DEPRESSIVE DEMENTIA - A TRANSITIONAL DEMENTIA

This review comprises a historical, clinical, and empirical examinatio n of the dementia spectrum of depression. The primary focus of the art icle is to evaluate the usual dichotomy between depressive dementia as functional-reversible and degenerative dementia as organic irreversib le. II is proposed that depression, cognitive impairment, and degenera tive dementia be viewed as intersecting continua. Five prototypical gr oups are defined along these continua: (1) major depression without de pressive dementia, (2) depressive dementia, (3) degenerative dementia without depression, (4) depression of degenerative dementia, and (5) r andom co-occurrence of depression and degenerative dementia. The data suggest that a subset of cases of major depression without dementia ap pear to evolve into depressive dementia, and in turn, depressive demen tia may constitute a risk factor for degenerative dementia. Depressive dementia and degenerative dementia can sometimes represent two differ ent points of organic deterioration and severity in a long-term, multi phasic disease course; depressive dementia sometimes appears to be a t ransitional stage or phase in a disease progression from depression wi thout dementia to a degenerative dementia. The concept of ''transition al dementia'' is introduced in a heuristic and preliminary attempt to accommodate the nosologic entity of depressive dementia. (C) 1997 Wile y-Liss, Inc.