"Doctor, my mother always forgets things and is prone to falling down when walking. Is her Alzheimer's disease getting worse?" This is one of the most common questions asked by family members at the memory clinic.
But the truth is: unsteady walking is likely not the "culprit" of Alzheimer's disease. Once confused, patients may miss the optimal intervention period and bear unnecessary risks of accelerated disease progression.
As a family member, mastering the ability to make preliminary distinctions is a crucial step in buying time for your loved ones. Today, with a clear 'family self-examination guide' and 'interpretation of medical terminology', I will guide you through the fog and help you understand the essential differences between the two diseases.
[Family Self-Inspection] An Urgent "Discrimination Guide" for You
When family members exhibit both "poor memory" and "shaky gait", please do not panic. Refer to the table below for a calm initial observation. This will help you provide more precise information to the doctor when seeking medical attention.
Alzheimer's disease vs cerebellar atrophy
Family Self-Inspection Guide
Important note: This table is intended for auxiliary family observation and cannot replace professional medical diagnosis. If you have any concerns, please seek medical attention promptly.
Why are the symptoms so different?
Alzheimer's disease: It attacks the "highest command", with its root cause lying in the cerebral cortex (especially the hippocampus). This area is akin to the CEO's office and core database of a company, responsible for thinking, memory, and decision-making.
Aβ amyloid plaques and tau protein neurofibrillary tangles are the two main culprits. They destroy nerve cells, leading to memory loss, decreased judgment, and ultimately paralyzing the entire "command system".
Cerebellar atrophy: The damaged part is the "precise dispatch center", and the root cause lies in the cerebellum. It does not issue commands, but is responsible for fine-tuning and coordinating the commands from the brain, serving as the body's "autopilot".
When the cerebellum atrophies, movement loses coordination, leading to ataxia - the patient "knows" they want to walk, but their legs refuse to obey; they "want" to pick up a cup, but their arms shake and they cannot complete the action accurately.
In simple terms: one is not being able to recall "what needs to be done", and the other is not being able to do "what one wants to do" well.
[Scientific Diagnosis] The "magic mirror" of modern medicine
Family observation provides us with direction, while a definitive diagnosis relies on the professional tools of neurologists.
1. Structural imaging: seeing the "topographic map" clearly - cranial magnetic resonance imaging is the cornerstone
• Alzheimer's disease: The typical manifestation is the atrophy of the hippocampus, which is the "switch" for memory. The shrinkage of the hippocampus is an important sign of AD.
• Cerebellar atrophy: The cerebellum is clearly visible with reduced volume and widened sulci and gyri, resembling a shriveled walnut.
2. Marker diagnosis technology: a cutting-edge weapon for pinpointing the "culprit" and achieving precise diagnosis
•Aβ PET: Like a detector, it directly shows whether there are Aβ amyloid plaques in the brain.
• Cerebrospinal fluid (CSF) testing: By performing lumbar puncture, directly detecting the decrease in Aβ42 and the increase in phosphorylated Tau protein in CSF serves as one of the "gold standards" for diagnosis.
• Blood test: By drawing blood and measuring p-tau217, one can qualitatively diagnose Alzheimer's disease, with a consistency of up to 90% with the gold standard Aβ PET.
Cerebellar atrophy:
Genetic testing can help identify specific subtypes of certain hereditary ataxias.
Accurate identification is the starting point of effective care
Distinguishing between Alzheimer's disease and cerebellar atrophy implies a fundamentally different focus in caregiving.
For AD patients: focus on cognitive training, environmental safety, and emotional support.
For patients with cerebellar atrophy: focus on balance rehabilitation, fall prevention, and swallowing function training.
Hainan Chengmei Hospital's Memory Clinic integrates professional resources from multiple fields to provide patients with comprehensive, precise, and personalized diagnosis and treatment services.
Expert Introduction
Dai Wenxin, Chief Physician
Executive Director of the Multidisciplinary Geriatric Diagnosis and Treatment Center
Professor, PhD candidate
Postdoctoral researcher, master's supervisor
Medical expertise:
I. Diagnosis and treatment of Alzheimer's disease and other geriatric diseases
II. Diagnosis and treatment of diseases across multiple disciplines, including respiratory system, cardiovascular system, nervous system, and geriatric diseases
III. Genetic diagnosis, chemotherapy, targeted therapy, immunotherapy, microenvironment analysis, and integrated precision treatment of tumors
IV. Genetic diagnosis and precision treatment of hypertension, hyperlipidemia, hyperuricemia, and hyperglycemia
V. New biomedical technologies such as stem cells and gene programming, as well as new technologies like insulin pumps and diabetes reversal
VI. High-intensity focused ultrasound (HIFU) therapy for benign and malignant tumors
VII. Microbial therapy of intestinal flora for chronic diseases and mental and psychological disorders
VIII. Diagnostic and therapeutic techniques under medical endoscopes such as bronchoscope, mediastinoscope, and thoracoscope
IX. Sleep medicine
X. Chronic disease management
Clinic Hours: Monday and Wednesday morning
Source | WeChat official account of Professor Han Ying's team at Xuanwu Hospital