Skip to main content
SpringerLink
Log in
Book cover

Geriatric Medicine pp 897–916Cite as

Dementia

  • Chapter

  • 240 Accesses

Abstract

Elderly people may manifest a variety of behavioral syndromes produced by brain dysfunction, including 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. These disorders are not mutually exclusive: delirium may be superimposed on dementia and is frequently accompanied by anxiety, delusions, and/or mood changes; demented patients may manifest personality alterations, delusions, or mood alterations in addition to their intellectual deficits; personality changes often develop in patients with amnesia; and patients with aphasia may exhibit delusions or mood disorders that result from their underlying disease.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   74.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.

    Google Scholar 

  2. Chedru F, Geschwind N. Disorders of higher cortical function in acute confusional states. Cortex. 1972; 8: 395–411.

    PubMed  CAS  Google Scholar 

  3. Lipowski ZJ. Delirium (acute confusional states). JAMA. 1987; 258: 1789–1792.

    Article  PubMed  CAS  Google Scholar 

  4. Rabins PV, Folstein MF. Delirium and dementia: diagnostic criteria and fatality rates. Br J Psychiatry. 1982; 140: 149–153.

    Article  PubMed  CAS  Google Scholar 

  5. Masterman DL, Craig AH, Cummings JL. Alzheimer’s Disease. In: Gabbard G ed, Treatments of Psychiatric Disorders, 2nd ed. American Psychiatric Press: Washington, DC; 1995: 479–513.

    Google Scholar 

  6. Sultzer DL, Levin HS, Mahler ME, High WM, Cummings JL. A comparison of psychiatric symptoms in vascular dementia and Alzheimer’s disease. Am J Psychiatry. 1993; 150: 1806–1812.

    PubMed  CAS  Google Scholar 

  7. Cummings JL. Organic delusions: phenomenology, anatomical correlations, and review. Br J Psychiatry. 1985; 146: 184–197.

    Article  PubMed  CAS  Google Scholar 

  8. Peden JG, Jr., Kathol R. Mood disorders and general medical illness. In: Gabbard G ed, Treatments of Psychiatric Disorders. 2nd ed. American Psychiatric Press: Washington, DC; 1995: 1329–1348.

    Google Scholar 

  9. Cummings JL. Clinical Neuropsychiatry. New York: Grune & Stratton; 1985.

    Google Scholar 

  10. Kauf er D, Cummimgs JL. Personality alterations in degenerative brain diseases. In: Ratey JJ, ed, Neuropsychiatry of Personality Disorders, Blackwell Scientific Publication, London; 1995: 172–209.

    Google Scholar 

  11. O’Brien JT, Levy R. Age associated memory impairment (editorial). Br Med J. 1992; 304: 5–6.

    Article  Google Scholar 

  12. Evans DA, Funkenstein H, Albert MS, et al. Prevalence of Alzheimer’s disease in a community population of older persons. Higher than previously reported. JAMA. 1989; 261: 921–923.

    Google Scholar 

  13. Cummings JL, Benson DF. Dementia: A Clinical Approach. 2nd ed. Stoneham, MA: Weinemann-Butterworths; 1992.

    Google Scholar 

  14. Corder EH, Saunders AM, Strittmatter WJ, et al. Gene dose of apolipoprotein E type 4 allele and the risk of Alzheimer’s disease in late onset families. Science. 1993; 261: 921–923.

    CAS  Google Scholar 

  15. Kallmann FJ. Heredity in Health and Mental Disorder. New York: Norton; 1953.

    Google Scholar 

  16. Brietner JC, Gatz M, Bergem AL, et al. Use of twin cohorts for research in Alzheimer’s disease. Neurology. 1993; 43: 261–267.

    Article  Google Scholar 

  17. Ashall F, Goate AM. Role of the beta-amyloid precursor protein in Alzheimer’s disease. Trends Biochem Sei. 1994; 19: 42–46.

    Article  CAS  Google Scholar 

  18. Roth M, Tomlinson BE, Blessed G. The relationship between quantitative measures of dementia and of degenerative changes in the cerebral grey matter of elderly subjects. Proc R Soc Med. 1967; 60: 254–258.

    PubMed  CAS  Google Scholar 

  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

    Google Scholar 

  20. Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology. 1984; 34: 939–944.

    Google Scholar 

  21. 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.

