Dementia:The Search for Treatable Causes--Where Do You Draw the Line?
Agustinus S. Suhardja, MD
Introduction
Dementia is reported to affect 3-11% of the population over 65 years of age, with a greater propensity among institutionalized residents.1
Due to the increasing number of dementing illnesses in the elderly population, the prevalence of dementia can be expected to continue to rise. The evaluation and care of patients with dementia could ultimately become a major component of the health care delivery system.
Dementia by definition, is the loss of intellectual abilities previously attained. Even though memory loss is the cardinal feature, the diagnosis of dementia according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), requires at least one more intellectual deficit (language, perception, visuospatial function, calculation, judgment, abstraction, and problem solving skills) which leads to impairment in day to day functioning.
Within the last two decades, some authors have proposed that as many as 10% of dementias are potentially treatable.2 It is more likely that treatable dementias occur in less than 5% of cases.