NeurologyPending review

Dementia

A progressive, acquired decline in cognitive function severe enough to impair daily function, whose pattern of deficits directly reflects which brain networks the underlying pathology, most often amyloid and tau, Lewy bodies, or vascular injury, has damaged.

In a nutshell

Dementia is a syndrome of progressive cognitive decline whose pattern of deficits reflects which network is damaged: hippocampal loss gives memory-led Alzheimer's disease, cumulative infarcts give stepwise vascular dementia, and synuclein pathology gives fluctuating cognition with hallucinations and parkinsonism in Lewy body dementia.

Classic presentation

An older adult with insidious, progressive short-term memory loss over months to years, affecting daily function, with relative preservation of remote memories early on.

Key points

  • The pattern of deficit predicts the cause: memory-led in Alzheimer's disease, stepwise or executive in vascular dementia, fluctuating with hallucinations and parkinsonism in Lewy body dementia.

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Educational content pending clinical review. Not medical advice.