Neurocognitive Disorders in Old Age: Alzheimer’s Disease, Frontotemporal Dementia, Dementia with Lewy Bodies, and Prion and Infectious Diseases

Abstract

Dementia is a clinical syndrome of cognitive decline resulting in impaired activities of daily living. It affects a person in their personhood, which, together with behavioural and psychological features, causes enormous suffering for both patient and caregiver.Many diseases cause dementia, but neurodegenerative, vascular, and mixed disorders are most often involved. The type of dementia may influence the clinical presentation, its course, and the available therapeutic options. Thus, an aetiopathogenic assessment is crucial and includes somatic, cognitive, psychopathological, functional, and paraclinical investigations.Most dementias have no cure although depression and substance-induced cognitive impairment are central differential diagnoses as they are potentially reversible when treated. Antidementia drugs have a limited indication. Psychosocial treatments, in particular of behavioural and psychological features, are paramount and often efficient. Medication, if required, complements psychosocial treatment. Treatment options must be evaluated dynamically as the patient and caregiver needs change over time.Primary care is an essential component of the care provided to people with dementia, from early detection to treatment across all stages of the illness, to help alleviate patient and caregiver suffering.