Chapter 2 Cognitive, emotional and behavioral dysfunctions in aging and dementia

Publisher Summary

This chapter evaluates the research on psychological dysfunctions in aging and dementia, focussing on cognitive and behavioral dysfunction. Because of the fact that currently early assessment is difficult, this chapter provides some information on the paradigms and methods that are used in the assessment of (senile) dementia and especially in the (senile) dementia of the Alzheimer type. It also summarizes the current knowledge on the cerebral substrate involved in aging and dementia, as far as can be concluded from behavioral research in patients. The assessment of very early stages of senile dementia is important for several reasons. First, it is important to differentiate between normal aging and various psychiatric and neurological diseases, in view of the possible intervention in the disease process by biological (drugs) and nonbiological (training and psychotherapy) methods. Treatment in an early stage of the disease process can be expected to be more successful in view of the less pronounced structural changes. Second, when a person can be diagnosed as being in a (very) early stage of senile dementia, the profile of behavioral, emotional, and cognitive deficits may give some clue as to a possible cause of the disease(s) and its pathogenesis. With respect to Alzheimer's disease, the pattern of cognitive deficits is similar to that in normal aging but the dementing subject is also characterized by deficiencies in verbal functions and recognition memory. Other forms of dementia such as multiinfarct dementia and Pick's disease appear to have another pattern of cognitive strengths and weaknesses.