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Dementia

  • Jeffrey L. Cummings
  • Lissy F. Jarvik

Abstract

Elderly people may manifest a variety of behavioral syndromes produced by brain dysfunction. They may show evidence of multiple deficits in the delirious and dementia syndromes or single deficits in amnestic and aphasic disorders. In addition, brain lesions may cause “productive” behavioral syndromes, such as anxiety, delusions, hallucinations, depression, mania, and personality alterations. Furthermore, these disorders are not mutually exclusive: delirium may be superimposed on dementia and is frequently accompanied by anxiety, delusions, and/or manic behavior; demented patients may manifest personality alterations, delusions, or mood changes in addition to their intellectual deficits; personality alterations often develop in patients with amnesia; and patients with aphasia may exhibit delusions or mood changes that result from their underlying disease.

Keywords

Progressive Supranuclear Palsy Demented Patient Dementia Syndrome Short Portable Mental Status Questionnaire Cerebrotendinous Xanthomatosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    American Psychiatric Association. Diagnostic and Sta-tistical Manual of Mental Disorders. 3rd ed, Revised (DSM-III R). Washington, DC: American Psychiatric Association; 1987.Google Scholar
  2. 2.
    Chedru F, Geschwind N. Disorders of higher cortical function in acute confusional states. Cortex 1972; 8: 395–411.PubMedGoogle Scholar
  3. 3.
    Lipowski ZJ. Delirium (acute confusional states). JAMA 1987; 258: 1789–1792.PubMedCrossRefGoogle Scholar
  4. 4.
    Rabins PV, Folstein MF. Delirium and dementia: diag-nostic criteria and fatality rates. Br J Psychiatry 1982; 140: 149–153.PubMedCrossRefGoogle Scholar
  5. 5.
    Small GW. Dementia and amnestic syndromes. In: Karasu TB, et al, eds. Treatment of Psychiatric Disor-ders: A Task Force Report of the American Psychiatric Association Washington, DC: American Psychiatric Press Inc. In press.Google Scholar
  6. 6.
    Cummings JL, Miller B, Hill MA, et al. Neuropsychiatry aspects of multi-infarct dementia and dementia of the Alzheimer type. Arch Neurol 1987; 44: 389–393.PubMedCrossRefGoogle Scholar
  7. 7.
    Cummings JL. Organic delusions: phenomenology, ana-tomical correlations, and review. Br J Psychiatry 1985; 146: 184–197.PubMedCrossRefGoogle Scholar
  8. 8.
    Spar JE. Organic mood syndrome. In: Karasu TB, et al, eds. Treatment of Psychiatric Disorders: A Task Force Report of the American Psychiatric Association Wash-ington, DC: American Psychiatric Press Inc. In press.Google Scholar
  9. 9.
    Cummings JL. Clinical Neuropsychiatry. New York, NY: Grune and Stratton; 1985.Google Scholar
  10. 10.
    Spar JE. Organic personality syndrome. In: Karasu TB, et al, eds. Treatment of Psychiatric Disorders: A Task Force Report of the American Psychiatric Association Washington, DC: American Psychiatric Press Inc. In press.Google Scholar
  11. 11.
    Larrabee GT, Levin HS, High WM. Senescent forgetful-ness: a quantitative study. Dev Neuropsychol 186; 2: 373–385.Google Scholar
  12. 12.
    Cummings JL, Benson DF. Dementia: A Clinical Ap-proach. Stoneham, Mass: Butters worths; 1983.Google Scholar
  13. 13.
    Ineichen B. Measure the rising tide: how many dementia cases will there be by 2001? Br J Psychiatry 1987; 150: 193–200.PubMedCrossRefGoogle Scholar
  14. 14.
    Tomlinson BE, Blessed G, Roth M. Observations on the brains of demented old people. J Neurol Sci 1970; 11: 205–224.PubMedCrossRefGoogle Scholar
  15. 15.
