Dementia
A syndrome of acquired cognitive and functional decline whose cause must be established through longitudinal history, collateral information, examination and targeted investigation, with delirium and treatable contributors addressed first.
Definition
Dementia is an acquired decline in cognitive and functional abilities that interferes with everyday life and is not explained by delirium alone. It is a syndrome caused by several possible neurodegenerative, vascular, mixed, inflammatory, structural or other conditions.
First principles
Dementia is a syndrome with multiple causes
Dementia describes progressive cognitive and functional decline, not one pathology. Alzheimer's disease, vascular disease, dementia with Lewy bodies, frontotemporal dementia and mixed pathology produce different patterns of memory, executive, language, visuospatial, behavioural and motor change. The pattern guides the differential, but diagnosis remains clinical and specialist.
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