Just because it’s dementia, doesn’t mean it’s Alzheimer’s
This past week the nation was stunned by Bruce Willis’ diagnosis of dementia. Media reports that his family is shocked and saddened by the diagnosis but relieved to have a diagnosis so they can focus on care and treatment. Bruce Willis is not the only person living with dementia. While the exact figure is unconfirmed, experts estimate that currently at least 7 million Americans have a form of dementia, and that number is projected to be more than 12 million by 2030. It is unlikely that you have not met someone with dementia, although you may not have known it at the time. Because of that, it is important to be aware of dementia – what it is, its signs and symptoms, and then learn how to interact and communicate with someone living with dementia.
First, not all dementia is Alzheimer’s disease. Many people unfamiliar with dementia use the term Alzheimer’s disease as a common term for all dementias. While Alzheimer’s disease is one type of dementia, there are others. For example, Bruce Willis is reported to have frontotemporal dementia (“FTD”). This type of dementia is characterized by the loss or degeneration of nerve cells in the brain’s frontal and temporal lobes. Loss of speech is one symptom of this type of dementia but changes in conduct, judgement and the ability to have reasonable foresight are also characteristic of his type of dementia.
Another type of dementia is dementia with Lewy bodies (also called Lewy body dementia or “LBD”). LBD was actually discovered by Frederich H. Lewy, M.D. who was working and researching with Dr. Alois Alzhemier in the early 1900s. This type of dementia is caused by protein alpha-synuclein in the brain. Symptoms of LBD include sleep disorders, changes in attention, difficulty in movement, and visual hallucinations. While memory loss is also associated with LBD, it is less prominent than what is commonly associated with Alzheimer’s disease.
Yet another type of dementia is vascular dementia which is caused by a condition that reduces blood flow to parts of the brain (such as having high blood pressure). Symptoms of vascular dementia include confusion and disorientation, trouble speaking, and difficulty walking. The difficulty in thinking may be sudden in onset such as after a stroke or may be gradual and increase with multiple minor strokes.
These are just a few types of dementia that are different than Alzheimer’s disease and there are more. Others include Parkinson’s disease related dementia, Huntington’s Disease, Creutzfeldt-Jakob disease, posterior cortical atrophy, and more. Each type of dementia has symptoms which differ slightly from Alzheimer’s disease. Knowing there are different types of dementia is critical because treatment for the disease differs as does the care the person needs.
As dementia becomes more prolific in our population, it is essential that those of us non-medical professionals are able to recognize the signs of dementia, understand that not all dementia is the same, and to be aware that not every person with dementia has memory loss (or at least does not have the same rate of loss of cognition). Accordingly, we all need to be able to adjust our style of communication so we’re able to effectively communicate with individuals living with dementia. While Bruce Willis’ diagnosis is heartbreaking for his family and those of us die hard fans, we can use this as an opportunity to raise awareness on a condition that will affect all of us at some point.
Pets Corner – Ask Dan and Riggs:

Hook Law: Hey guys, I seem to gain a few pounds every winter. Do pets have winter weight gain and what can we do about it?
Dan and Riggs: Hi reader – thanks for following us! Yes, winter weight gain exists for pets (and our humans). We aren’t as active during the winter, often because colder temperatures and shorter daylight hours keeps us indoors more. For parts of the winter our humans may not get home before dark to take us for our walks, yet we still want to eat the same amount of food we do in the summer (and the same amount of treats!). In addition, weight gain for dogs and cats can result in the same health problems that humans can get. If you are worried about gaining pounds in the winter, ask your humans to try to keep you active – maybe you can get their management to let them come in to work early and then leave early so you can have your daily walk. Also ask your humans to measure your food and give you a slightly smaller portion than you may eat in summer. Finally, watch the treats – too many taste good at the time you are munching on them but they can quickly lead to weight gain and you’ll regret those pounds when you are running on the beach this summer!
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Letha Sgritta McDowell
Letha Sgritta McDowell is a Shareholder of Hook Law practicing in the areas of estate planning, elder law, special needs planning, estate and trust administration, asset protection planning, long-term care planning, personal injury settlement consulting, guardianships & conservatorships, and tax law. Ms. McDowell’s clients range from high-net-worth individuals with over $75 million in net worth to families with limited assets.
Ms. McDowell is a past President of the National Academy of Elder Law Attorneys and was named as a Fellow of the prestigious American College of Trusts and Estates Council (“ACTEC”) in 2020. She is certified as an elder law attorney by the National Elder Law Foundation (“CELA”) and Board Certified as a specialist in Elder Law by the North Carolina State Bar Board of Legal Specialization. Furthermore, McDowell is accredited to prepare and prosecute claims with the Department of Veterans Affairs.
Ms. McDowell is currently the chair of NAELA’s strategic planning committee, a member of the Board of Directors for the North Carolina Chapter of NAELA, and a member of the Board of Directors for the Purdue Center for Cancer Research. She is the former Chair of the North Carolina State Bar’s Elder Law Specialization Committee and is the former Editor-in-Chief of “Gray Matters”, the newsletter for the Elder Law Section of the North Carolina Bar Association. She is a consultant for InterActive Legal and has worked on several law and technology initiatives including IBM’s Watson project. Along with her experience practicing as an attorney, she has dedicated much of her time writing for national publications including, but not limited to: Wolters Kluwer, Wealthmanagement.com, the NAELA Journal, Trust & Estates Magazine and many more.
Practice Areas
- Elder Law
- Estate & Trust Administration
- Estate Planning
- Asset Protection Planning
- Long-Term Care Planning
- Special Needs Planning