美国国家公共电台 NPR Is It Alzheimer's Or Another Dementia? The Right Answer Matters（在线收听）

STEVE INSKEEP, HOST:

When older people have dementia, it's commonly assumed that they have Alzheimer's disease, but that is not the only form of dementia. There are other causes. NPR's Jon Hamilton reports on why it's important to get the right diagnosis.

JON HAMILTON, BYLINE: When Julie Schneider was training to be a doctor in the 1980s and '90s, dementia was simple.

JULIE SCHNEIDER: We were taught that almost all dementia is Alzheimer's disease, and that there wasn't other things going on in the brain.

HAMILTON: Today, Schneider is a professor at the Rush Alzheimer's Disease Center in Chicago, and last week she served as scientific chair of a summit on dementias at the National Institutes of Health. Schneider says one key message from that summit is that dementia can have many causes. These include strokes, a form of Parkinson's and a disease that damages brain areas that regulate emotion and behavior.

SCHNEIDER: We still believe that Alzheimer's is important, but these other pathologies are also important.

HAMILTON: Alzheimer's is associated with plaques and tangles in the brain, but Schneider says a different culprit causes Lewy body dementia, which affects more than 1 million people in the U.S.

SCHNEIDER: It's these little aggregates called Lewy bodies, which were first identified in the brains of people with Parkinson's disease.

HAMILTON: And Schneider says people with Lewy body disease can expect different challenges than people with Alzheimer's.

SCHNEIDER: You're going to be more rapidly declining. You might have more motor problems, more falls, gait changes, balance problems, sleep problems, hallucinations.

HAMILTON: Many of these symptoms can be treated, even though the underlying disease can't be. Dr. Walter Koroshetz directs the National Institute of Neurological Disorders and Stroke. He says frontotemporal dementia damages areas of the brain involved in personality and behavior, and he says that can lead to tragic misunderstandings, if family members don't know the cause.

WALTER KOROSHETZ: Not infrequently, the spouse thinks that their spouse is just not worth being married to anymore, and they believe it's a psychological thing, and they get divorced. And later, there's a lot of guilt.

HAMILTON: One preventable cause of dementia is stroke, says Roderick Corriveau, a program director at the NIH.

RODERICK CORRIVEAU: One-third of the people who have strokes go on to have dementia. Preventing strokes is about preventing damage to your brain.

HAMILTON: Corriveau says people who've had one stroke can often avoid a second by taking blood thinners and controlling their blood pressure.

Jon Hamilton, NPR News.

(SOUNDBITE OF STRFKR'S "SOMETHING AIN'T RIGHT (LINDSTROM AND PRINS THOMAS REMIX)")