Research and Care of Patients With Dementia: Moving Beyond Memory Loss

Abstract

Received Aug. 26, 2005; accepted Sept. 26, 2005. From the Depts. of Psychiatry, Neurology, and Epidemiology, Univ. of California, San Francisco, and the San Francisco VA Medical Center. Send correspondence and reprint requests to Kristine Yaffe, M.D., Univ. of California, San Francisco, 4150 Clement St., San Francisco, CA 94121. e-mail: kyaffe@itsa.ucsf.edu 2005 American Association for Geriatric Psychiatry Alzheimer disease (AD), the most common cause of dementia, currently affects over 4 million individuals in the United States and has an annual cost of $100 billion. By the year 2050, the number of individuals affected by AD is projected to quadruple. Mild cognitive impairment (MCI), represents a cognitive state between normal cognitive aging and dementia, usually referring to patients with memory impairment. The prevalence of MCI is thought to be even higher than that of dementia, with a recent population-based study reporting that 23% of the elderly population had MCI. In addition to its common occurrence, MCI is a clinically significant condition because many patients with this diagnosis are at an increased risk for dementia, especially dementia of the Alzheimer type. Given the projected demographic shift in our population and the devastating nature of these illnesses, the imperative to study dementia and MCI is even greater. This issue of the Journal, dedicated to dementia, underscores some exciting emerging themes in dementia research: 1) the importance of non–memorydomain impairment, such as frontal lobe or executive functioning in AD and other dementias; 2) the common occurrence of neuropsychiatric symptoms (NPS) of dementia and the need for better treatment of these symptoms; 3) new directions in the treatment of AD and amnesticMCI; 4) ethnic/racial differences on rate of cognitive decline; and 5) how to measure severe dementia and the impact of severe dementia on caregiver decision-making. The Role of Non-Memory CognitiveDomain Impairment in AD