Definition of dementia

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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

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

• Neurodegenerative disorders
• Alzheimers disease
• Picks disease
• Vascular (multi-infarct) dementia
• Reversible causes

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Alzheimers disease
Other causes
Vascular dementia
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Alzheimers disease

• cognitive deficits
• profound memory loss (anterograde/retrograde)
• language - anomic, empty, circumlocutory
• visuospatial disturbance
• behavioral deficits
• no significant early changes in personality
• unawareness or denial of illness
• psychosis
• no sensory or motor deficits

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Cortical atrophy
Normal brain
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Cortical atrophy
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Cortical atrophy - MRI scanAlzheimers disease
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Normal
Alzheimers
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Pathology of Alzheimers disease
Amyloid plaques
Neurofibrillary tangles(tau protein)
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Pathology of Alzheimers disease
Degeneration of the basal forebrain cholinergic
system
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Treatment of Alzheimers disease

• Cholinergic replacement
• Anti-amyloid agents

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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

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Cortical atrophy
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Cortical atrophy - MRI scanPicks disease
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PET scan of Picks disease
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Pathology of Picks disease
Picks bodies
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Alzheimers
Picks