Question:
Does This Patient Have Dementia?

DSM-III-R definition

impairment in short and long term memory at least one of the following:

impairment of abstract thinking, indicated by difficulty in definingwords and concepts impaired judgment, indicated by inability to make reasonable plans todeal with problems other disturbances of higher cortical function:language disorder apraxia (inability to carry out motor activities despite intactcomprehension and motor function) failure to recognized or identify objects despite intact sensoryfunction constructional difficulty; i.e., inability to copy three dimensionalfigures or assemble blocks personality changes

the disturbance interferes with work, usual social activities orrelationships with others

Answer: Dementia is the loss of a person's cognitive, or intellectual,function. Cognitive function refers to all the various conscious mentaltasks that we perform every waking second of every day, fromremembering our name to performing complicated mathematicalcalculations. Memory is one of the most essential cognitive functions,and it is the often the first and most crucial one that dementiaimpairs. Dementia also affects problem-solving ability, decisionmaking, judgment, our ability to orient ourselves in space, and ourability to put together simple sentences and understand and communicatewith words. It is also often associated with personality change.Dementia is a permanent, progressive disease that affects mostly theelderly. People who suffer from dementia eventually are unable to takecare of themselves and require round-the-clock care.Sometimes people experience symptoms that resemble dementia but areperfectly normal or associated with some other illness. Forgetfulness,for example, is something that can happen at any age. Isolatedincidents of temporary memory loss or other temporary cognitiveimpairments are not considered dementia. A person, who has never beenfully competent and has always had dementia-like symptoms, unless thesymptoms progress, does not have dementia.

Dementia develops when the parts of the brain that are involved withlearning, memory, decision making and language are affected by any ofvarious neurological, vascular, infectious, or metabolic diseases. Themost common cause by far is Alzheimer's disease, but there are as manyas 50 other known causes of dementia. Most of these are very rare, butsome, although not as common as Alzheimer's, are indeed common. Some ofthe disorders that cause dementia may be reversible, althoughunfortunately most types of dementia do not respond to treatment. It istherefore very important to evaluate dementia symptoms in acomprehensive manner, so as not to miss potentially treatableconditions. The frequency of "treatable" causes of dementia is believedto be about 20%.