Dementia

Abstract

With the increase in life expectancy, dementia has become a central medical problem. The challenge to the diagnostician is to single out treatable conditions that can be either cured or at least slowed down in their course of progression. The table shows that there is more to dementia than just degenerative or atherosclerotic disease of the brain. The important discussion as to whether the global concept of dementia is still adequate is beyond the scope of this book. Any disease process listed in the table is multifocal rather than diffuse in the trivial sense of the term. Consequently, it appears that the assumption of a unitary “chronic brain syndrome” is unrealistic, in that it ignores the results of many decades of neuropsychological research into the differential organization of cognitive functions in the brain. Accepting the need for precise analysis of the multifaceted syndromes of cognitive disturbance in organic brain disease will open an avenue for neuropsychological therapy, which might, at least in a proportion of cases, complement medical therapy.