    Article  PubMed  CAS  Google Scholar 

  22. Mayeux R, Stern Y, Spanton S. Heterogeneity in dementia of the Alzheimer type: evidence of subgroups. Neurology. 1985; 35: 453–461.

    Article  PubMed  CAS  Google Scholar 

  23. Chandra V, Bharucha NE, Schoenberg BS. Conditions associated with Alzheimer’s disease at death: case-control study. Neurology. 1986; 36: 209–211.

    Article  PubMed  CAS  Google Scholar 

  24. Galasko D, Corey-Bloom J, Thal LJ. Monitoring progression in Alzheimer’s disease. J Am Geriatr Soc. 1991; 39: 932–942.

    PubMed  CAS  Google Scholar 

  25. NIH (National Institutes of Health). Consensus Development Conference Statement. Differential diagnosis of dementing diseases. JAMA. 1987; 258: 3411–3416.

    Google Scholar 

  26. Prichard JW, Brass LM. New anatomical and functional imaging methods. Ann Neurol. 1992; 32: 395–400.

    Article  PubMed  CAS  Google Scholar 

  27. Katzman R. Alzheimer’s disease. N Engl J Med. 1986; 314: 964–973.

    Article  PubMed  CAS  Google Scholar 

  28. Brun A, Gustafson L. Distribution of cerebral degeneration in Alzheimer’s disease. Arch Psychiatr Nervenk. 1976; 223: 15–33.

    Article  CAS  Google Scholar 

  29. 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.

    Article  PubMed  CAS  Google Scholar 

  30. Mirra SS, Heyman A, McKeel D, et al. The consortium to establish a registry for Alzheimer’s disease (CERAD). Part II. Standardization of the neuropathologic assessment of Alzheimer’s disease. Neurology. 1991; 41: 479–486.

    Article  PubMed  CAS  Google Scholar 

  31. The Lund and Manchester Groups. Clinical and neuropathological criteria for frontotemporal dementia. J Neurol Neurosurg Psychiatry. 1994; 57: 416–418.

    Google Scholar 

  32. Gustafsson L. Frontal lobe degeneration of non-Alzheimer type. II. Clinical picture and differential diagnosis. Arch Gerontol Geriatr. 1987; 6: 209–223.

    Article  Google Scholar 

  33. Albert ML, Feldman RG, Willis AG. The “subcortial dementia” of progressive supranuclear palsy. J Neurol Neurosurg Psychiatry. 1974; 37: 121–130.

    Article  PubMed  CAS  Google Scholar 

  34. Martilla RJ. Epidemiology. In: Koller WC, ed. Handbook of Parkinson’s Disease. New York: Marcel Dekker; 1976.

    Google Scholar 

  35. Cummings JL. Intellectual impairment in Parkinson’s disease: clinical, biochemical, and pathologic correlates. J Geriatr Psychiartr Neurol. 1988; 1: 24–36.

    Article  CAS  Google Scholar 

  36. Chang Chui H, Perlmutter LS. Pathological correlates of dementia in Parkinson’s disease. In: Huber S, Cummings JL, eds. Neurobehavioral Aspects of Parkinson’s Disease. New York: Oxford University Press; 1992: 164–177.

    Google Scholar 

  37. Lewin R. Dramatic results with brain grafts. Science. 1987; 237: 245–247.

    Article  PubMed  CAS  Google Scholar 

  38. Forstl H, Burns A, Luthert P, et al. The Lewy-body variant of Alzheimer’s disease. Clinical and pathological findings. Br J Psychiatry. 1993; 162: 385–392.

    Article  PubMed  CAS  Google Scholar 

  39. Hayden MR. Huntington’s Chorea. New York: Springer- Verlag; 1981.

    Book  Google Scholar 

  40. Gusella JF, Wexler NS, Conneally PM, et al. A polymorphic DNA marker genetically linked to Huntington’s disease. Nature. 1983; 306: 234–238.

    Article  PubMed  CAS  Google Scholar 

  41. Roman GC, Tatemichi TK, Erkinjuntti T, et al. Vascular dementia: diagnostic criteria for research studies. Neurology. 1993; 43: 259–260.

    Google Scholar 

  42. Rosen WG, Terry RD, Fuld PA, et al. Pathological verification of ischemic score in differentiation of dementias. Ann Neurol. 1980; 7: 486–488.

