Dementia: Difference between revisions
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==Overview== | ==Overview== | ||
Dementia | Dementia is an acquired cognitive impairment in different cognitive areas such as attention, learning, memory, language, executive function, and motor function. Dementia may be classified according to the etiology into 5 groups including neurodegenerative, vascular, infectious, drug-related, and metabolic. The most common causes of dementia include [[alzheimer's disease|alzheimer's Disease]], [[parkinson's disease|parkinson's Disease]], [[binswanger's disease|binswanger's Disease]], [[dementia with Lewy bodies]], [[frontotemporal lobar degeneration]],[[thiamine deficiency]],[[vitamin B12 deficiency]], [[vitamin B6 deficiency]], [[vascular dementia]], [[marijuana abuse]], [[HIV AIDS|AIDS]] | ||
[[neurosyphilis]], and [[normal pressure hydrocephalus]]. | |||
==Classification== | ==Classification== | ||
Dementia may be classified according to the etiology into 5 groups including neurodegenerative, vascular, infectious, drug-related, and metabolic. | |||
{{Family tree/start}} | |||
{{Family tree | | | | | | | | | | | | | | A01 | | | | | | | | | | | | | | |A01= Dementia}} | |||
{{Family tree | | | | | | |,|-|-|-|v|-|-|-|+|-|-|-|v|-|-|-|.| | | | | | | | | }} | |||
{{Family tree | | | | | | |!| | | |!| | | |!| | | |!| | | |!| | | | | | | }} | |||
{{Family tree | | | | | | B01 | | B02 | | B03 | | B04 | | B05 | | | | | | |B01=[[Neurodegenerative]]|B02=Vascular|B03=[[Infectious]]|B04=Drug related|B05=[[Metabolic]]}} | |||
{{Family tree | | | | | | |!| | | |!| | | |!| | | |!| | | |!| | | | | | | | | }} | |||
{{Family tree | | | | | | C01 | | C02 | | C03 | | C04 | | C05 | | | | | | | |C01=•[[Alzheimer's disease|Alzheimer's Disease]]<br>•[[Parkinson's disease|Parkinson's Disease]]<br>•[[Binswanger's disease|Binswanger's Disease]]<br>•[[Dementia with Lewy bodies]]<br>•[[Frontotemporal lobar degeneration]]|C02=•[[Vascular dementia]]|C03=•[[HIV AIDS|AIDS]]<br>•[[Neurosyphilis]]|C04=•[[Marijuana abuse]]|C05=•[[Thiamine deficiency]]<br>•[[Vitamin B12 deficiency]]<br>•[[Vitamin B6 deficiency]]}} | |||
{{Family tree/end}} | |||
==Causes== | ==Causes== | ||
Dementia may be caused by: | |||
*[[Alzheimer's disease|Alzheimer's Disease]] | *[[Alzheimer's disease|Alzheimer's Disease]] | ||
*[[Parkinson's disease|Parkinson's Disease]] | *[[Parkinson's disease|Parkinson's Disease]] | ||
*[[Binswanger's disease|Binswanger's Disease]] | *[[Binswanger's disease|Binswanger's Disease]] | ||
*[[Dementia with Lewy bodies]] | *[[Dementia with Lewy bodies]] | ||
*[[Frontotemporal lobar degeneration]] | |||
*[[Thiamine deficiency]] | *[[Thiamine deficiency]] | ||
*[[Vitamin B12 deficiency]] | |||
*[[Vitamin B6 deficiency]] | |||
*[[Vascular dementia]] | *[[Vascular dementia]] | ||
*[[Marijuana abuse]] | *[[Marijuana abuse]] | ||
| Line 32: | Line 43: | ||
*[[Neurosyphilis]] | *[[Neurosyphilis]] | ||
*[[Normal pressure hydrocephalus]] | *[[Normal pressure hydrocephalus]] | ||
==Differential Diagnosis== | |||
Dementia causes must be differentiated from each other: <ref name="pmid18525132">{{cite journal |vauthors=Jellinger KA |title=The pathology of "vascular dementia": a critical update |journal=J. Alzheimers Dis. |volume=14 |issue=1 |pages=107–23 |year=2008 |pmid=18525132 |doi= |url=}}</ref><ref name="pmid19198143">{{cite journal |vauthors=Murayama S |title=[Neuropathology of frontotemporal dementia] |language=Japanese |journal=Rinsho Shinkeigaku |volume=48 |issue=11 |pages=998 |year=2008 |pmid=19198143 |doi= |url=}}</ref><ref name="pmid9375155">{{cite journal |vauthors=Hodges JR, Patterson K |title=Nonfluent progressive aphasia and semantic dementia: a comparative neuropsychological study |journal=J Int Neuropsychol Soc |volume=2 |issue=6 |pages=511–24 |year=1996 |pmid=9375155 |doi= |url=}}</ref><ref name="pmid1486461">{{cite journal |vauthors=Hodges JR, Patterson K, Oxbury S, Funnell E |title=Semantic dementia. Progressive fluent aphasia with temporal lobe atrophy |journal=Brain |volume=115 ( Pt 6) |issue= |pages=1783–806 |year=1992 |pmid=1486461 |doi= |url=}}</ref><ref name="urlDementia, Globalization