[Rehabilitation and the pathology of dementia]

To recognize the influence of the social and physical environment on demential pathology has methodological and therapeutical implications. Since the beginning of the seventies, many works have demonstrated that senile deterioration is not a continuous nor insurmountable process. There is no ineluctable evolution, independent of environment. The different therapeutical strategies can be analysed in terms of behavior modification through an action upon the physical and social determinants of the environment. The authors present two complementary methods of revalidation: an individualised reeducation of necessary behaviors for a social autonomy (toilet, dressing, continence) and a program of physical and psychic activation, to maintain or reestablish social skills (management of the institutional environment, physical mobilisation, ergotherapy and sociotherapy). These methods are relevant to the functional analysis and behavior modification. They are in concordance with the goals of the contemporary gerontology.