ABSTRACT
In the process which we call dementia, the clinical picture is usually dominated by intellectual disintegration, but feeling and striving are always affected. The general features of the syndrome show a fairly consistent pattern which is varied in the individual case according to the premorbid personality, the age of onset, the nature of the cause, and any local preponderance in the early lesions. The impairment of memory for recent events, which is the earliest change, may be effectively compensated for a considerable time by a surprising ingenuity in concealment, adherence to a rigid daily routine and the use of a notebook. This adjustment breaks down as intellectual grasp weakens and thinking becomes slow, labored and ill defined. Attention is now aroused and sustained with difficulty, the patient tires easily, particularly with any unaccustomed task, and he is prone to become lost in the middle of an argument or sentence. Poverty of thought supervenes in a once richly stored, flexible mind: it shrinks to a small core of ever-recurring, rigidly held ideas and re-evoked memories of the remote past, which may long remain vivid and clear. (Mayer-Gross, Slater, & Roth, 1969, p. 491)
