Dementia is a clinical, social and economic problem worldwide as a consequence of increased longevity, and is the commonest condition leading to institutional care. Four conditions, alone or in combination, account for about 95% of cases of dementia: Alzheimer's disease, cerebrovascular disease, Parkinson's disease and frontal lobe dementia. The pathological changes occurring within the brain in these conditions will be discussed and compared to those resulting from the normal aging process.
. GrabowskiTJDamasioARDefinition, clinical features and neuroanatomical basis of dementia. In EsiriMMMorrisJH (Eds). The neuropathology of dementia. Cambridge Univ Press1997, 1–20.
2.
. OttABretelerMMBvan HarskampFPrevalence of Alzheimer's disease and vascular dementia: association with education. The Rotterdam study. Br Med J1995; 310: 970–3.
3.
. EsiriMMMorrisJH (Eds). The neuropathology of dementia. Cambridge Univ Press1997.
4.
. EsiriMMDementia and normal aging: neuropathology. In HuppertFABrayneCO'ConnorDW (Eds). Dementia and normal aging. Cambridge Univ Press1994, 385–436.
5.
. AndersonJMHubbardBMCoghillGRSliddersW.The effect of advanced old age on the neurone content of the cerebral cortex. J Neurol Sci1983; 14: 287–93.
6.
. WestM.Regionally specific loss of neurons in the aging human hippocampus. Neurobiol Aging1993; 14: 287–93.
7.
. MasliahEMalloryMHansenLDeTeresaRTerryRDQuantitative synaptic alterations in the human neocortex during normal aging. Neurology1993; 43: 192–7.
8.
. KhachaturianZSDiagnosis of Alzheimer's disease. Arch Neurol1985; 42: 1097–1194.
9.
. TierneyMCFisherRHLewisAJThe NINCDS-ADRDA work group criteria for the clinical diagnosis of probable Alzheimer's disease: a clinicopathological study of 57 cases. Neurology1988; 38: 359–64.
10.
. MirraSMHeymanAMcKeelDThe consortium to establish a registry of Alzheimer's disease (CERAD). Pt II. Standardisation of the neuropathologic assessment of Alzheimer's disease. Neurology1991; 41: 479–86.
11.
. NagyZEsiriMMJobstKARelative roles of plaques and tangles in the dementia of Alzheimer's disease: correlations using three sets of neuropathological criteria. Dementia1995; 6: 21–31.
12.
. EsiriMMWilcockGKMorrisJHNeuropathological assessment of the lesions of significance in vascular dementia. J Neurol Neurosurg Psychiat1997; 63: 749–53.
13.
. SpillantiniMGSchmidtMLLeeVM-Yα-synuclein in Lewy bodies. Nature1997; 388: 839–40.
14.
. McKeithIGGalaskoDKosakaKConsensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies. Neurology1996; 47: 1113–24.
15.
. McShaneRHEsiriMMJoachimCSmithADNigral cell loss, but not cortical Lewy bodies, determines severity of cognitive decline in dementia with Lewy bodies (DLB). Neuropathol Appl Neurobiol. In Press.
16.
. BrunAEnglundBGustafsonLClinical and neuropathological criteria for frontotemporal dementia. J Neurol Neurosurg Psychiat1994; 57: 416–8.
17.
. GoateAChartier-HarlinMCMullanMSegregation of a missense mutation in the amyloid precursor protein gene with familial Alzheimer's disease. Nature1991; 349: 704–6.
18.
. MannDMAEsiriMMRegional acquisition of plaques and tangles in Down's syndrome patients under 50 years of age. J Neurol Sci1989; 89: 169–79.
19.
. HardyJ.Amyloid, the presenilins and Alzheimer's disease. Trends in Neurosci1997; 20: 154–8.
20.
. SaundersAStrittmatterWJSchmechelDAssociation of lipoprotein E allele Σ4 with the late onset familial and sporadic Alzheimer's disease. Neurology1993; 443: 1467–72.
21.
. LehmannDJJohnstonCSmithADSynergy between the genes for butyrylcholinesterase K variant and apolipoprotein E4 in late-onset confirmed Alzheimer's disease. Hum Mol Genet1997; 6: 1933–6.
22.
. MortimerJAVan DuijnCMCandraVHead injury as a risk factor for Alzheimer's disease: a collaborative re-analysis of case-control studies. Int J Epidemiol1991; 20 (Suppl 2): 528–35.
23.
. StewartWFKawasCCorradaMMetterEJRisk of Alzheimer's disease and duration of NSAID use. Neurology1997; 48: 626–32.
24.
. KawasCResnickSMorrisonAA prospective study of oestrogen replacement therapy and the risk of developing Alzheimer's disease. Neurology1997; 48: 1512–21.
25.
. Tournier-LasserveEJoutelAMelkiJCerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy maps to chromosome 19q12. Nat Genet1993; 3: 256–9.
26.
. LangstonJWBallardPTetrudJWIrwinI.Chronic parkinsonism in humans due to a product of meperidine-analog synthesis. Science1983; 219: 979–80.
27.
. GoodPFWernerPHsuA.OlanowCWPerlDPEvidence for neuronal oxidative damage in Alzheimer's disease. Amer J Pathol1996; 149: 21–28.
28.
. BealMFAging, energy and oxidative stress in neurodegenerative diseases. Ann Neurol1995; 38: 357–66.
29.
. ShapiraAHVOxidative stress and mitochrondrial dysfunction in neurodegeneration. Curr Op Neurol1996; 9: 260–64.
30.
. OppenheimRWRelated mechanisms of action of growth factors and antioxidants in apoptosis: an overview. In SeilFJ (Ed). Adv Neurol 72, Neuronal regeneration, reorganisation and repair. 1997, Lippicott-RavenPhiladelphia, 69–78.
