Alzheimer's disease and dementia.

Dementia is frequent in the elderly and, given the expansion of the aged in our society, is a health problem of increasing importance. The most common cause of dementia in the elderly is Alzheimer's disease. Over the past 15 years, great strides have been made in expanding our knowledge of this disease. Some putative risk factors have been defined, the molecular aspects of the pathologic process are being explored, and numerous experimental therapies are being investigated, but to date, clinical studies have demonstrated only mild symptomatic improvement. However, recent advances offer some hope of discovering interventions which might halt or slow the progression of this devastating disease. The clinical evaluation of a patient with dementia should focus primarily on the discovery of treatable causes or contributing factors which may be ameliorated. The primary care physician plays an important role in diagnosis, in management of psychiatric complications, and in providing guidance and counsel on psychosocial and legal issues.