Am J Psychiatry 1990; 147:435-438
Copyright © 1990 by American Psychiatric Association
Progression of illness in the differential diagnosis of primary dementia
GS Zubenko
Department of Psychiatry, University of Pittsburgh, PA.
The diagnostic utility of determinations of insidious or stepwise
progression of illness was examined in 124 geriatric inpatients with
primary dementia. Such determinations failed to distinguish patients with
primary degenerative dementia of the Alzheimer type from those with
multi-infarct dementia. Episodic behavioral complications, especially
depression and delusions, in the patients with primary degenerative
dementia were associated with stepwise progression. Determinations of
stepwise progression were made in only six (15%) of the 40 demented
patients with at least two cerebral infarctions, a finding inconsistent
with current diagnostic criteria for multi-infarct dementia.
