DSM-III

Diagnostic Criteria

A. Dementia.

B. Insidious onset with uniformly progressive deteriorating course.

C. Exclusion of all other specific causes of Dementia by the history, physical examination, and laboratory tests.

Subtypes

Primary Degenerative Dementia, Senile Onset (after age 65)

  • with delirium
  • with delusions
  • with depression
  • uncomplicated

Primary Degenerative Dementia, Presenile Onset (age 65 and below)

  • with delirium
  • with delusions
  • with depression
  • uncomplicated

Differential Diagnosis

Normal aging

The normal process of aging has been associated in a number of studies with certain decrements in intellectual functioning. The nature and significance of these changes are controversial. The diagnosis of Primary Degenerative Dementia should be limited to cases in which there is clear evidence of progressive and significant deterioration of intellectual and social or occupational functioning.

Other causes of Dementia

Subdural hematoma, normal-pressure hydrocephalus, cerebral neoplasm, Parkinson's disease, vitamin B12 deficiency, hypothyroidism, substance intoxication, and other specific and possibly treatable physical disorders that may cause Dementia need to be ruled out by the history, physical examination, and appropriate laboratory tests.

Multi-infarct Dementia

In Multi-infarct Dementia the clinical course is more variable and typically progresses in stepwise fashion with focal neurological signs and systemic evidence of vascular disease. In occasional cases, the two disorders may coexist, and both diagnoses should be recorded.

Major depressive episode

Elderly individuals with a major depressive episode may have features strongly suggesting Dementia.

DSM-IV

See Dementia of the Alzheimer's Type and Dementia Due to Pick's Disease

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