Mace NL, Rabins PV. The 36-Hour Day: A Family Guide to Caring for Persons With Alzheimer’s Disease, Related Dementia Illness, and Memory Loss in Later Life. Baltimore: Johns Hopkins University Press; 1999.
When discussing the concept of cognitive impairment, many terms are used, including dementia, amnestic disorder, cognitive impairment not dementia (CIND), cognitive impairment associated with normal aging, mild cognitive impairment, vascular cognitive impairment, and vascular cognitive impairment not dementia (VCIND). Although definitions of such terms are clinically important, there is significant uncertainty about associating a given cognitive syndrome with specific neuropathology.1
The assessment and treatment of psychiatric symptoms in persons with cognitive dysfunction are becoming increasingly important. Prevalence estimates of dementia in the United States range from 5% in those aged 71 to 79 years to 25% to 50% in those 90 or older.
In the new century, the dementias will probably become 1 of the 2 or 3 dominant behavioral health problems in the United States. This article provides an overview of the major clinical features of these cognitive loss syndromes and emphasizes the perspective of the practicing psychiatrist.
A variety of conditions may account for the sleep difficulties experienced by many older adults, including specific sleep disorders, circadian rhythm disturbances, and medical and psychiatric comorbidities.
Parkinson disease (PD) is a progressive neurodegenerative disorder that is characterized by its motor signs, including resting tremor, rigidity, bradykinesia, and postural instability. PD is more common in the elderly, and there is usually no family history of the disease.