    Kallmann FJ. Heredity in Health and Mental Disorder. New York, NY: WW Norton and Co Inc; 1953.Google Scholar
  16. 16.
    Nee LE, Eldridge R, Sunderland T, et al. Dementia of the Alzheimer type: clinical and family study of 22 twin pairs. Neurology 1987; 37: 359–363.PubMedCrossRefGoogle Scholar
  17. 17.
    Jarvik LF, Matsuyama SS, Kessler JO, et al. Philother-mal response of polymorphonuclear leukocytes in de-mentia of the Alzheimer type. Neurobiol Aging 1982; 3: 93–99.PubMedCrossRefGoogle Scholar
  18. 18.
    Roth M, Tomlinson BE, Blessed G. The relationship be-tween quantitative measures of dementia and of de-generative changes in the cerebral grey matter of elderly subjects. Proc R Soc Med 1967; 60: 254–258.PubMedGoogle Scholar
  19. 19.
    McKhann G, Drachman D, Folstein M, et al. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS- ADRDA Work Group under the auspices of the Depart-ment of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984; 34: 939–944.PubMedCrossRefGoogle Scholar
  20. 20.
    Tierney MC, Fisher RH, Lewis AJ, et al. The NINCDS- ADRDA Work Group criteria for the clinical diagnosis of probable Alzheimer’s disease: a clinicopathologic study of 57 cases. Neurology 1988; 38: 359–364.PubMedCrossRefGoogle Scholar
  21. 21.
    Mayeux R, Stern Y, Spanton S. Heterogeneity in demen-tia of the Alzheimer type: evidence of subgroups. Neurol-ogy 1985; 35: 453–461.CrossRefGoogle Scholar
  22. 22.
    Chandra V, Bharucha NE, Schoenberg BS. Conditions associated with Alzheimer’s disease at death: case-control study. Neurology 1986; 36: 209–211.PubMedCrossRefGoogle Scholar
  23. 23.
    NIH (National Institutes of Health), Consensus Develop-ment Conference Statement. Differential Diagnosis of Dementing Diseases. JAMA 1987; 258: 3411–3416.Google Scholar
  24. 24.
    Katzman R. Alzheimer’s disease. N Engl J Med 1986; 314: 964–973.PubMedCrossRefGoogle Scholar
  25. 25.
    Brun A, Gustafson L. Distribution of cerebral degenera-tion in Alzheimer’s disease. Arch Psychiatr Nervenk 1976; 223: 15–33.CrossRefGoogle Scholar
  26. 26.
    Whitehouse PJ, Price DL, Clark AW, et al. Alzheimer’s disease and senile dementia: loss of neurons in the basal forebrain. Science 1982; 215: 1237–1239.PubMedCrossRefGoogle Scholar
  27. 27.
    Khachaturian ZS. Diagnosis of Alzheimer’s disease. Arch Neurol 1985; 42: 1097–1105.PubMedCrossRefGoogle Scholar
  28. 28.
    Wechsler AF, Verity M, Rosenchein S, et al. Pick’s dis-ease. Arch Neurol 1982; 39: 287–290.PubMedCrossRefGoogle Scholar
  29. 29.
    Albert ML, Feldman RG, Willis AG. The ‘subcortial de-mentia’ of progressive supranuclear palsy. J Neurol Neu-ro surg Psychiatry 1974; 37: 121–130.CrossRefGoogle Scholar
  30. 30.
    Martilla RJ. Epidemiology. In: Koller WC, ed. Hand-book of Parkinson’s Disease. New York, NY: Marcel Dekker Inc; 1987.Google Scholar
  31. 31.
    Cummings JL. Intellectual impairment in Parkinson’s disease: clinical, biochemical, and pathologic correlates. J Geriatr Psychiatr Neurol 1988; 1: 24–36.CrossRefGoogle Scholar
  32. 32.
    Boiler F. Alzheimer’s disease and Parkinson’s disease: clinical and pathological associations. In: Reisberg B, ed. Alzheimer’s Disease: The Standard Reference. New York, NY: The Free Press; 1983.Google Scholar
  33. 33.
    Lewin R. Dramatic results with brain grafts. Science 1987; 237: 245–247.PubMedCrossRefGoogle Scholar
  34. 34.
    Hayden MR. Huntington’s Chorea. New York, NY: Springer-Verlag NY Inc; 1981.CrossRefGoogle Scholar
  35. 35.
    Gusella JF, Wexler NS, Conneally PM et al. A polymor-phic DNA marker genetically linked to Huntington’s dis-ease. Nature 1983; 306: 234–238.PubMedCrossRefGoogle Scholar