and Contemporary Art">{{cite web |url=https://kohlibri.e-bookshelf.de/products/reading-epub/product-id/4033550/title/Dementia.html |title=Dementia, Globalization and Contemporary Art |format= |work= |accessdate=}}</ref><ref name="pmid3178177">{{cite journal |vauthors=Helkala EL, Laulumaa V, Soininen H, Riekkinen PJ |title=Recall and recognition memory in patients with Alzheimer's and Parkinson's diseases |journal=Ann. Neurol. |volume=24 |issue=2 |pages=214–7 |year=1988 |pmid=3178177 |doi=10.1002/ana.410240207 |url=}}</ref><ref name="pmid22474609">{{cite journal |vauthors=Weintraub S, Wicklund AH, Salmon DP |title=The neuropsychological profile of Alzheimer disease |journal=Cold Spring Harb Perspect Med |volume=2 |issue=4 |pages=a006171 |year=2012 |pmid=22474609 |pmc=3312395 |doi=10.1101/cshperspect.a006171 |url=}}</ref><ref name="pmid24757110">{{cite journal |vauthors=Goldman JG, Williams-Gray C, Barker RA, Duda JE, Galvin JE |title=The spectrum of cognitive impairment in Lewy body diseases |journal=Mov. Disord. |volume=29 |issue=5 |pages=608–21 |year=2014 |pmid=24757110 |pmc=4126402 |doi=10.1002/mds.25866 |url=}}</ref><ref name="pmid17715794">{{cite journal |vauthors=Metzler-Baddeley C |title=A review of cognitive impairments in dementia with Lewy bodies relative to Alzheimer's disease and Parkinson's disease with dementia |journal=Cortex |volume=43 |issue=5 |pages=583–600 |year=2007 |pmid=17715794 |doi= |url=}}</ref><ref name="pmid18855701">{{cite journal |vauthors=Uversky VN |title=Alpha-synuclein misfolding and neurodegenerative diseases |journal=Curr. Protein Pept. Sci. |volume=9 |issue=5 |pages=507–40 |year=2008 |pmid=18855701 |doi= |url=}}</ref><ref name="pmid15023815">{{cite journal |vauthors=Bennett DA, Schneider JA, Wilson RS, Bienias JL, Arnold SE |title=Neurofibrillary tangles mediate the association of amyloid load with clinical Alzheimer disease and level of cognitive function |journal=Arch. Neurol. |volume=61 |issue=3 |pages=378–84 |year=2004 |pmid=15023815 |doi=10.1001/archneur.61.3.378 |url=}}</ref><ref name="pmid9748670">{{cite journal |vauthors=Brion JP |title=Neurofibrillary tangles and Alzheimer's disease |journal=Eur. Neurol. |volume=40 |issue=3 |pages=130–40 |year=1998 |pmid=9748670 |doi= |url=}}</ref><ref name="pmid28748674">{{cite journal |vauthors=Lee JS, Jung NY, Jang YK, Kim HJ, Seo SW, Lee J, Kim YJ, Lee JH, Kim BC, Park KW, Yoon SJ, Jeong JH, Kim SY, Kim SH, Kim EJ, Park KC, Knopman DS, Na DL |title=Prognosis of Patients with Behavioral Variant Frontotemporal Dementia Who have Focal Versus Diffuse Frontal Atrophy |journal=J Clin Neurol |volume=13 |issue=3 |pages=234–242 |year=2017 |pmid=28748674 |pmc=5532319 |doi=10.3988/jcn.2017.13.3.234 |url=}}</ref><ref name="pmid21346515">{{cite journal |vauthors=Pao WC, Dickson DW, Crook JE, Finch NA, Rademakers R, Graff-Radford NR |title=Hippocampal sclerosis in the elderly: genetic and pathologic findings, some mimicking Alzheimer disease clinically |journal=Alzheimer Dis Assoc Disord |volume=25 |issue=4 |pages=364–8 |year=2011 |pmid=21346515 |pmc=3107353 |doi=10.1097/WAD.0b013e31820f8f50 |url=}}</ref><ref name="pmid11603162">{{cite journal |vauthors=Tsolaki M, Kokarida K, Iakovidou V, Stilopoulos E, Meimaris J, Kazis A |title=Extrapyramidal symptoms and signs in Alzheimer's disease: prevalence and correlation with the first symptom |journal=Am J Alzheimers Dis Other Demen |volume=16 |issue=5 |pages=268–78 |year=2001 |pmid=11603162 |doi=10.1177/153331750101600512 |url=}}</ref><ref name="pmid19810010">{{cite journal |vauthors=McGuinness B, Barrett SL, Craig D, Lawson J, Passmore AP |title=Executive functioning in Alzheimer's disease and vascular dementia |journal=Int J Geriatr Psychiatry |volume=25 |issue=6 |pages=562–8 |year=2010 |pmid=19810010 |doi=10.1002/gps.2375 |url=}}</ref> | |||
{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align="center" | {| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align="center" | ||
|+ | |+ | ||
! rowspan="2" style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Cause of dementia}} | ! rowspan="2" style="background: #4479BA; width: 200px;" |{{fontcolor|#FFF|Cause of dementia}} | ||
