit of tremor. They may have problems walking and they’re very sensitive to antipsychotic medication. You're tempted to give antipsychotic medication because of the hallucinations but it makes them much more unsteady. Having a conversation with your physician about the particular type of dementia that a loved one has is very important in terms of how you approach the treatment.
