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[Consensus diagnosis in dementia syndrome].

B P Schulte

    Nederlands Tijdschrift Voor Geneeskunde
    |May 13, 1989
    PubMed
    Summary

    Consensus was reached on defining dementia as a behavioral syndrome with cognitive decline, excluding delirium. Standardized examinations and tests are crucial for accurate dementia diagnosis and prognosis.

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    Area of Science:

    • Neurology
    • Geriatrics
    • Psychiatry

    Background:

    • A consensus development conference addressed the diagnosis of dementia syndrome.
    • The conference aimed to establish agreement on definition, diagnostic criteria, and investigations.

    Purpose of the Study:

    • To define dementia syndrome and establish diagnostic criteria.
    • To outline appropriate clinical and ancillary investigations for dementia diagnosis.

    Main Methods:

    • A consensus development conference was convened.
    • Discussions focused on diagnostic criteria, distinguishing dementia types, and relevant investigations.
    • DSM-III-R criteria were reviewed and adapted.

    Main Results:

    • Dementia defined as a clinical syndrome with behavioral manifestations, cognitive decline (e.g., memory loss), and functional impairment, diagnosed clinically.
    • DSM-III-R criteria accepted, excluding the requirement for an organic etiological factor.
    • Delirium invalidates dementia diagnosis; distinction between cortical and subcortical dementia is clinically important.
    • Pseudodementia is an outdated concept; epidemiological data aids diagnosis and prognosis.
    • Comprehensive physical, neurological, psychiatric, and neuropsychological examinations are recommended.
    • The role of drugs in dementia and delirium in the elderly is significant.
    • Standardized laboratory tests, EEG, CT, or NMR are valuable for differential diagnosis.

    Conclusions:

    • Dementia is a clinically diagnosed syndrome characterized by cognitive decline and functional impairment.
    • Standardized diagnostic protocols, including comprehensive examinations and tests, are essential for accurate dementia diagnosis and management.
    • Distinguishing dementia subtypes and considering drug-induced causes are critical for effective patient care.

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