Psychiatry for Physicians - Dementia

Dementia is a syndrome of acquired, persistent9. Toxic conditions
intellectual impairment with compromised function in10. Metabolic disorders
multiple spheres of mental activity, such as memory,11. Psychiatric disorders
language, visuospatial skills, emotion or personality,In 1997 the APA found that 5% to 8% of individuals
and cognition. Recent studies showed that reversibleolder than 65 years, 15% to 20% of individuals older
dementia syndrome occurs in only 1% of thethan 75 years, and 25% to 50% of individuals older
outpatients. Previous assumption was much higherthan 85 years suffer from dementia syndromes. The
than the current finding. For clinical purpose dementingchanges seen in dementia are due to pathological
disorders can be categorized into cortical andchanges in the brain. With aging frontal cortex and
subcortical varieties. In cortical dementia the functionsbasal ganglia loses cells and also and deep white and
of the cerebral cortex are impaired. It is representedgray matters show ischemic changes resulting in loss
by amnesia, aphasia, apraxia, and agnosia. Dementiaof brain tissue and ventricular enlargement.
of Alzheimer's Type is a good example of corticalPsychomotor speed, arousal, performance on
dementia. Subcortical dementia is caused bynonverbal tasks, recalling nonverbal information, and
dysfunction in the deep gray and white matterperformance on nonverbal tasks of cognitive
structures that includes basal ganglia, thalamus, brainflexibility etc are age sensitive function while naming,
stem nuclei, and their projections in the frontal lobe.attention, and verbal tasks are relatively insensitive to
These dysfunctions are represented by psychomotoraging. A physician must be careful in differentiating
retardation, defective recall, poor abstraction andcases with aging process from dementia syndromes.
strategy formation, and mood and personalitySpecific disorders with dementia like-
alteration. Dementia caused by Parkinson's disease is1. Dementia of Alzheimer's Type
a good example of subcortical dementia.2. Vascular dementia
As syndrome dementia can also be classified3. Dementia due to Picks disease
etiologically. The classes are -4. Dementia due to Creutzfeldt-Jakob disease
1. Degenerative disorders5. Dementia due to Huntington's disease
2. Vascular dementia6. Dementia due to Parkinson's disease
3. Myelinoclastic disorders7. Dementia due to HIV disease
4. Traumatic conditions8. Substance induced dementia
5. Neoplastic dementias9. Dementia syndrome of depression
6. Hydrocephalic dementias10. Dementia caused by other conditionswill be
7. Inflammatory conditionsdiscussed in the following articles keeping this one as
8. Infection related dementiasintroductory.