There is much confusion in regard to the classification of the various mental states of the senium. Terms in common use fail to define the conditions clearly and are frequently used interchangeably. In an effort to catalog these mental states, about 500 cases were reviewed from an organic standpoint, and about 100 of these were selected as a basis for this report. The vascular pathologic changes were carefully studied in the material obtained at necropsy, and it was found that all the cases fell definitely into four major groups: (1) a group in which there was sclerosis mainly of vessels of large caliber; (2) a group in which the sclerosis was mainly confined to vessels of small caliber; (3) a group in which both large and small vessels were about equally sclerosed, and (4) a group in which the vascular change was a "fibrosis" rather than a "sclerosis."
RHEIN JHW, WINKELMAN NW, PATTEN CA. MENTAL CONDITIONS IN THE AGED. Arch NeurPsych. 1928;20(2):329–335. doi:10.1001/archneurpsyc.1928.02210140097007
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