Dementia in human populations exposed to neurotoxic agents: a portable microcomputerized dementia screening battery

Dementia has been described as a clinical syndrome associated with chronic diffuse cerebral hemispheric dysfunction resulting in multiple involvement of cognition, memory, language, visual-spatial skills, and personality. While the specific diseases causing dementia are diverse, the severity of the dementia is directly correlated with the loss of functional brain tissue, independent of the primary neuropathology. Many neurotoxicants are pharmacologically nonselective. Thus, chronic exposure to these agents would be expected to result in progressive, diffuse impairment of CNS functioning that would present clinically as a substance-induced dementia. This suggests that diagnostic techniques developed for the early detection of incipient dementia in the aged might prove useful in screening for dementia in younger populations. A microcomputer based Psychometric Assessment System (PAS) and Dementia Screening Battery (DSB) with high predictive value for differentiating the normal age-related changes in cognition from those associated with incipient dementia in the aged have been developed. The DSB is DSM-III compatible as it evaluates intellectual deterioration, malignant memory loss, amnestic aphasia, and spatial disorientation. A diagnosis of dementia is obtained by findings of intellectual deterioration and malignant memory loss and either amnestic aphasia or spatial deterioration.