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The dysfunction may be primary, as in diseases, injuries, and insults that affect the brain directly and selectively; or secondary, as in systemic diseases and disorders that attack the brain only as one of the multiple organs or systems of the body that are involved.
❖ Dementia in Alzheimer disease, atypical or mixed type ❖ Dementia in Alzheimer disease, unspecified
RISKS
Etiology is unclear, risks as below: ❖Age (doubles with every 6.3 year increase in age, from 3.9
Progressive supranuclear palsy
Many others Dementia with Lewy bodies
Vascular dementias and AD
Parkinson’s disease Diffuse Lewy body disease
Lewy body variant of AD AD and dementia with
Classification of dementia
DLB
AD
VD
Other dementias
Frontal lobe dementia
Vascular dementias
Creutzfeldt-Jakob disease Corticobasal degeneration
Multiinfarct dementia Binswanger’s disease
The impairments of cognitive function are commonly accompanied, and occasionally preceded, by deterioration in emotional control, social behaviour, or motivation.
Organic Mental Disorders
❖Concept (compared to unctional Mental Disorders)
❖ History ❖Controversy ❖Including： Dementia, delirium, Amnestic
syndrome, et al
Dementia
Demenia is a syndrome due to disease of the brain, usually of a chronic or progressive nature, in which there is disturbance of multiple higher cortical functions, including memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement.
Organic, including symptomatic, mental disorders
Concept
A range of mental disorders grouped together on the basis of their having in common a demonstrable etiology in cerebral disease, brain injury, or other insult leading to cerebral dysfunction.
Famous persons with dementia
Alzheimer disease
❖Alzheimer disease is a primary degenerative cerebral disease
❖unknown etiology with characteristic neuropathological and neurochemical features.
Lewy bodies
AD
8%
10-20%?
65%?
5% 7%
Small GW et al. JAMA. 1997;278:1363-1371; American Psychiatric Association. Am J Psychiatry. 1997;154(suppl):1-39; Morris JC. Clin Geriatr Med. 1994;10:257-276.
❖The disorder is usually insidious in onset and develops slowly but steadily over a period of several years.
Subgroups
❖ Dementia in Alzheimer disease with early onset onset before the age of 65, with a relatively rapid deteriorating course and with marked multiple disorders of the higher cortical functions.
❖ Dementia in Alzheimer disease with late onset, onset after the age of 65, usually in the late 70s or thereafter, with a slow progression, and with memory impairment as the principal feature.
