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Senile Dementia - Policy and services (Paperback, Softcover reprint of the original 1st ed. 1989)
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Senile Dementia - Policy and services (Paperback, Softcover reprint of the original 1st ed. 1989)
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The concept of dementia has itself been the subject of increasing
refinement and precision in definition and diagnosis. Two important
sub-types have been identified: Alzheimer's disease and
multiple-infarct dementia. Alzheimer's disease or Senile Dementia
of the Alzheimer Type (SDA T), arises out of changes in the brain
which are as yet poorly understood and identifiable with certainty
only at post mortem examination. This type of dementia has been
named after Alois Alzheimer, who first identified these changes, in
the earliest years of this century. Alzheimer's is the commonest
type of identified dementia. The second commonest type is
multi-infarct dementia (MID), which follows a stroke or strokes
affecting the relevant part of the brain. Like SDA T, it can be
diagnosed with certainty only after death, although Jorm (1987, Ch.
8) reviews progress in using various types of tests which can
suggest, if not confirm, its presence during the sufferer's
lifetime. As will be shown in Chapter 2, some populations appear to
reverse the general picture and exhibit more MID than SDAT. Many
dementia sufferers cannot, even after a post-mortem examination, be
neatly categorized as one or the other of these sub-types. A
considerable uncertain 'grey area' of dementia remains at present
very poorly understood. Some elderly people develop dementia as a
side-effect of known physical disease. Some of these conditions are
curable. Care of the demented person has traditionally taken place
in the community: hospitalization is a fairly recent innovation.
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