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Caring for Elderly Patients With Dementia

Eric B. Larson, MD, MPH; David M. Buchner, MD, MPH; Richard F. Uhlmann, MD, MPH; Burton V. Reifler, MD, MPH
Arch Intern Med. 1986;146(10):1909-1910. doi:10.1001/archinte.1986.00360220053008.
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Dementia in elderly patients is a common, serious, and often frustrating problem. Until recently, most articles in general medical journals have focused on the relatively unusual problem of dementia in younger patients.1,2 The demographic shift to an increasingly aged population, however, has forced us to redirect our attention to dementia in older persons, as demonstrated by the two large series reported in this issue.3,4

It is important to realize that dementia signifies a syndrome, and is not a diagnosis per se. Furthermore, dementia is not a normal finding in the elderly.5 Thus, determination of an accurate diagnosis is important for effective care. The distribution of dementia diagnoses appears to vary considerably in different settings. In younger patients, rare diseases such as normal pressure hydrocephalus and brain tumor, are relatively more common than cerebrovascular disease and Alzheimer's disease.6 Among elderly outpatients, Alzheimer's type dementia, which usually is an insidious, progressive illness,


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