Reversible dementias - Do they exist?

Abstract

Reversible dementias do exist. Potentially-reversible conditions are frequently encountered in patients with cognitive impairment or dementia, in some they are the cause of the dementia, in others they are a comorbidity to a progressive dementing disorder. Numerous potentially reversible conditions may be associated with or even present with cognitive impairment. Some are very rare, yet treatable (e.g. Wilson's disease). Other conditions are more common, but may only occasionally present with dementia in the absence of other neurological symptoms (e.g. space-occupying lesions). Finally, some are very common (e.g. depression, vitamin deficiency). In some of the treatable conditions, reversibility of the cognitive symptoms has not been well-documented in the literature and is based on case reports, clinical belief, or common sense. Although more research is needed, it is essential that patients with cognitive impairment are evaluated for possible reversible conditions. Such conditions will be encountered most often in patients with mild symptoms, more rarely in patients meeting all the present criteria for dementia. Most reversible conditions are easily identified by a careful history, physical examination, psychiatric evaluation, brain CT or MRI, and routine laboratory tests. With more patients presenting for early assessment of cognitive impairment, the neurologist should be very aware of reversible conditions. © 2002 Blackwell Science Ltd.