Dementia and disability in old-age: a clinical perspective

This article briefly reviews the subject of disability in elderly dementia patients, and focuses primarily on the clinical perspective. The prevalence of dementia among community-dwelling elderlies is estimated to be about 5% and increases with age. Disability due to cognitive impairment and dementia is frequent in this group. Clinical determinants of disability in dementia include: a) Diagnosis of dementia: disability is inherent to the diagnosis of dementia even though the term is not specified in modern psychiatric classifications; b) Severity of dementia: expressed by breakdown into stages or by providing a psychometric score; c) Neuropsychological correlates of performance; d) Associated psychopathology; e) Etiology of dementia; f) Associated impairment in health or physical handicap. Finally, some management principles of disability in dementia are considered.