Brain, Mind and Dementia: With Particular Reference to Alzheimer's Disease

1989 ◽  
Vol 9 (1) ◽  
pp. 1-15 ◽  
Author(s):  
Tom Kitwood

ABSTRACTA new theoretical framework for understanding and working with the dementing illnesses of old age is presented, and explicated with particular reference to senile dementia of the Alzheimer type. For several reasons the commonly accepted model, which assumes a simple linear causal relationship between neuropathology and dementia, is inadequate. A more comprehensive model, grounded in a monistic view of the mind-brain relationship, must take into account not only the psychological states that correspond to particular brain states, but also both developmental and pathological aspects of brain structure. Using this we can describe the dementing process, ‘normal’ psychological functioning in old age, pseudodementia and ‘benign senescent forgetfulness’. Further, the scope for some degree of ‘rementia’ is explored.

1985 ◽  
Vol 147 (1) ◽  
pp. 63-66 ◽  
Author(s):  
John Colgan

SummaryComputed cranial tomography was performed on 48 patients with Senile Dementia of the Alzheimer Type (SDAT) who have since been followed up in a continuing prospective study. At six-months follow-up, ten patients had died; these did not differ significantly from the survivors either in mean age or duration of dementia, although the latter tended to have been shorter in the deceased. Despite having shorter histories, the deceased had performed worse on initial testing with several cognitive measures, and this was significant for the mental test score; this suggests some patients may have a more rapidly progressive form of SDAT. In a comparison between the CT scan of the deceased and survivors, the deceased were found to have significantly lower mean attenuation densities in the parietal, occipital, and left thalamic regions. The hypothesis that low attenuation density in the parietal regions of the CT scan in SDAT is associated with a more rapid demise is supported for the present period of follow-up.


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