Dementia syndromes
Framing
- Dementia syndromes are distinguished by their dominant early clinical/pathological pattern - Alzheimer disease (progressive episodic memory loss, amyloid/tau pathology), vascular dementia (stepwise decline, cerebrovascular disease burden), dementia with Lewy bodies (fluctuating cognition, visual hallucinations, parkinsonism), and frontotemporal dementia (early personality/behavioural or language change with relatively preserved memory) - accurate subtyping matters because management, prognosis, and specific drug sensitivities (notably antipsychotic sensitivity in Lewy body dementia) differ substantially
- Mixed pathology (particularly Alzheimer plus vascular change) is common, especially in older patients, meaning a single "pure" diagnosis should not always be assumed even when one pattern predominates clinically
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