Dementia-- Introduction

Dementia is a generic syndrome characterized usually, by a gradual or step-wise progressive loss of cognitive function. Clinical diagnosis os based on the history of progression, neuropsychological profile and elementary neurologic exam. Definitive diagnosis of the precise type usually would require an examination of brain tissue. Some would allow indolence, or even reversability to be included in the definition, certainly the work up is designed to reveal treatable causes of dementia, which implies improvement after treatment. The dementia of depression (seen in about 10% of patients referred for dementia evaluation) is an example of true cognitive deficit cured by treating the cause. An old term for this syndrome was "pseudo-dementia" but the deficit is very real and not at all "pseudo". With progressive dementia there is inevitable loss of activities of daily living, but normal aging is compatible with independent living.