Hanyang Med Rev.  2006 Feb;26(1):14-25.

Clinical Diagnosis and Differential Diagnosis of Dementia

  • 1Department of Neurology, Seoul National University College of Medicine, Clinical Neuroscience Center, Bundang Seoul National University Hospital, Korea. neuroksy@snu.ac.kr


Dementia is a syndrome of acquired intellectual impairment produced by brain dysfunction and has tremendous consequences for the patients' families, and society. Recently treatment options to manage the symptoms of dementia are being developed and the effectiveness of these options are being enhanced. Having broad spectrum of symptom severity and with many different causes of cognitive dysfunction, dementia should be diagnosed accurately before starting medication or prognosis judgment. The diagnosis of dementia consists of three steps; the first step is the diagnosis of dementia, where we should determine how severe the patient's cognitive dysfunction is. The second step is the differential diagnosis of the dementia, where we have to find the etiological disorders to produce the patient's res ponsible cognitive dysfunction. The third and last step is for the individual and personal diagnosis. At this step, we consider other associated disorders, concomitant medications, life style and quality of care givers. In the first step, the mild cognitive impairment and dementia will be discussed. In the second step, Alzheimer's disease and vascular dementia will be reviewed, because these two disorders are the most important and prevalent diagnoses for the patients with dementia. Dementia with Lewy bodies and frontotemporal dementia are also important features of neurodegenerative dementia for the differential diagnosis of dementia of the Alzheimer's type.


Dementia; Mild cognitive impairment; Alzheimer's disease; Vascular dementia
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