ABSTRACT
Progressive degenerative dementia is caused by several conditions. The most common conditions are Alzheimer’s disease, vascular dementia, dementia with Lewy bodies and fronto-temporal dementia. The early stages of these diseases present different symptoms to some extent,1 but with the progression of dementia the patients develop similar problems regardless of the etiology. In addition, more than one cause of dementia is often found on autopsy of patients with advanced dementia. The most common finding is a combination of both Alzheimer’s and vascular changes. While senile plaques and neurofibrillary tangles are found even in some cognitively intact aged individuals, cognitive impairment is more common if Alzheimer’s changes are present together with brain infarcts.2
Similarly, a combination of Alzheimer’s changes and Lewy bodies in cortical cells is also very common and contributes to the severity of dementia.3 Therefore, management of late stage dementia poses similar problems regardless of the initial clinical diagnosis.