! colspan="11 | ! colspan="11" style="background:#4479BA; color: #FFFFFF; width: 400px;" align="center" + |Clinical features | ||
! rowspan="3 | ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |Associated features | ||
! rowspan="3 | ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |Nature of progression | ||
! rowspan="3 | ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |Histopathological findings | ||
|- | |- | ||
! colspan="11 | ! colspan="11" style="background:#4479BA; color: #FFFFFF;" align="center" + |Cognitive impairment | ||
|- | |- | ||
! | ! style="background:#4479BA; color: #FFFFFF;" align="center" + | | ||
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Recall | |||
! | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Recollection | ||
! | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Cue requirement for recall | ||
! | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Infirngement of thoughts | ||
! | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Semantic memory | ||
! | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Procedural memory | ||
! | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Working memory | ||
! | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Awareness | ||
! | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Attention | ||
! | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Executive functioning issues | ||
! | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Visuo-spatial skills | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Alzheimer's disease]] | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Alzheimer's disease]] | ||
| Line 64: | Line 74: | ||
(Slow [[cognitive]] and functional decline with early loss of awareness) | (Slow [[cognitive]] and functional decline with early loss of awareness) | ||
|<nowiki>+++</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>+++</nowiki> | ||
|Not helpful | | style="padding: 5px 5px; background: #F5F5F5;" |Not helpful | ||
|<nowiki>+++</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>+++</nowiki> | ||
|<nowiki>++</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>++</nowiki> | ||
|<nowiki>-</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>-</nowiki> | ||
|<nowiki>++</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>++</nowiki> | ||
|<nowiki>+++</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>+++</nowiki> | ||
|<nowiki>++</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>++</nowiki> | ||
|<nowiki>++</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>++</nowiki> | ||
|<nowiki>++</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>++</nowiki> | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* [[Focal neurologic signs|Focal neurological signs]] absent during early stage (may develop later) | *[[Focal neurologic signs|Focal neurological signs]] absent during early stage (may develop later) | ||
* Mild [[extrapyramidal]] signs | *Mild [[extrapyramidal]] signs | ||
|Has the following clinical stages: | | style="padding: 5px 5px; background: #F5F5F5;" |Has the following clinical stages: | ||
* Pre-clinical | |||
* [[Mild cognitive impairment]] | *Pre-clinical | ||
* Advanced [[dementia]] (full blown dementia) | *[[Mild cognitive impairment]] | ||
| | *Advanced [[dementia]] (full blown dementia) | ||
* [[Neurofibrillary tangle|Neurofibrillary tangles]] | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* [[Senile plaques|Senile (neuritic) plaques]] | *[[Neurofibrillary tangle|Neurofibrillary tangles]] | ||
*[[Senile plaques|Senile (neuritic) plaques]] | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Lewy body dementia]] | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Lewy body dementia]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | ++ | | style="padding: 5px 5px; background: #F5F5F5;" | ++ | ||
|<nowiki>-</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>-</nowiki> | ||
|Helpful | | style="padding: 5px 5px; background: #F5F5F5;" |Helpful | ||
|<nowiki>+++</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>+++</nowiki> | ||
|<nowiki>+</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>+</nowiki> | ||
