Psychological Co-morbidities of Dementia

Abstract

(from the chapter) Dementia is a clinical syndrome characterized by a gradually progressing cognitive impairment. This impairment is commonly manifested by memory deficits; but the presence of one or more additional cognitive disturbances, including aphasia, agnosia, apraxia or executive dysfunction, is required to make the diagnosis, according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) criteria. Those disturbances should be a change from the previous baseline and should cause significant distress to the patient and caregivers. Medical problems that can cause memory impairment, substance abuse and a psychiatric axis I diagnosis need to be ruled out before making the diagnosis of dementia (Rabins et al., 2007). Although there are differences in pathophysiology, clinical symptoms and course of dementia, there are only small differences in the prevalence of behavioral symptoms across the dementias. Kunik et al. looked at those differences in a study comparing 150 dementia patients with AD, vascular dementia and alcohol-related dementia. They found that neither the characteristics nor severity of agitation differed among the different subtypes, but that the patients admitted for behavioral disturbances with a diagnosis of vascular dementia were less cognitively impaired (Kunik et al., 2000). (PsycINFO Database Record (c) 2013 APA, all rights reserved)