Reversible Causes of Mental Impairment

Abstract

To the Editor.— The article entitled Senility Reconsidered: Treatment Possibilities for Mental in the Elderly by the Task Force sponsored by the National Institute on Aging (1980;244:259) is informative and helpful. There are, however, inaccuracies that have crept into it, especially in the table entitled Reversible Causes of Mental Impairment on p 261. The first one is Cushing's syndrome, which is denoted as a cause of dementia. In fact, Cushing's syndrome produces acute psychosis and confusional states more frequently when drug induced. Cushing's disease, itself, produces an organic brain syndrome or depression-like syndrome with about 10% making suicidal attempts. 1 Second, traumatic intracerebral hemorrhage is known to cause an acute organic brain syndrome (OBS), and during the recovery phase, varying degrees of neurological and intellectual impairment. 2(p1065-1078) Therefore, it should be denoted as a cause of both dementia and delirium. Epidural hematoma can cause both acute OBS and dementia.