    Article  PubMed  CAS  Google Scholar 

  43. Thompson TL II, Moran MG, Nies AS. Psychotropic drug use in the elderly. N Engl J Med. 1983; 308: 134–138.

    Article  PubMed  Google Scholar 

  44. Cutting J. The relationship between Korsakov’s syndrome and “alcoholic dementia.” Br J Psychiatry. 1978; 132: 240–251.

    Google Scholar 

  45. Ron MA. Brain damage in chronic alcoholism: a neuropathologica, neuroradiological, and psychological review. Psychol Med. 1977; 7: 103–112.

    Article  PubMed  CAS  Google Scholar 

  46. Price RW, Brew B, Sidtis J, et al. The brain in AIDS: central nervous system HIV-I infection and AIDS dementia complex. Science. 1987; 239: 586–592.

    Article  Google Scholar 

  47. Yarchoan R, Brouwers P, Spitzer AR, et al. Response of human-immunodeficiency-virus-associated neurological disease to 3’-azido-3’-deoxythymicine. Lancet. 1987; 20: 597–602.

    Google Scholar 

  48. Collings J, Palmer MS. Prion diseases in humans and their relevance to other neurodegenerative diseases. Dementia. 1993; 4: 178–185.

    Google Scholar 

  49. 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.

    Article  PubMed  CAS  Google Scholar 

  50. Gajdusek DC. Unconventional viruses and the origin and disappearances of kuru. Science. 197: 943–960.

    Google Scholar 

  51. Mahler ME, Cummings JL. Treatable dementias. West J Med. 1987; 146: 705–712.

    PubMed  CAS  Google Scholar 

  52. Corsellis JAN. Postrumatic dementia. In: Katzman R, Terry RD, Bick KL, eds. Aging: Alzheimer’s Disease: Senile Dementia and Related Disorders. New York: Raven Press; 1973: 7.

    Google Scholar 

  53. Black PM. Idiopathic normal-pressure hydrocephalus: results of shunting in 62 patients. J Neurosurg. 1980; 52: 371–377.

    Article  PubMed  CAS  Google Scholar 

  54. LaRue A, D’Elia LF, Clark EO, et al. Clinical tests of memory in dementia, depression, and healthy aging. Psychology Aging. 1986; 1: 69–77.

    Article  CAS  Google Scholar 

  55. Alexopoulos GS, Meyers BS, Young RC, Maitis S, Kakuma T. The course of geriatric depression with “reversible dementia”: a controlled study. Am J Psychiatry. 1993; 150: 1693–1699.

    PubMed  CAS  Google Scholar 

  56. Rubin SM, Glasser ML, Werckle MA. The examination of physician’s awareness of dementing disorders. J Am Geriatr Soc. 1987; 35: 1051–1058.

    PubMed  CAS  Google Scholar 

  57. 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.

    Article  PubMed  CAS  Google Scholar 

  58. Blessed, Tomlinson BE, Roth M. The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. Br J Psychiatry. 1968; 114: 797–811.

    Google Scholar 

  59. Kahn RL. Psychological aspects of aging. In: Rossman I, ed. Clinical Geriatrics. Philadelphia: JB Lippincott; 1971.

    Google Scholar 

  60. Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc. 1975; 23: 433–441.

    PubMed  CAS  Google Scholar 

  61. Roth M, Tym E, Mountjoy CQ, et al. CAMDEX: a standardized instrument for the diagnosis of mental disorders in the elderly with special reference to the early detection of dementia. Br J Psychiatry. 1986; 4149: 698–709.

    Article  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  63. Reisberg B, Ferris SH, DeLeon MJ, et al. The global deterioration scale for assessment of primary degenerative dementia. Am J Psychiatry. 1982; 139: 1136–1139.

    PubMed  CAS  Google Scholar 

  64. Larson EB, Reifler BV, Featherstone HJ, et al. Dementia in elderly outpatients: a prospective study. Ann Intern Med. 1984; 100: 417–423.

    PubMed  CAS  Google Scholar 

  65. Martin DC, Miller J, Kapoor W, et al. Clinical prediction rules for computed tomographic scanning in senile dementia. Arch Intern Med. 1987; 147: 77–80.

    Article  PubMed  CAS  Google Scholar 

  66. Garber HJ, Weilburg JB, Buananno FS, et al. Use of magnetic resonance imaging in psychiatry. Am J Psychiatry. 1988; 145: 164–171.

