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March 13, 1981

Senility Reconsidered

Author Affiliations

George Washington University Medical Center Washington, DC

JAMA. 1981;245(10):1025. doi:10.1001/jama.1981.03310350015007

To the Editor.—  The article "Senility Reconsidered: Treatment Possibilities for Mental Impairment in the Elderly" (1980;244:259) is probably the most comprehensive overview of the state of the art and current thinking about dementia. The presented, easyto-use diagnostic check list will be of great help for physicians who do not regularly see patients requiring thorough examination for organic brain disease. However, a few points, in particular the classification of dementia, should be elaborated.Following suggestions of other authors, presenile dementia and senile dementia are classified as one clinicopathological entity—Alzheimer's disease. However, the current dispute on the value and use of the concept of organic brain syndrome (OBS), with all of its pros and cons, widely discussed in psychiatric literature, is not presented. Alcoholic dementia; posttraumatic, postanoxic, and postinfectious encephalopathies; and dementia supervening on schizophrenia; multiple sclerosis; or Parkinson's disease are treatable, although not always reversible, forms of dementia. The use of