|<nowiki>+</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>+</nowiki> | ||
|<nowiki>+++</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>+++</nowiki> | ||
|<nowiki>+</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>+</nowiki> | ||
|<nowiki>+++</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>+++</nowiki> | ||
|<nowiki>+++</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>+++</nowiki> | ||
|<nowiki>+++</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>+++</nowiki> | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Focal neurological signs present in majority | *Focal neurological signs present in the majority | ||
* Strongly associated with [[extrapyramidal]] signs | *Strongly associated with [[extrapyramidal]] signs | ||
* [[Autonomic]] changes | *[[Autonomic]] changes | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Early [[visual hallucinations]] | *Early [[visual hallucinations]] | ||
* [[Muscle rigidity]] | *[[Muscle rigidity]] | ||
* [[Sleep disturbance]] | *[[Sleep disturbance]] | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* [[Alpha-synuclein|α-synuclein]] deposits present in [[Neuron|neurons]] | *[[Alpha-synuclein|α-synuclein]] deposits present in [[Neuron|neurons]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Frontotemporal lobar degeneration]] | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Frontotemporal lobar degeneration]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | +/- | | style="padding: 5px 5px; background: #F5F5F5;" | +/- | ||
|<nowiki>-</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>-</nowiki> | ||
|Helpful | | style="padding: 5px 5px; background: #F5F5F5;" |Helpful | ||
|<nowiki>+++</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>+++</nowiki> | ||
|<nowiki>+</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>+</nowiki> | ||
|<nowiki>-</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>-</nowiki> | ||
|<nowiki>+++</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>+++</nowiki> | ||
|<nowiki>+++</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>+++</nowiki> | ||
|<nowiki>++</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>++</nowiki> | ||
|<nowiki>+++</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>+++</nowiki> | ||
|<nowiki>-</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>-</nowiki> | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* [[Focal neurologic signs|Focal neurological signs]] present ([[motor neuron disease]]) | *[[Focal neurologic signs|Focal neurological signs]] present ([[motor neuron disease]]) | ||
* [[Extrapyramidal|Extrapyramidal signs]] present (familial [[Frontotemporal lobar degenerations|frontotemporal lobar degeneration]]) | *[[Extrapyramidal|Extrapyramidal signs]] present (familial [[Frontotemporal lobar degenerations|frontotemporal lobar degeneration]]) | ||
* Onset in young age | *Onset in young age | ||
* Strong [[familial]] association | *Strong [[familial]] association | ||
* Focal [[atrophy]] of [[Frontal lobe|frontal]] and [[temporal lobes]] | *Focal [[atrophy]] of [[Frontal lobe|frontal]] and [[temporal lobes]] | ||
* Knife-edge [[atrophy]] noted on [[Magnetic resonance imaging|MRI]] | *Knife-edge [[atrophy]] noted on [[Magnetic resonance imaging|MRI]] | ||
* [[Personality changes|Personality]] and behavioral changes | *[[Personality changes|Personality]] and behavioral changes | ||
* Language impairment | *Language impairment | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Two major variants: | *Two major variants: | ||
** Progressive nonfluent [[aphasia]] | **Progressive nonfluent [[aphasia]] | ||
** [[Semantic Dementia|Semantic]] variant | **[[Semantic Dementia|Semantic]] variant | ||
* [[Progressive supranuclear palsy]] | *[[Progressive supranuclear palsy]] | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* [[Pick bodies]] | *[[Pick bodies]] | ||
* [[Corticobasal degeneration]] | *[[Corticobasal degeneration]] | ||
