differential diagnosis types of dementia

Differential diagnosis

• Alzheimer's disease
  • onset gradual
  • cognitive symptoms
    • memory inpairment, learning impairment, language impairment, visuospatial dysfunction, executive dysfunction
  • motor symptoms: rare, apraxia late
  • disease progression: gradual over 8-10 years
  • brain MRI: global atrophy, cortical atrophy, hippocampal atrophy
• vascular dementia
  • onset sudden or stepwise
  • cognitive symptoms depend on location of stroke(s)
  • motor symptoms depend on location of stroke(s)
  • disease progression: gradual or stepwise
  • affective & psychotic manifestations are common
    • delusions, apathy, disinhibition
    • personality or mood changes may be early manifestation
    • emotional incontinence (abrupt crying, laughter)
  • mental slowing
    • impairment in processing speed & executive dysfunction,
      • generally associated with lesions in white matter tracts & subcortical gray matter
      • brain MRI: cortical or subcortical infarcts
        • ischemic, hypoxic or hemorrhagic lesions
  • visual spatial skills impaired
  • attention deficit
  • impaired organizational skills
  • motor disturbances or gait instability
    • slowing of motor performance
• lewy body dementia
  • onset gradual
  • cognitive symptoms
    • memory inpairment, visuospatial dysfunction, visual hallucinations, fluctuating symptoms, REM sleep behavioral disorder, sensitivity to neuroleptics
    • motor symptoms:
      • parkinsonism present prior to or with cognitive impairment, frequent falls
    • disease progression: gradual, faster than Alzheimer's disease
    • brain MRI: global atrophy
• frontotemporal dementia
  • gradual onset < 60-65 years of age
  • cognitive symptoms
    • executive dysfunction, personality changes, disinhibition, apathy language impairment, +/- memory impairment
    • performance on objective cognitive testing may be near normal
  • motor symptoms: none
  • disease progression: gradual, faster than Alzheimer's disease
  • brain MRI: atrophy in frontal lobes & temporal lobes
• autoimmune dementia
• frontal-subcortical dementia
  • AIDS dementia complex
• cerebral amyloid angiopathy
• rapidly progressive dementia
• mixed dementia
• semantic dementia
• Parkinson's dementia
  • generally Parkinson's disease for mamy years prior to dementia
  • memory inpairment, visuospatial dysfunction, visual hallucinations, fluctuating symptoms
  • brain MRI: global atrophy
• dementia pugilistica

* see specific dementia for characteristic features

More general terms

• differential diagnosis