Definition of dementia

an acquired persistent impairment of intellectual function with compromise in memory and at least two other cognitive domains such as language, visuospatial skills or executive function

Prevalence of dementia
20 Prevalence Rate (%) 15 10 5 0
60-64 65-69 70-74 60-64 65-69 70-74 75-79 80-84 85+
1

75-79

80-84

85+

AGE

Causes of dementia

Neurodegenerative
disorders

- Alzheimers disease P - Picks disease

Vascular (multi-infarct)
dementia Reversible causes

Other causes

Alzheimers disease

Vascular dementia

Alzheimers disease

cognitive deficits - profound memory loss

behavioral deficits - no significant early changes in personality - unawareness or denial of illness - psychosis no sensory or motor deficits

(anterograde/retrograde) language - anomic, empty, circumlocutory visuospatial disturbance

Normal brain

Cortical atrophy

Cortical atrophy

Cortical atrophy - MRI scan Alzheimers disease

Normal

Alzheimers

Pathology of Alzheimers disease

Neurofibrillary tangles (tau protein) Amyloid plaques

Pathology of Alzheimers disease

Degeneration of the basal forebrain cholinergic system

Treatment of Alzheimers disease

C Cholinergic replacement

Anti-amyloid agents

Picks disease/frontal dementias

cognitive deficits - profound executive dysfunction - good memory, language, visuospatial skills behavioral deficits - early prominent personality changes - poor judgment, insight, disinhibited, labile,
euphoric, socially inappropriate, sexual indiscretions

frontal release signs on neurological exam but no senory or motor deficits

Cortical atrophy

Cortical atrophy - MRI scan Picks disease

PET scan of Picks disease

Pathology of Picks disease

Picks bodies

Alzheimers

Picks