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Dementia is an organic brain syndrome which results in global cognitive impairments Dementia can occur as a result of a variety of neurological diseases Some of the more well known dementing diseases include Alzheimers disease AD multi-infarct dementia MID and Huntingtons disease HD Throughout this essay the emphasis will be placed on AD also known as dementia of the Alzheimers type and primary degenerative dementia because statistically it is the most significant dementing disease occurring in over 50 of demented patients see epidemiology The clinical picture in dementia is very similar to delirium except for the course Delirium is an acute transitory disorder By contrast Dementia is a long term progressive disorder with the exception of the reversible dementias The course of AD can range anywhere from 15 to 15 years with an average of about 81 years Terry 1988 AD is usually divided into three stages mild moderate and severe Throughout these stages a specific sequence of cognitive deterioration is observed Lezak 1993 The mild stage begins with memory attention speed dependent activities and abstract reasoning dysfunction Also mild language impairments begin to surface In the moderate stage language deficits such as aphasia and apraxia become prominent Dysfluency paraphasias and bizzare word combinations are common midstage speech defects In the severe stage the patient is gradually reduced to a vegetative state Speech becomes nonfluent repetitive and largely non-communicative Auditory comprehension is exceedingly limited with many patients displaying partial or complete mutism Late in the course of the disease many neuropsychological functions can no longer be measured Also primitive reflexes such as grasp and suck emerge Death usually results from a disease such as pneumonia which overwhelms the limited vegetative functions of the patient Dementia is commonly differentiated along two dimensions age and cortical level The first dimension age distinguishes between senile and presenile dementia Senile dementia is used to describe patients who become demented after the age of 65 whereas presenile
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