The clinical issues of age-related dementia.

The dementing disorder constitute the largest single problem because of the state of extreme helplessness that characterizes its advanced stages. The clinical psychiatry have to face with this disabling disease, for which the adequate treatment or strategies have not been established. Firstly the author describes the size of the problem by introducing our recent epidemiological study on age-related dementia in Kanagawa Prefecture. The result of the study revealed that the prevalence of dementia was 4.8% and it increased with age. The other recent epidemiological study also showed similar findings. One of the common findings in these studies was that the prevalence of senile dementia was much lower than that of vascular dementia and apparently indicated the reverse tendency reported in the traditional studies in Europe and USA. Secondly the author discusses the diagnostic criteria of dementia as well as the differential diagnosis. Thirdly he describes the validity study of Hasegawa's dementia scale which is widely used as the screening instrument of the demented aged in Japan. The author also describes the Hasegawa's scale was applicable for research tool for the measurement of cognitive decline of the very old aged by introducing the centenarian study. Lastly the author states the issues of family care status of the demented elderly and emphasized the importance of caring the care-givers in the family.