DEMENTIA (OTHER)

VASCULAR DEMENTIA is caused by an accumulation of strokes. It’s pretty straightforward. In a question stem, the patient would likely have a lot of cardiovascular risk factors (smoking, hypertension, diabetes). The patient’s dementia will worsen in a stepwise pattern (each time they have a stroke, the dementia gets a little worse). The diagnosis is made using an MRI. There is no treatment. 

FRONTOTEMPORAL DEMENTIA (Pick’s Disease) is a form of dementia characterized by prominent personality changes (apathy, hypersexual grandpa) that precede memory loss. The MRI will show cortical atrophy predominantly of the frontal and temporal lobes (duh). The MRI is often quite dramatic (see picture below). In Alzheimer’s, the cortical atrophy seen on MRI is diffuse.

Lewy Body Dementia is characterized by dementia, visual hallucinations and Parkinsonian symptoms. On histology, there will be Lewy Bodies (bundle of misfolded proteins) throughout the brain (in Parkinson’s the Lewy Bodies are only in the substantia nigra). The visual hallucinations can be very realistic and wild (for example, smurfs or little children running around you). Not-fun Fact: Robin Williams was diagnosed with LBD post-mortem.