Dementia older people

Klotz U, Avant GR, Hoyumpa Aet al. (1975) The effects of age and liver disease on the disposition and elimination of diazepam in adult man. J Clin Invest 55(2) 347-359 Kompoliti K and Goetz CG (1998) Neuropharmacology in the elderly. Neurol Clin 16(3) 599-610 Lanctot KL, Best TS, Mittmann N et al. (1998) Efficacy and safety of antipsychotics in behavioral disorders associated with dementia. J Clin Psychiatry 59(10) 550-561 Landi F, Onder G, Cesari M et al. (2005) Psychotropic medications and risk for falls among community-dwelling frail older people an observational study. J Gerontol A Biol Sci Med Sci 60(5) 622-626... 

Alzheimer s disease (AD) along with vascular and mixed dementia is the commonest form of dementia affecting older people and accounts for 60-65% of dementia cases, whereas vascular dementia and mixed dementia account for 15-20% of the cases each (1). The Brain of individuals with AD manifest two characteristic lesions senile plaques and intracellular neurofibrillary tangles of the hyperphosphorylated tau protein (2). The amyloid fi-protein (Afi) is the principal component of the senile plaques. It is a peptide of 39-43 amino acids, derived from a larger precursor, the amyloid precursor protein (APP) (Fig. 1). 

Some research dollars are pursuing new classes of drugs, which may supplant older therapies or create new markets in areas where there was before no effective therapy. Several companies have current research programs on drugs for Alzheimer s disease, a major cause of dementia in older people, but so far no drug can offer substantial improvements in patient functioning. (See chapter 5, box 5-E for more information on... 

Unfortunately, the term dementia has been used as a catchall phrase when discussing older people. The professional community has not always attempted to diagnose or differentiate which type of dementia an individual is experiencing. The possible reasons for this may be that the person is... 

Alzheimer s disease is a form of dementia common in older people that affects the patient s ability to carry out daily activities. Part of the patient s brain that controls thought, memory, and language becomes impaired. 

Alzheimer s disease (AD) is the most frequent cause of dementia (50-70%), followed by vascular dementia (30 0%) and mixed dementia (15-20%). These prevalent forms of age-related neurodegeneration represent a major problem of health in developed countries, with more than 25 million people affected and probably more than 75 million people at risk during the next 20-25 years worldwide. The prevalence of dementia increases exponentially, from approx. 1% at 60-65 yr to more than 30-35% in people older than 80yr. It is very likely that in those patients older than 75-80 yr most cases of dementia are mixed in nature (degenerative plus vascular), whereas pure AD cases are very rare after 80yr (1-3). 

Older adults without dementia, and individuals with mild dementia of the Alzheimer type, were different from patients with AD. There were differences between normal aging and Alzheimer s disease. The corpus callosum was smaller in older adults, regardless of whether they had dementia or not. Volume reductions in the hippocampus were markedly greater in people with AD. 

As the population continues to age and longevity increases, the need for psychiatrists to treat dementia is growing. Projections indicate that by 2030, nearly 8 million people in the United States aged sixty-five and older will be diagnosed with Alzheimer s disease. 

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