Dementia

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le dementia. The second dimension, cortical level, differentiates between cortical and sub-cortical dementia. Cortical dementia is used to describe dementia which results from brain lesions at the cortical level, whereas sub-cortical dementia describes dementia resulting from sub-cortical brain lesions. AD and HD disease are the best known examples of cortical dementia; whereas Parkinson's disease (PD) and progressive supra-nuclear palsy (PSP) are good examples of sub-cortical dementia (Mayke, 1994). Dementia with both cortical and sub-cortical features is also possible, in that case the term mixed dementia is used. MID is a common example of mixed dementia.
2 Historical Developments in Dementia
Pre-Modern Developments
The use of the term dementia dates back to Roman times. The Latin word “demens” did not originally have the specific connotation that it does today. It meant 'being out of one's mind' and, as such, was a general term for insanity (Pitt, 1987). It was the encyclopedist Celsus who first used the word dementia in his “De Re Medicina”, published around AD 30. A century later the Cappadocian physician Aretaeus first described senile dementia with the word dotage (i.e., "The dotage which is the calamity of old age...dotage commencing with old age never intermits, but accompanies the patient until death."). Curiously, dementia was mentioned in most systems of psychiatric classification throughout pre-modern times, though the precise meaning of the word is often unclear (Pitt, 1987).
Nineteenth Century
It can be argued that the origins of the scientific study of dementia date back to the early nineteenth century. The initial steps were undertaken by the great French psychiatrist Pinel at the beginning of that century. Pinel's observations led him to the conclusion that the term dementia should be applied in relation to the "progressive mental changes seen in some idiots" (Pitt,3). Furthermore, Pinel thou...