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May 3, 1985, Vol 253, No. 17 >
ARTICLE | May 3, 1985

Dementia: Its Definition, Differential Diagnosis, and Subtypes FREE

M-Marsel Mesulam, MD
JAMA. 1985;253(17):2559-2561. doi:10.1001/jama.1985.03350410125033
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References

Dementia, not unlike heart failure or renal insufficiency, is a generic term that makes little assumption about etiology. Because there are no specific laboratory tests, however, its diagnosis relies exclusively on clinical criteria. The presence of dementia should be suspected whenever mental changes of insidious onset emerge without sufficient situational stress and gradually interfere with the daily living activities that are appropriate for age and background. Dementia can be reversible or irreversible, precipitously progressive or indolent, bristling with multiple cognitive deficits, or characterized almost exclusively by disturbances of affect, motivation, and personality. When the behavioral changes are dramatic and interfere with active careers in younger individuals, early diagnosis poses little difficulty. The real challenge arises among the elderly, in whom dementia is also far more common. This is because the elderly tend to have less demanding daily activities, the disruption of which may take longer to detect, and also because

REFERENCES

1 +
Benton AL, Eslinger PJ, Damasio AR:  Normative observations on neuropsychological test performances in old age . J Clin Neuropsychol 1981;;3:33-42.
2 +
Weintraub S, Mesulam M-M:  Mental state assessment of young and elderly adults in behavioral neurology , in Mesulam M-M (ed): Principles of Behavioral Neurology . Philadelphia, FA Davis Co, 1985;, pp 71-123.
3 +
Cicero:  On old age , in Grant M (trans): Selected Works. Middlesex , England, Penguin Books, 1960;.
4 +
Brody H:  Organization of the cerebral cortex: III. A study of aging in the human cerebral cortex . J Comp Neurol 1955;;102:511-556.
5 +
Buell SJ, Coleman PD:  Dendritic growth in the aged human brain and failure of growth in senile dementia . Science 1979;;206:854-856.
6 +
Kaes T: Die Grosshirnrinde des Menschen in ihren Massen und in ihrem Fasergehalt . Jena, Gustav Fischer, 1907;.
7 +
Eslinger PJ, Damasio AR, Benton AL, et al:  Neuropsychologic detection of abnormal mental decline in older persons . JAMA 1985;;253:670-674.
8 +
Freeman RL, Galaburda AM, Diaz-Cabral R, et al:  Neurology of depression . Arch Neurol 1985;;42:289-291.
9 +
Weingartner H, Cowan RM, Murphy DL, et al:  Cognitive processes in depression . Arch Gen Psychiatry 1981;;38:42-47.
10 +
Mesulam M-M:  Attention, confusional states, and neglect , in Mesulam M-M (ed): Principles of Behavioral Neurology . Philadelphia, FA Davis Co, 1985;, pp 125-168.
11 +
Mesulam M-M:  Slowly progressive aphasia without generalized dementia . Ann Neurol 1982;;11:592-598.
12 +
Davies P. Maloney AJF:  Selective loss of central cholinergic neurons in Alzheimer's disease . Lancet 1976;;2:1403.
13 +
Little A, Chaqui-Kidd P, Levy R:  Early results from a double-blind, placebo-controlled trial of high-dose lecithin in Alzheimer's disease , in Wurtman RJ, Corkin Sh, Growdon JH (eds): Alzheimer's Disease: Advances in Basic Research and Therapies . Cambridge, Mass, Center for Brain Sciences and Metabolism, 1984;, pp 313-331.
14 +
Harbaugh RE, Roberts DW, Coombs DW, et al:  Preliminary report: Intracranial drug infusion in patients with Alzheimer's disease . Neurosurgery 1984;;15:514-518.
15 +
Wurtman RJ:  Alzheimer's disease . Sci Am 1985;;252:62-74.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Benton AL, Eslinger PJ, Damasio AR:  Normative observations on neuropsychological test performances in old age . J Clin Neuropsychol 1981;;3:33-42.
2 +
Weintraub S, Mesulam M-M:  Mental state assessment of young and elderly adults in behavioral neurology , in Mesulam M-M (ed): Principles of Behavioral Neurology . Philadelphia, FA Davis Co, 1985;, pp 71-123.
3 +
Cicero:  On old age , in Grant M (trans): Selected Works. Middlesex , England, Penguin Books, 1960;.
4 +
Brody H:  Organization of the cerebral cortex: III. A study of aging in the human cerebral cortex . J Comp Neurol 1955;;102:511-556.
5 +
Buell SJ, Coleman PD:  Dendritic growth in the aged human brain and failure of growth in senile dementia . Science 1979;;206:854-856.
6 +
Kaes T: Die Grosshirnrinde des Menschen in ihren Massen und in ihrem Fasergehalt . Jena, Gustav Fischer, 1907;.
7 +
Eslinger PJ, Damasio AR, Benton AL, et al:  Neuropsychologic detection of abnormal mental decline in older persons . JAMA 1985;;253:670-674.
8 +
Freeman RL, Galaburda AM, Diaz-Cabral R, et al:  Neurology of depression . Arch Neurol 1985;;42:289-291.
9 +
Weingartner H, Cowan RM, Murphy DL, et al:  Cognitive processes in depression . Arch Gen Psychiatry 1981;;38:42-47.
10 +
Mesulam M-M:  Attention, confusional states, and neglect , in Mesulam M-M (ed): Principles of Behavioral Neurology . Philadelphia, FA Davis Co, 1985;, pp 125-168.
11 +
Mesulam M-M:  Slowly progressive aphasia without generalized dementia . Ann Neurol 1982;;11:592-598.
12 +
Davies P. Maloney AJF:  Selective loss of central cholinergic neurons in Alzheimer's disease . Lancet 1976;;2:1403.
13 +
Little A, Chaqui-Kidd P, Levy R:  Early results from a double-blind, placebo-controlled trial of high-dose lecithin in Alzheimer's disease , in Wurtman RJ, Corkin Sh, Growdon JH (eds): Alzheimer's Disease: Advances in Basic Research and Therapies . Cambridge, Mass, Center for Brain Sciences and Metabolism, 1984;, pp 313-331.
14 +
Harbaugh RE, Roberts DW, Coombs DW, et al:  Preliminary report: Intracranial drug infusion in patients with Alzheimer's disease . Neurosurgery 1984;;15:514-518.
15 +
Wurtman RJ:  Alzheimer's disease . Sci Am 1985;;252:62-74.

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