Summary

According to the DSM IV, dementia is “The development of multiplecognitive deficits that include memory impairment and at least one of the followin: afasia, apraxia, agnosia disturbance in executive functioning. Must be sufficiently severe to cause impairment in occupational or social functioning. The diagnosis should not be made during a course of delirium”. The two more common causes for the dementia syndrome are: Alzheimer disease and cerebral vascular stroke. Fundamental steps to determine dementia and its causes are: the history, physical and neurological examinations. Complementary examinations requested are: hemogram, urea, creatinin, calcium, phosphorus, magnesium, sodium, potassium, T3, T4, TSH, protein electrophoreses, TGO, TGP, protrombin time, RSS, Ftabs, HIV, B12 vitamin and pholic acid level, urinary sediment, thorax radiography, cranium tomography and/or resonance. Other examinations which may be requested are: electroencephalogram, cephalo-rachidean liquid and Spect. The treatment should be aimed at elimination of the cause, which most often is not possible. The treatment of the Alzheimer disease includes E vitamin and selegilin to reduce the disease progress. Symptomatic treatment is made with colynergics, such as donepezil, Aricept®. Besides pharmacologic treatment, behaviour therapy is fundamental to cope with agitation, aggressiveness and sleep disturbance.