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Dementia: What are
the various different diagnoses?
Dementia overview
 Dementia disorders
are characterized by the development of multiple cognitive deficits
(including memory loss) but are differentiated on the basis of the
etiology (i.e. Dementia of the Alzheimer's type, Dementia due to
Pick's Disease, Dementia due to Parkinson's Disease, Dementia due to
Huntington's Disease, Vascular Dementia, Dementia due to HIV disease,
Dementia due to Head Trauma, dementia due to other general medical
conditions, substance-induced persisting dementia, and dementia due to
multiple etiologies). The first information presented in this section
will be related to general dementia information.
Dementia diagnosis:
Dementia as it is
defined in the DSM-IV-TR is a series of disorders which are
characterized by the development of multiple cognitive deficits
(including memory loss) that are due to the direct effects of a
general medical condition, the continuing effects of a substance, or
multiple etiologies. Dementias share some common features but are
basically classified according to their believed etiology. The
cognitive deficits must be to the degree that they interfere
significantly with an individual’s occupational or social
functioning. Also, the deficits must show a progressive decline from
the individual’s previous higher-level of cognitive functioning and
must not be the result of delirium. However, delirium may be
superimposed on a dementia and both may be diagnosed if the dementia
diagnosis is evident previous to the development of the delirium.
Dementia is a chronic disease that typically occurs even though an
individual has clear sensory abilities such as hearing and vision. If
it is believed that an individual’s consciousness is somewhat clouded,
they will usually receive a diagnosis of delirium. Another factor
essential to the diagnosis of dementia, is the presence of cognitive
deficits that include memory impairment in a least one of the
following cognitive abnormalities: aphasia, agnosia, apraxia, or a
disturbance of executive functioning.
Memory functioning in the dementia diagnosis:
A dementia
diagnosis will require testing of memory abilities. The memory
function is usually divided into three different departments that can
be easily evaluated during a mental status examination. These three
departments of memory functioning include immediate recall (primary
memory), recent memory (secondary) and remote memory (tertiary).
Immediate recall
is characterized by a limited capacity to remember things that one has
been exposed to recently. It is believed that the anatomic site of
destruction of immediate memory is the reticular activating system
resulting in an inability to register new information. Immediate or
primary memory can be tested in several ways including asking an
individual to remember three words in a row and asking the individual
to repeat them in the same order. This inability to immediately
register new information accounts in part for an individual’s
confusion and the frustration an individual may feel when confronted
with unexpected changes in their daily routine.
Some information from DSM-IV-TR Mental Disorders:
Diagnosis, Etiology & Treatment by Michael B. First and Allan Tasman
Additional information and
webpage By Paul Susic MA Licensed
Psychologist Ph.D. Candidate
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