* [[Ubiquitination|Ubiquitinated]] inclusions | *[[Ubiquitination|Ubiquitinated]] inclusions | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Vascular dementia]] | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Vascular dementia]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | + (Dysexecutive syndrome) | | style="padding: 5px 5px; background: #F5F5F5;" | + (Dysexecutive syndrome) | ||
|<nowiki>-</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>-</nowiki> | ||
|Helpful | | style="padding: 5px 5px; background: #F5F5F5;" |Helpful | ||
|<nowiki>+</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>+</nowiki> | ||
|<nowiki>+</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>+</nowiki> | ||
|<nowiki>+</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>+</nowiki> | ||
|<nowiki>++</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>++</nowiki> | ||
|<nowiki>-</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>-</nowiki> | ||
|<nowiki>++</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>++</nowiki> | ||
|<nowiki>+++</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>+++</nowiki> | ||
|<nowiki>+</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" |<nowiki>+</nowiki> | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* [[Focal neurologic signs|Focal neurological signs]] present typically | *[[Focal neurologic signs|Focal neurological signs]] present typically | ||
* Mild [[extrapyramidal]] signs | *Mild [[extrapyramidal]] signs | ||
* [[Depression]] | *[[Depression]] | ||
* Mild [[Motor disorders|motor signs]] in subcortical [[vascular dementia]] | *Mild [[Motor disorders|motor signs]] in subcortical [[vascular dementia]] | ||
* Slowed processing speed | *Slowed processing speed | ||
* Presentation might be similar to Alzheimer's disease | *Presentation might be similar to Alzheimer's disease | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Stepwise progression and focal neurologic signs (also known as [[multi-infarct dementia]] or poststroke [[dementia]]) | *Stepwise progression and focal neurologic signs (also known as [[multi-infarct dementia]] or poststroke [[dementia]]) | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Multifocal and/or diffuse lesions (lacunes and microinfarcts) | *Multifocal and/or diffuse lesions (lacunes and microinfarcts) | ||
* The following [[brain]] areas may be involved: | *The following [[brain]] areas may be involved: | ||
** [[Subcortical|Subcortical area]] | **[[Subcortical|Subcortical area]] | ||
** [[Thalamus]] | **[[Thalamus]] | ||
** Frontobasal[[limbic system]] | **Frontobasal[[limbic system]] | ||
** [[White matter]] lesions | **[[White matter]] lesions | ||
** [[Hippocampal sclerosis]] | **[[Hippocampal sclerosis]] | ||
** Diffuse post-ischemic lesions | **Diffuse post-ischemic lesions | ||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Normal pressure hydrocephalus]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
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|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Parkinson's disease]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
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|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Binswanger's disease]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
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| style="padding: 5px 5px; background: #F5F5F5;" | | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Thiamine deficiency]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
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| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Marijuana abuse]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
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| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[AIDS]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Neurosyphilis]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Vitamin B12 deficiency]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Vitamin B6 deficiency]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
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|} | |} | ||
Latest revision as of 23:34, 7 March 2021
 |
Resident Survival Guide |
|
Dementia Microchapters |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.