    PubMed  CAS  Google Scholar 

  67. Jagust WJ, Budinger TF, Reed BR. The diagnosis of dementia with single photon emission computed tomography. Arch Neurol. 1987; 44: 258–262.

    Article  PubMed  CAS  Google Scholar 

  68. Johnson KA, Mueller ST, Walshe TM, et al. Cerebral perfusion imaging in Alzheimer’s disease. Arch Neurol. 1987; 44: 165–168.

    Article  PubMed  CAS  Google Scholar 

  69. Foster NL, Chase TN, Mansi L, et al. Cortical abnormalities in Alzheimer’s disease. Ann Neurol. 1984; 16: 649–654.

    Article  PubMed  CAS  Google Scholar 

  70. Knapp MJ, Knopman DS, Soloman PR, et al. A 30-week randomized controlled trial of high-dose tacrine in patients with Alzheimer’s disease. JAMA. 1994; 271: 985–991.

    Article  PubMed  CAS  Google Scholar 

  71. Gent M, Blakely JA, Easton JD, et al. The Canadian American ticlopidine study (CATS) in thromboembolic stroke. Lancet. 1989: 1215–1220.

    Google Scholar 

  72. Jarvik LF, Trader DW. Treatment of behavioral and mood changes. In: Aronson M, ed. Understanding Alzheimer’s Disease. New York: Charles Scribner’s Sons; 1988: 128–145.

    Google Scholar 

  73. Schneider LS, Pollock VE, Lyness SA. A metaanalysis of controlled trials of neuroleptic treatment in dementia. J Am Geriat Soc. 1990; 38: 553–563.

    PubMed  CAS  Google Scholar 

  74. Yodufsky SC, Silver JM, Hales RE. Pharmacologic management of aggression in the elderly. J Clin Psychiatry. 1990; 51 (suppl): 22–28.

    Google Scholar 

  75. Teri L, Rabins P, Whitehouse P, et al. Management of behavior disturbance in Alzheimer’s disease: current knowledge and future directions. Alzheimer Dis Assoc Disord. 1992; 6: 77–88.

    Article  PubMed  CAS  Google Scholar 

  76. Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Geron-tologist. 1980; 20: 649–655.

    Article  CAS  Google Scholar 

  77. NIH consensus conference. Diagnosis and treatment of depression in late life. JAMA. 1992; 268: 1018–1024.

    Google Scholar 

Download references

Authors
  1. Jeffrey L. Cummings
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dag Årsland
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lissy Jarvik
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. The Henry L. Schwartz Department of Geriatrics and Adult Development, The Mount Sinai Medical Center, 10029-6574, New York, NY, USA

    Christine K. Cassel M.D. (Professor and Chairman) & Diane E. Meier M.D. (Associate Professor) (Professor and Chairman) &  (Associate Professor)

  2. Center for Study of Aging and Geriatric Research Education and Clinical Center, Duke University Medical Center, 27710, Durham, NC, USA

    Harvey J. Cohen M.D. (Director) (Director)

  3. University of Washington Medical Center, 98195, Seattle, WA, USA

    Eric B. Larson M.D., M.P.H. (Medical Director) (Medical Director)

  4. Gerontology Division, Harvard Medical School, Brigham and Women’s Hospital, 02115, Boston, MA, USA

    Neil M. Resnick M.D. (Chief) (Chief)

  5. Geriatric Research Education and Clinical Center, Sepulveda VA Medical Center, 91343, Sepulveda, CA, USA

    Laurence Z. Rubenstein M.D., M.P.H. (Director) (Director)

  6. Department of Medicine, University of Chicago, 60637, Chicago, IL, USA

    Leif B. Sorensen M.D. (Professor and Vice Chairman) (Professor and Vice Chairman)

Rights and permissions

Reprints and permissions

Copyright information

© 1997 Springer Science+Business Media New York

About this chapter

Cite this chapter

Cummings, J.L., Årsland, D., Jarvik, L. (1997). Dementia. In: Cassel, C.K., et al. Geriatric Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-2705-0_59

Download citation

  • DOI: https://doi.org/10.1007/978-1-4757-2705-0_59

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4757-2707-4

  • Online ISBN: 978-1-4757-2705-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation