Alzheimer's Disease and Other Dementing Disorders

Publisher Summary This chapter discusses the organic mental disorders that produce the dementia syndrome in older adults and focuses on Alzheimer's disease (AD), the latter being the most common and devastating of these disorders. The chapter reviews clinical phenomenology, epidemiology, pathophysiology, and pathogenesis for each disorder. AD and other dementing illnesses are the most important neuropsychiatric disorders of the elderly, devastating millions of patients and their caregivers and costing the country and patients' families tens of billions dollars for care at home and in institutional settings. During the past two decades, however, substantial progress has been made in understanding AD and related disorders, and effective treatments based on new knowledge are on the horizon. Although people still cannot prevent or reverse the primary cognitive deficits of AD, they are increasingly aware of the need to treat superimposed delirium and noncognitive problems such as depression, agitated behaviors, and psychotic symptoms and to support the needs of caregivers with respite care programs and community services. The chapter also discusses delirium and depression, both of which can mimic or complicate the dementing disorders as they relate to differential diagnosis and treatment. General treatment approaches to the dementia patient and his or her caregiver are also reviewed in the chapter. Particular emphasis also is given to recent research findings. Managing the elderly patient with dementia is a rewarding experience and will become even more so as effective treatment modalities become available.