Synonyms and keywords: dementia
Overview
Dementia is an acquired cognitive impairment in different cognitive areas such as attention, learning, memory, language, executive function, and motor function. Dementia may be classified according to the etiology into 5 groups including neurodegenerative, vascular, infectious, drug-related, and metabolic. The most common causes of dementia include alzheimer's Disease, parkinson's Disease, binswanger's Disease, dementia with Lewy bodies, frontotemporal lobar degeneration,thiamine deficiency,vitamin B12 deficiency, vitamin B6 deficiency, vascular dementia, marijuana abuse, AIDS neurosyphilis, and normal pressure hydrocephalus.
Classification
Dementia may be classified according to the etiology into 5 groups including neurodegenerative, vascular, infectious, drug-related, and metabolic.
Causes
Dementia may be caused by:
- Alzheimer's Disease
- Parkinson's Disease
- Binswanger's Disease
- Dementia with Lewy bodies
- Frontotemporal lobar degeneration
- Thiamine deficiency
- Vitamin B12 deficiency
- Vitamin B6 deficiency
- Vascular dementia
- Marijuana abuse
- AIDS
- Neurosyphilis
- Normal pressure hydrocephalus
Differential Diagnosis
Dementia causes must be differentiated from each other: [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]
| Cause of dementia | Clinical features | Associated features | Nature of progression | Histopathological findings | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Cognitive impairment | ||||||||||||||
| Recall | Recollection | Cue requirement for recall | Infirngement of thoughts | Semantic memory | Procedural memory | Working memory | Awareness | Attention | Executive functioning issues | Visuo-spatial skills | ||||
| Alzheimer's disease | +++
(Slow cognitive and functional decline with early loss of awareness) |
+++ | Not helpful | +++ | ++ | - | ++ | +++ | ++ | ++ | ++ |
|
Has the following clinical stages:
|
|
| Lewy body dementia | ++ | - | Helpful | +++ | + | + | +++ | + | +++ | +++ | +++ |
|
| |
| Frontotemporal lobar degeneration | +/- | - | Helpful | +++ | + | - | +++ | +++ | ++ | +++ | - |
|
|
|
| Vascular dementia | + (Dysexecutive syndrome) | - | Helpful | + | + | + | ++ | - | ++ | +++ | + |
|
|
|
| Normal pressure hydrocephalus | ||||||||||||||
| Parkinson's disease | ||||||||||||||
| Binswanger's disease | ||||||||||||||
| Thiamine deficiency | ||||||||||||||
| Marijuana abuse | ||||||||||||||
| AIDS | ||||||||||||||
| Neurosyphilis | ||||||||||||||
| Vitamin B12 deficiency | ||||||||||||||
| Vitamin B6 deficiency | ||||||||||||||
References
- ↑ Jellinger KA (2008). "The pathology of "vascular dementia": a critical update". J. Alzheimers Dis. 14 (1): 107–23. PMID 18525132.
- ↑ Murayama S (2008). "[Neuropathology of frontotemporal dementia]". Rinsho Shinkeigaku (in Japanese). 48 (11): 998. PMID 19198143.
