Table 3.

Features Suggestive of Diagnoses Other Than Alzheimer’s Disease.

Differential Diagnosis	Features
Frontotemporal dementia (FTD)39,40	Early marked behavioral disinhibition or apathy; early perseverative or compulsive behavior; hyperorality and dietary changes; executive function deficits but sparing of memory and visuospatial functions; prominent early aphasia (particularly loss of word and object knowledge, motor speech, and grammatical deficits).
Dementia with Lewy bodies (DLB)41	Fluctuating cognition; recurrent visual hallucinations, typically well-formed and detailed; spontaneous features of parkinsonism; REM sleep behavior disorder; severe neuroleptic sensitivity; deficits on tests of attention, executive function, visuospatial ability.
Vascular dementia (VD)42	Onset of dementia within 3 months of recognized stroke; abrupt deterioration in cognitive function; fluctuating, stepwise progression of cognitive deficits; early presence of gait disturbance; early urinary symptoms not due to urologic disease; pseudobulbar palsy (dysphagia, dysarthria, emotional lability, inappropriate laughter or crying); depression, emotional incontinence, psychomotor retardation and abnormal executive function. (Note: Sudden onset of aphasia suggests a vascular etiology.)
Idiopathic normal pressure hydrocephalus (NPH)43	Urinary incontinence not due to urologic conditions (e.g., prostatism or chronic UTI); “glue-footed,” “magnetic” gait.
	Any of these findings on imaging: (1) enlargement of the temporal horns of the lateral ventricles not entirely attributable to hippocampus atrophy; (2) callosal angle of 40° or more; (3) evidence of altered brain water content, including periventricular signal changes not attributable to microvascular ischemic changes or demyelination. (Note: NPH may also be secondary to traumatic brain injury and other insults.)

Abbreviations: REM, rapid eye movement; UTI, urinary tract infection.