Some observations on the spectrum of dementia.

A study was designed to generate epidemiological and clinical data on dementia, in a teaching hospital in India. It was conducted on 124 (94 male and 30 female) elderly patients (aged more than 60 years) presenting with clinical syndrome of dementia (DSM-3). Their age range was 64-78 (mean 65.7 4.1) years. Detailed clinical, biochemical, radiological and electrophysiological evaluation was done to establish etiology. Patients with psychiatric ailments, cranial trauma and tumors were excluded. The study period was 4.2 years. Multi-infarct dementia (MID) was observed to be commonest cause of dementia and was present in 59 (47.6%) cases. There were 10 (8%) patients each of tuberculosis (TB) and neurocysticercosis (NCC). Alcohol-related dementia was present in 13 (10.5%), while malnutrition (Vitamin B12 deficiency) was present in 9 (7.2%). Alzheimer's Disease (AD) was present (NINCDS-ADRDA criteria) in 6 patients (4.8%). There were 3 (2.4%) cases 1 each of Huntington's disease, Parkinson's and Normal Pressure Hydrocephalus and 2 each of diabetes, hypothyroidism, hyperthyroidism and Creutzfeldt' Jakob Disease. We conclude that AD, which is irreversible and common in the west, is relatively uncommon in India as compared to MID, infections and malnutrition, which are potentially treatable.

Racial differences in the Hachinski ischemic score

Se describen las características de la Escala Isquémica de Hachinski en 29 pacientes afro-americanos y en 51 pacientes americanos de raza blanca. Los pacientes afro-americanos presentaron una mayor prevalencia de hipertensión arterial, así como valores más altos en la Escala Isquémica de Hachinski. Sin embargo, en el 93%(27-29) de los mismos la Escala de Hachinski mostró valores compatibles con el diagnóstico de una demencia degenerativa primaria. En una población racial mixta con una alta prevalencia de hipertensión arterial la Escala Isquémica de Hachinski clasificó correctamente a los pacientes afro-americanos con enfermedad de Alzheimer definida por los criterios del DSM III-R