  36. 36.
    Hachinski VC, Iliff LD, Zilhka E, et al. Cerebral blood flow in dementia. Arch Neurol 1975; 32: 632–637.PubMedCrossRefGoogle Scholar
  37. 37.
    Rosen WG, Terry RD, Fuld PA, et al. Pathological verifi-cation of ischemic score in differentiation of dementias. Ann Neurol 1980; 7: 486–488.PubMedCrossRefGoogle Scholar
  38. 38.
    Erkinjuntti T. Types of multi-infarct dementia. Acta Neu-rol Scand 1987; 75: 391–399.CrossRefGoogle Scholar
  39. 39.
    Ishii N, Nishahara Y, Imamura T. Why do frontal lobe symptoms predominate in vascular dementia with lacu-nes? Neurology 1986; 36: 340–345.PubMedCrossRefGoogle Scholar
  40. 40.
    Roman GC. Senile dementia of the Binswanger type. JAMA 1987; 258: 1782–1788.PubMedCrossRefGoogle Scholar
  41. 41.
    Thompson TL II, Moran MG, Nies AS. Psychotropic drug use in the elderly. N Engl J Med 1983;308: 134–138, 194–199.Google Scholar
  42. 42.
    Cutting J. The relationship between Korsakov’s syn-drome and ‘alcoholic dementia.’ Br J Psychiatry 1978; 132: 240–251.Google Scholar
  43. 43.
    Ron MA. Brain damage in chronic alcoholism: a neuropa-thological, neuroradiological, and psychological review. Psychol Med 1977; 7: 103–112.PubMedCrossRefGoogle Scholar
  44. 44.
    McLachlan C. Aluminum and Alzheimer’s disease. Neu-robiol Aging 1986; 7: 525–532.CrossRefGoogle Scholar
  45. 45.
    Price RW, Brew B, Sidtis J, et al. The brain in AIDS: central nervous system HIV-1 infection and AIDS de-mentia complex. Science 1987; 239: 586–592.CrossRefGoogle Scholar
  46. 46.
    Yarchoan R, Brouwers P, Spitzer AR, et al. Response of human-immunodeficiency-virus-associated neurological disease to 3’-azido-3’-deoxy thymidine. Lancet 1987; 1: 132–135.PubMedCrossRefGoogle Scholar
  47. 47.
    Brown P, Cathala F, Castaigne P, et al. Creutzfeldt-Jakob disease: clinical analysis of a consecutive series of 230 neuropathologically verified cases. Ann Neurol 1986; 20: 597–602.PubMedCrossRefGoogle Scholar
  48. 48.
    Gajdusek DC. Unconventional viruses and the origin and disappearances of kuru. Science 1977; 197: 943–960.PubMedCrossRefGoogle Scholar
  49. 49.
    Mahler ME, Cummings JL. Treatable dementias. West J Med 1987; 146: 705–712.PubMedGoogle Scholar
  50. 50.
    Corsellis JAN. Posttraumatic dementia. In: Katzman R, Terry RD, Bick KL, eds. Aging: Alzheimer’s Disease: Senile Dementia and Related Disorders. New York, NY: Raven Press; 1973: 7.Google Scholar
  51. 51.
    Black PM. Idiopathic normal-pressure hydrocephalus: results of shunting in 62 patients. J Neurosurg 1980; 52: 371–377.PubMedCrossRefGoogle Scholar
  52. 52.
    LaRue A, D’Elia LF, Clark EO, et al. Clinical tests of memory in dementia, depression, and healthy aging. Psy-chology Aging 1986; 1: 69–77.CrossRefGoogle Scholar
  53. 53.
    Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1967; 23: 56–62.CrossRefGoogle Scholar
  54. 54.
    Zung WWK. A self-rating depression scale. Arch Gen Psychiatry 1965; 12: 63–70.PubMedCrossRefGoogle Scholar
  55. 55.
    Rubin SM, Glasser ML, Werckle MA. The examination of physician’s awareness of dementing disorders. J Am GeriatrSoc 1987; 35: 1051–1058.Google Scholar
  56. 56.
    Folstein MF, Folstein SE, McHugh PR. ‘Mini-Mental State’: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189–198.PubMedCrossRefGoogle Scholar
  57. 57.
    Blessed G, Tomlinson BE, Roth M. The association be-tween quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. Br J Psychiatry 1968; 114: 797–811.PubMedCrossRefGoogle Scholar
  58. 58.
