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Misinformation is rampant on the Internet. One area of misinformation I come across often concerns Alzheimer’s disease and dementia. Articles on these topics are often written by unqualified writers who cite dubious references. Having many years of experience diagnosing and assisting in the treatment and follow-up care of dementia patients, I find this situation disconcerting. As a result, I thought that a general series of articles in dementia would help to correct some of the misconceptions out there.

What is Dementia?

In the same way that alcoholism, cocaine addiction, and heroin addiction are different and yet are all addictions, Alzheimer’s disease is a form of dementia. There are many types of dementia, which is a term for a general syndrome in the same way that addiction or cancer are general terms for a family of related syndromes. The term "dementia" is used to describe a number of conditions that result in a loss of intellectual capacities occurring in the context of clear consciousness (e.g., occurring in the absence of a delirium). Most often the first cognitive domain affected in dementia is memory; however, in some forms of dementia this is not necessarily the case.

The DSM-IV-TR diagnostic criteria for dementia (the diagnostic manual used by mental health care professionals in the United States) consists of memory loss and the loss of one other cognitive domain (e.g., a significant decline in language-related skills, visual-spatial skills, or executive functions such as the ability to sequence events or to think abstractly). This loss of functioning must result in significant distress or impairment in occupational, social, or other areas of the person’s functioning and reflect a significant change from the person’s prior functioning (APA, 2000). There are some concerns that these criteria are too liberal sometimes resulting in inappropriate dementia diagnoses and more stringent criteria have been proposed (Ropper and Samuels, 2009). In any event, a diagnosis of dementia should be made after a formal evaluation that includes a full medical workup (preferably by a neurologist) and a neuropsychological evaluation.

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