[Dementias: present situation and future perspectives (III). Neurological, therapeutic, psychosocial aspects and patient care].

The lack of univocal diagnostic biological markers which are easily reproducible, highly specific and sensitive has propitiated the apparition of a conjunct of neuropsychological instruments for the detection and evaluation of dementias. The main markers are reviewed in this paper, the third of three papers dedicated to dementias by the authors. Also in the absence of a unic effective treatment for the Alzheimer's disease (AD), the potential pharmacological approaches pass through the design of methodologically correct trials which have to combine several drugs with palliative therapies in order to attempt to stop or delay the disturbance course. All that, in addition to the quick progresses obtained in genetics, in the neuronal transplants, in the administration of neurotrophical factors, in monogangliosides, in the intervention on the production of the beta-amyloid protein or in the excitatory amino acid toxicity prevention make it possible to conceive realistic hopes on the discovery of a future effective therapy for the AD. On the other hand, a helpful surrounding for the patient suffering from dementia should adequately contemplate his security, stability, stimulation, freedom of movement and, also, the necessary environmental treatment. Creating units and residences specialized in dementias, home assistance aids, day centres, self-help groups, patients' family associations, the effective presence of social services which evaluate, give advice and guide behaviorally, and the creation of group aid programs for caretakers are necessary elements to improve the life quality of dementia patients and their families.