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Review
. 2015 May;84(2):79-87.

Dementia

E L Cunningham  1 , B McGuinness  2 , B Herron  3 , A P Passmore  2
Affiliations
Review

Dementia

E L Cunningham et al. Ulster Med J. 2015 May.

Abstract

Dementia is a clinical diagnosis requiring new functional dependence on the basis of progressive cognitive decline. It is estimated that 1.3% of the entire UK population, or 7.1% of those aged 65 or over, have dementia. Applying these to 2013 population estimates gives an estimated number of 19,765 people living with dementia in Northern Ireland. The clinical syndrome of dementia can be due to a variety of underlying pathophysiological processes. The most common of these is Alzheimer's disease (50-75%) followed by vascular dementia (20%), dementia with Lewy bodies (5%) and frontotemporal lobar dementia (5%). The clinical symptoms and pathophysiological processes of these diseases overlap significantly. Biomarkers to aid diagnosis and prognosis are emerging. Acetylcholinesterase inhibitors and memantine are the only medications currently licensed for the treatment of dementia. The nature of symptoms mean people with dementia are more dependent and vulnerable, both socially and in terms of physical and mental health, presenting evolving challenges to society and to our healthcare systems.

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Figures

Fig 1
Fig 1
Pie chart showing estimated frequencies of dementiacausing disease processes
Fig 2
Fig 2
An immunohistochemical section taken through the cortex in a case of ADD. An antibody to Beta A4 amyloid is applied to the tissue and detects this antigen which in turn stains the antigen brown. This shows a dense deposition of amyloid throughout the cortex as dense core (DC) and diffuse (D) plaques.
Fig 3
Fig 3
Neuronal tangles stained with an antibody to Tau (T)
Fig 4
Fig 4
A pigmented neuron from the substantia nigra. A single Lewy Body is present. This patient also had diffuse cortical Lewy bodies characteristic of Pure Lewy Body Dementia
Fig 5
Fig 5
A section from the hippocampal dentate fascia showing dot like deposition of ubiquitin. This is characteristic of Frontotemporal Lobar Dementia with Ubiquitinised inclusions (now called TDP).
Fig 6
Fig 6
Figures 6 and 7 show normal and reduced uptake on FDG-PET scanning respectively. The decreased uptake in the temporoparietal and precuneus (arrow) regions, typical of ADD, can be seen.
Fig 7
Fig 7
Figures 6 and 7 show normal and reduced uptake on FDG-PET scanning respectively. The decreased uptake in the temporoparietal and precuneus (arrow) regions, typical of ADD, can be seen.
See this image and copyright information in PMC

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