Bradford Dickerson - Dementia: Comprehensive Principles and Practices

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Library of Congress Cataloging-in-Publication Data
Dementia (Dickerson)
Dementia : comprehensive principles and practice / edited by Bradford C. Dickerson & Alireza Atri.
p. ; cm.
Includes bibliographical references.
ISBN 9780199928453 (alk. paper)
I. Dickerson, Bradford C., editor of compilation. II. Atri, Alireza, editor of compilation. III. Title.

[DNLM: 1. Dementia. WM 220]
RC521
616.83dc23
2014004364

The science of medicine is a rapidly changing field. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy occur. The author and publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is accurate and complete, and in accordance with the standards accepted at the time of publication. However, in light of the possibility of human error or changes in the practice of medicine, neither the author, nor the publisher, nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete. Readers are encouraged to confirm the information contained herein with other reliable sources, and are strongly advised to check the product information sheet provided by the pharmaceutical company for each drug they plan to administer.

The writing and production of this book have been conducted during early mornings, late nights, weekends, and several vacations. Dr. Atris contributions to this book were conducted both outside his VA tour of duty and his Massachusetts General Hospital/Harvard University/National Institutes of Health research and clinical time. The contents of this book do not represent the views of the Department of Veterans Affairs, the United States Government, Massachusetts General Hospital, or Harvard Medical School.

eISBN: 9780199321728

To my mother and father, Jeannae and John Dickerson, who showed me the value and joy of a lifelong love of learning; and my grandmother, Gladys Jastram, and my great-grandmother, Tillie Sorensen, whose strength and kindness inspired me to try to be compassionate in every interaction with patients and families.

Brad C. Dickerson

To my father Seyed Ali Atri, who showed me that giving is the greatest joy in life and that optimism, resilience, and forgiveness are necessary choices; my uncle, A. Hamid Ghodse, M.D., Ph.D., whose character, integrity, and humanity shine as an eternal beacon to guide and emulate; and my aunt, Zahra Daneshmand, whose unconditional kindness, generosity and love sustained and taught me what matters.

Alireza Atri

To all patients, families, caregivers, and colleagues who suffer from and continue to battle these devastating conditions.

Brad C. Dickerson and Alireza Atri

Creighton H. Phelps

David Caplan

Jeremy D. Schmahmann and Deepak N. Pandya

Kirk R. Daffner and Kim C. Willment

Andrew E. Budson

Kenneth M. Heilman

Etty P. Cortes Ramirez and Jean-Paul G. Vonsattel

Ann C. McKee

Bradford C. Dickerson

Marsel Mesulam

David F. Tang-Wai, Alison Lake, and Neill Graff-Radford

Stephanie Lessig and Irene Litvan

Hamet A. Hanaas, Baar Bilgi, and Murat Emre

Charles DeCarli

Ellis S. van Etten, Steven M. Greenberg, and Anand Viswanathan

Jeremy D. Schmahmann

Alireza Atri

Meredith Wicklund and Ronald C. Petersen

Reisa A. Sperling

Meghan B. Mitchell and Alireza Atri

Sandra Weintraub

Haythum O. Tayeb, Evan D. Murray, and Bruce H. Price

Bradford C. Dickerson

Michael Rafii and Paul Aisen

Clive Ballard and Anne Corbett

James M. Ellison and Cynthia T. Greywolf

Sumer Verma

Licet Valois and James E. Galvin

Barry S. Fogel

The concept of dementia, defined originally as without mind or madness, has existed since ancient times. The term referred to many mental disorders, including schizophrenia, which was originally termed dementia praecox. Gradually dementia became more associated with old age and was often termed senility or senile dementia and was considered by many to be a normal consequence of the aging process. However, it became more apparent late in the 19th century and early 20th century that many dementias occurred earlier in life and were presenile. Others were reversible or sometimes preventable such as the dementia caused by syphilis, if treated early. In the mid-1970s Robert Katzman proposed that presenile dementia and senile dementia due to Alzheimers disease (AD) pathology very likely represented variations of the same syndrome differing only in age of onset. The term dementia as it is used now refers to progressive and severe loss of cognitive abilities that prevent affected persons from functioning normally in society no matter what their age or the underlying cause. Since AD is the most common form of dementia, research in recent years has focused more on AD than other dementias, even though they are sometimes closely related or even overlapping with AD.

Because clinical differentiation among the dementias is sometimes difficult in practice, especially in early stages and, often, more than one underlying cause may contribute to the clinical presentation, diagnosis has been difficult for many clinicians. In recent years guidelines for diagnosis have been developed for many of the dementias caused by neurodegenerative diseases, and they have helped to distinguish among the various dementias. The diagnostic guidelines for dementias due to frontotemporal lobar degeneration, Lewy bodies, vascular changes, and Alzheimers-related pathologies are discussed at length in this volume by respected experts. In addition, the American Psychiatric Association has issued a new version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in which they present neurocognitive disorders as major and minor, and have reclassified the dementias as major neurocognitive disorders.