From the Guidelines
Dementia can be caused by several conditions beyond Alzheimer's disease and vascular dementia, including Lewy body dementia, frontotemporal dementia, Parkinson's disease, Huntington's disease, Creutzfeldt-Jakob disease, and others, as outlined in the 2025 Alzheimer's Association clinical practice guideline 1.
Causes of Dementia
The causes of dementia beyond Alzheimer's and vascular dementia are diverse and include:
- Lewy body dementia, characterized by abnormal protein deposits in the brain, often presenting with visual hallucinations and movement problems similar to Parkinson's disease
- Frontotemporal dementia, which affects personality, behavior, and language skills, often starting at a younger age than other types
- Parkinson's disease, which can lead to dementia in its advanced stages
- Huntington's disease, a progressive brain disorder caused by a genetic mutation
- Creutzfeldt-Jakob disease, a rare, degenerative, and fatal brain disorder
- Normal pressure hydrocephalus, a condition characterized by an accumulation of cerebrospinal fluid in the brain
- Chronic traumatic encephalopathy, caused by repeated head injuries
- Certain infections, such as HIV, syphilis, and Lyme disease, if left untreated
- Vitamin deficiencies, particularly B vitamins, thyroid problems, or chronic alcohol abuse
- Medications, especially anticholinergics and sedatives, which can cause cognitive impairment that mimics dementia
Importance of Accurate Diagnosis
Accurate diagnosis is crucial for proper management, as many of these conditions have specific treatments that can slow progression or manage symptoms. The 2015 ESPEN guidelines on nutrition in dementia highlight the importance of identifying potentially reversible conditions, such as hypothyroidism or vitamin B12 deficiency, which can cause dementia-like symptoms 1. The 2011 National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease also emphasize the need to rule out other systemic or brain diseases that could account for cognitive decline 1.
Clinical Evaluation
A comprehensive clinical evaluation, including historical information, ancillary testing, and neuropsychological assessment, is necessary to determine the underlying cause of dementia. The 2025 Alzheimer's Association clinical practice guideline provides recommendations for the diagnostic evaluation, testing, counseling, and disclosure of suspected Alzheimer's disease and related disorders, including the identification of mixed etiology dementia 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Causes of Dementia
- Dementia with Lewy bodies (DLB) is a common cause of dementia, characterized by the presence of Lewy bodies in the brain 2, 3, 4
- Frontotemporal lobar degeneration (FTLD) is another common cause of dementia, characterized by the presence of abnormal protein aggregates in the brain 2, 3, 4
- Other pathologies, such as cerebrovascular disease, may also contribute to the development of dementia 5
- Risk factors for dementia include increasing age, genetic factors, head injuries, infections, and environmental factors 6, 5
Diagnosis of Dementia
- Structural and functional imaging, such as MRI and PET scans, can aid in the diagnosis of dementia and help distinguish between different types of dementia 2, 3
- Clinical diagnostic criteria for dementia syndromes require refinement, and repeat clinical examinations and structural neuroimaging can improve diagnostic accuracy 3
- Biomarkers, such as 123I-FP-CIT SPECT and 123I-metaiodobenzylguanidine (123I-MIBG), can be used to support the diagnosis of DLB 2
Types of Dementia
- Dementia with Lewy bodies (DLB) is characterized by the presence of Lewy bodies in the brain and can be distinguished from Alzheimer's disease (AD) using imaging techniques such as 123I-FP-CIT SPECT and 123I-MIBG 2
- Frontotemporal lobar degeneration (FTLD) is a heterogeneous group of neurodegenerative disorders characterized by the presence of abnormal protein aggregates in the brain 2, 3, 4
- FTLD can be subdivided into different clinical subtypes, including behavioral variant FTD (bvFTD), primary progressive aphasia (PPA), and FTD associated with motor neuron disease (FTD-MND) 2