THE DIFFERENTIAL-DIAGNOSIS OF DEMENTIA

Dementia is misdiagnosed in up to 15% of cases referred for further as sessment. Real or apparent cognitive impairment is usually a prominent clinical feature of the most common differential diagnoses, including normal aging, depression, nonaffective psychoses, delirium, and amnes tic syndromes. To date, no practical biological marker exists to aid i n diagnosing dementia. However, other conditions that are frequently a menable to treatment can usually be differentiated from dementia follo wing detailed clinical assessment and the use of appropriate diagnosti c criteria. Some considerations that aid in distinguishing dementia fr om other conditions include: rates of onset and progression; duration of symptoms; fluctuations in the intensity and pattern of symptoms; th e pattern and extent of cognitive impairment and its effect on activit ies of daily living; alterations in the level of consciousness; the pr esence of affective and psychotic symptoms; past medical, family, and psychiatric history, including information about current medications, substance abuse, and premorbid personality.