New Trends in the Diagnosis and Therapy of Non-Alzheimer¿s Dementia

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Dementia is an acquired disorder of higher cerebral functions and cognition. Because of increasing life expectancy dementia poses a major health and socio­ economic problem. Alzheimer's disease accounts for 70-90% of mental decline in the elderly. Degenerative non-Alzheimer's dementi as are responsi­ ble for 7-30%. These include a variety of disorders clinically characterised by progressive cognitive dysfunction often combined with focal neurological def­ icits, e.g. Parkinson-plus syndromes, Lewy body dementia, lobar and multisys­ tem atrophies, other neurodegenerative disorders, and prion diseases. Often it is difficult to distinguish these illnesses from Alzheimer's disease and vascu­ lar dementia. In spite of considerable progress in molecular genetics, biochemistry, and neuropathology, the classification and pathogenesis of non-Alzheimer's dementias are still debatable. Diagnosis is frequently made only at postmor­ tem. Because disease markers are not available for the majority of non­ Alzheimer's dementias, consensus criteria for the identification of such diseas­ es are warranted. These criteria could serve at a basis for early diagnosis and distinction from other dementing disorders.