- ↑ Hodges JR, Patterson K (1996). "Nonfluent progressive aphasia and semantic dementia: a comparative neuropsychological study". J Int Neuropsychol Soc. 2 (6): 511–24. PMID 9375155.
- ↑ Hodges JR, Patterson K, Oxbury S, Funnell E (1992). "Semantic dementia. Progressive fluent aphasia with temporal lobe atrophy". Brain. 115 ( Pt 6): 1783–806. PMID 1486461.
- ↑ "Dementia, Globalization and Contemporary Art".
- ↑ Helkala EL, Laulumaa V, Soininen H, Riekkinen PJ (1988). "Recall and recognition memory in patients with Alzheimer's and Parkinson's diseases". Ann. Neurol. 24 (2): 214–7. doi:10.1002/ana.410240207. PMID 3178177.
- ↑ Weintraub S, Wicklund AH, Salmon DP (2012). "The neuropsychological profile of Alzheimer disease". Cold Spring Harb Perspect Med. 2 (4): a006171. doi:10.1101/cshperspect.a006171. PMC 3312395. PMID 22474609.
- ↑ Goldman JG, Williams-Gray C, Barker RA, Duda JE, Galvin JE (2014). "The spectrum of cognitive impairment in Lewy body diseases". Mov. Disord. 29 (5): 608–21. doi:10.1002/mds.25866. PMC 4126402. PMID 24757110.
- ↑ Metzler-Baddeley C (2007). "A review of cognitive impairments in dementia with Lewy bodies relative to Alzheimer's disease and Parkinson's disease with dementia". Cortex. 43 (5): 583–600. PMID 17715794.
- ↑ Uversky VN (2008). "Alpha-synuclein misfolding and neurodegenerative diseases". Curr. Protein Pept. Sci. 9 (5): 507–40. PMID 18855701.
- ↑ Bennett DA, Schneider JA, Wilson RS, Bienias JL, Arnold SE (2004). "Neurofibrillary tangles mediate the association of amyloid load with clinical Alzheimer disease and level of cognitive function". Arch. Neurol. 61 (3): 378–84. doi:10.1001/archneur.61.3.378. PMID 15023815.
- ↑ Brion JP (1998). "Neurofibrillary tangles and Alzheimer's disease". Eur. Neurol. 40 (3): 130–40. PMID 9748670.
- ↑ Lee JS, Jung NY, Jang YK, Kim HJ, Seo SW, Lee J, Kim YJ, Lee JH, Kim BC, Park KW, Yoon SJ, Jeong JH, Kim SY, Kim SH, Kim EJ, Park KC, Knopman DS, Na DL (2017). "Prognosis of Patients with Behavioral Variant Frontotemporal Dementia Who have Focal Versus Diffuse Frontal Atrophy". J Clin Neurol. 13 (3): 234–242. doi:10.3988/jcn.2017.13.3.234. PMC 5532319. PMID 28748674.
- ↑ Pao WC, Dickson DW, Crook JE, Finch NA, Rademakers R, Graff-Radford NR (2011). "Hippocampal sclerosis in the elderly: genetic and pathologic findings, some mimicking Alzheimer disease clinically". Alzheimer Dis Assoc Disord. 25 (4): 364–8. doi:10.1097/WAD.0b013e31820f8f50. PMC 3107353. PMID 21346515.
- ↑ Tsolaki M, Kokarida K, Iakovidou V, Stilopoulos E, Meimaris J, Kazis A (2001). "Extrapyramidal symptoms and signs in Alzheimer's disease: prevalence and correlation with the first symptom". Am J Alzheimers Dis Other Demen. 16 (5): 268–78. doi:10.1177/153331750101600512. PMID 11603162.
- ↑ McGuinness B, Barrett SL, Craig D, Lawson J, Passmore AP (2010). "Executive functioning in Alzheimer's disease and vascular dementia". Int J Geriatr Psychiatry. 25 (6): 562–8. doi:10.1002/gps.2375. PMID 19810010.