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February 11, 1974

Clinical Aspects of Dementia

Author Affiliations

Bonnie Pray (Thornton) Naples, Fla

JAMA. 1974;227(6):667-668. doi:10.1001/jama.1974.03230190059035

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The authors emphasize that this book is oriented to the clinical aspects of the subject. We found this emphasis to be disappointing. As a helpful, descriptive, and short book intended for the postgraduate student, it is acceptable. The authors appropriately emphasize that the first clinical aspect of dementia is recognition; however, in the second step—differential diagnosis from the psychiatric illnesses—the disappointment begins. The natural history of geriatric mental disorders commonly includes symptoms of dementia (or pseudodementia). Reversible symptoms often consistent with dementia coexist with geriatric mental illnesses, such as retarded depression, anxious depression, paranoid psychosis, and schizophrenias. On the other hand, these same mental pictures evolve secondary to a progressive-deteriorating process of cerebral death. Thus far, Roth (J Mental Sci 101:281, 1955) has significantly dealt with this poorly studied differential problem.

Pearce and Miller present tables for the essential investigation of treatable organic causes of dementia. The omission of screening