    Kahn RL. Psychological aspects of aging. In: Rossman I, ed. Clinical Geriatrics. Philadelphia, Pa: JB Lippincott; 1971.Google Scholar
  59. 59.
    Schwamm LH, Van Dyke C, Kiernan RJ, et al. The neurobehavior cognitive status examination: comparison with the Cognitive Capacity Screening Examination and the Mini-Mental State Examination in a neurosurgical population. Ann Intern Med 1987; 107: 486–491.PubMedGoogle Scholar
  60. 60.
    Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly pa-tients. J Am Geriatr Soc 1975; 23: 433–441.PubMedGoogle Scholar
  61. 61.
    Roth M, Tym E, Mountjoy CQ, et al. CAMDEX: a stan-dardized instrument for the diagnosis of mental disorders in the elderly with special reference to the early detection of dementia. Br J Psychiatry 1986; 149: 698–709.PubMedCrossRefGoogle Scholar
  62. 62.
    Hughes CP, Berg L, Danzinger WL, et al. A new clinical scale for the staging of dementia. Br J Psychiatry 1982; 140: 566–572.PubMedCrossRefGoogle Scholar
  63. 63.
    Reisberg B, Ferris SH, DeLeon MJ, et al. The global deterioration scale for assessment of primary degenera-tive dementia. Am J Psychiatry 1982; 139: 1136–1139.PubMedGoogle Scholar
  64. 64.
    Larson EB, Reifler BV, Featherstone HJ, et al. Dementia in elderly outpatients: a prospective study. Ann Intern Med 1984; 100: 417–423.PubMedGoogle Scholar
  65. 65.
    Martin DC, Miller J, Kapoor W, et al. Clinical prediction rules for computed tomographic scanning in senile de-mentia. Arch Intern Med 1987; 147: 77–80.PubMedCrossRefGoogle Scholar
  66. 66.
    Garber HJ, Weilburg JB, Buonanno FS, et al. Use of magnetic resonance imaging in psychiatry. Am J Psychia-try 1988; 145: 164–171.Google Scholar
  67. 67.
    Jagust WJ, Budinger TF, Reed BR. The diagnosis of dementia with single photon emission computed tomog-raphy. Arch Neurol 1987; 44: 258–262.PubMedCrossRefGoogle Scholar
  68. 68.
    Johnson KA, Mueller ST, Walshe TM, et al. Cerebral perfusion imaging in Alzheimer’s disease. Arch Neurol 1987; 44: 165–168.PubMedCrossRefGoogle Scholar
  69. 69.
    Foster NL, Chase TN, Mansi L, et al. Cortical abnormal-ities in Alzheimer’s disease. Ann Neurol 1984; 16: 649–654.PubMedCrossRefGoogle Scholar
  70. 70.
    Davenport S, Goldberg D, Millar T. How psychiatric disorders are missed during medical consultations. Lancet 1987; 2: 439–441.PubMedCrossRefGoogle Scholar
  71. 71.
    Jarvik LF, Trader DW. Treatment of behavioral and mood changes. In: Aronson M, ed. Understanding Alzheimer’s Disease. New York, NY: Charles Scribner’s Sons; 1988: 128–145.Google Scholar
  72. 72.
    Winograd CH, Jarvik LF. Physician management of the demented patient. J Am Geriatr Soc 1986; 34: 295–308.PubMedGoogle Scholar
  73. 73.
    Burnside I. Nursing care. In: Jarvik LF, Winograd CH, eds. Treatments for the Alzheimer Patient: The Long Haul. New York, NY: Springer Publishing Co Inc; 1988.Google Scholar
  74. 74.
    Summers WK, Majovski LV, Marsh GM, et al. Oral tetrahydroaminoacridine in long-term treatment of senile dementia, Alzheimer type. N Engl J Med 1986; 315: 1241–1245.PubMedCrossRefGoogle Scholar
  75. 75.
    Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Geron-tologist 1980; 20: 649–655.CrossRefGoogle Scholar
  76. 76.
    Winograd CH. The physician and the Alzheimer patient. In: Jarvik LF, Winograd CH, eds. Treatments for the Alzheimer Patient: The Long Haul. New York, NY: Springer Publishing Co Inc; 1988.Google Scholar

Copyright information

© Springer Science+Business Media New York 1990

Authors and Affiliations

  • Jeffrey L. Cummings
  • Lissy F. Jarvik

There are no affiliations available

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