Dementia in Elderly Outpatients: A Prospective Study

  1. ERIC B. LARSON, M.D., M.P.H.;
  2. BURTON V. REIFLER, M.D., M.P.H.;
  3. HARVEY J. FEATHERSTONE, M.D., M.P.H.; and
  4. DALLAS R. ENGLISH, Ph.D.
  1. Seattle, Washington

    Abstract

    We prospectively studied the evaluation of dementia in 107 unselected outpatients; 83 had so-called "irreversible" dementias, including 74 who had an Alzheimer-type dementia. Fifteen patients had potentially reversible dementias, of which hypothyroidism and drug toxicity were the commonest causes. Distinguishing features of reversible dementia were shorter duration, use of more prescription drugs, and less severe dementia. Almost half of the patients had other previously unrecognized treatable medical diseases. Most diagnoses were made from patient history and physical and mental status examination. Patients with reversible dementia improved but rarely reverted to normal. Objective improvement occurred in 25 patients after treating unrecognized

    Article and Author Information

    • ▸From the Departments of Medicine, Psychiatry, and Epidemiology, University of Washington Schools of Medicine and Public Health; Seattle, Washington.

    • Grant support: in part by grant 5-R01-MH33841 from the National Institute of Mental Health. Dr. Larson is a Henry J. Kaiser Family Foundation Faculty Scholar in General Internal Medicine.

    • ▸Requests for reprints should be addressed to Eric B. Larson, M.D., M.P.H., Department of Medicine RG-20, University of Washington; Seattle, WA 98195.

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