Functional disorders: refers to conditions such as depression and anxiety, which are the most common.
Organic disorders: more often than not refers to dementias, of various types, but long-term conditions are also included in this category such as strokes, mild cognitive impairment, and neurological conditions which develop in older age, such as Parkinson’s disease, but also rare types of parkinsonism such as progressive supranuclear palsy, corticobasal degeneration and multiple system atrophy.
Space occupying lesions such as meningiomas, and haemorrhages e.g. subdural haematoma, extradural haematoma, are also seen and need to be borne in mind when assessing.
As with all disorders, management begins with a thorough history, examination and relevant investigations.
Disorders in Old Age Diagnoses
Mild Cognitive Impairment
Many older people have the early stages of a future dementia in the form of mild cognitive impairment.
Alzheimer’s dementia is the most commonly diagnosed degenerative condition in older people with ageing.
It is known that many diseases which are more common with ageing, such as hypertension and diabetes, increase the risk of atherosclerotic damage to organs such as the brain, heart and kidneys.
This is a rare cause of dementia but FTD has many distinct features which help to distinguish it from more common dementias such as Alzheimer’s and vascular dementia.
Depression in Old Age
Depression in older adults can often be more severe and more resistant to treatment than in younger patients.
Other Dementing Conditions
There are many causes of dementia other than the most common which are Alzheimer’s and vascular dementia.