Dementia
Dementia Unlike confusional states and delirium, there is no disturbance of consciousness in dementia. It is a chronic or progressive condition characterized by impairment of higher mental function (e.g. memory, reasoning, comprehension) and emotional and behavioural changes. Common causes are Alzheimer's disease and multiple strokes (vascular dementia). Uncommon but treatable causes include communicating hydrocephalus; vitamin B 12 or B 1 deficiency; hypothyroidism; syphilis; cysticercosis; brain tumour; chronic subdural haematoma. HIV can cause a dementia that is responsive to antiretroviral therapy. What is my Management: identify the few patients with treatable causes. Aim to supply others with general support so that they may have the highest quality of life possible. Remember that the family will also need support.