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Observations on dementias with possibly reversible symptoms
E Farina1, S Pomati, C Mariani
1Neurorehabilitation Unit, S. Maria Nascente Medical Research Center, Don Carlo Gnocchi Foundation, University of Milano, Italy.
Aging (Milan, Italy)
|January 13, 2000
Summary
Potentially reversible dementias (PRD) are rare, found in 7.2% of dementia cases. True reversal of dementia after treatment is even rarer, highlighting the need for careful clinical evaluation to identify these cases.
Area of Science:
- Neurology
- Geriatrics
- Internal Medicine
Background:
- Dementia evaluation requires considering treatable conditions, though reversible diseases are infrequent.
- Optimizing diagnostic protocols for potentially reversible dementias (PRD) can reduce unnecessary investigations.
Purpose of the Study:
- To identify PRD in patients referred to a memory clinic.
- To determine the frequency and outcomes of PRD in a clinical setting.
Main Methods:
- Retrospective review of 513 patients referred to a memory clinic.
- Neurological, neuropsychological, and laboratory assessments, including CT brain scans for demented patients.
- Identification of PRD based on clinical criteria.
Main Results:
- 362 patients (70.6%) met dementia criteria.
- 26 PRD cases identified (7.2% of dementia cases, 5.1% of total sample).
- Complete reversal occurred in 3.6% of dementia cases, partial in 1.4%, with no improvement in 2.2%.
Conclusions:
- Potential and actual dementia reversibility differ; true reversibility is uncommon but significant.
- Thorough clinical history and examination are crucial for identifying PRD.
- Standard blood tests and vitamin B12 assays are useful; CT scans are less effective for PRD detection without neurological signs.