[Update on vascular dementias].

The concept of vascular dementia greatly evolved since Hachinski's description of multi-infarct dementia. Vascular dementias are reviewed with emphasis on current diagnostic criteria, elusive natural history, neuroradiological aspects, difficult epidemiological features and intriguing links with Alzheimer's disease. The recent proposed shift from vascular dementias to a broader definition of "vascular cognitive disorders", including non demented subjects with "vascular cognitive impairment", is described, followed by a brief review of current treatments.

Striatal dopamine transporter levels correlate with apathy in neurodegenerative diseases A SPECT study with partial volume effect correction.

Objectives: The aim of the present study was to stress the relationship between neuropsychiatric symptoms and most particularly apathy and striatal dopamine uptake in patients with Alzheimer's disease (AD) or dementia with Lewy body (DLB).

Patients And Methods: Twenty-two patients (AD n=14; DLB n=8) were included. All patients had neuropsychological and behavioral examination including Mini Mental Test Examination (MMSE), Neuropsychiatric Inventory (NPI), and UPDRS for the motor activity assessment.

[Semantic dementia].

Semantic dementia (SD) is characterized by an assymetric atrophy of the temporal lobes and, clinically, by an impairment of the semantic memory associated to psychobehavioral symptoms. The concept of SD was defined in 1989 and still remains controversial. Some authors consider DS as a specific entity, others as part of the frontotemporal dementia (FTD) or a variant of the progressive aphasia syndrome.

[Parkinson's disease dementia and Lewy body dementia].

To specify the existing relationship between Parkinson's disease dementia (PDD) and Lewy body dementia (LBD), it is necessary to retrace the natural history of an histopathological lesion, which, although being non-specific, is essential for a precise diagnosis, the Lewy body. The occurrence of Lewy bodies in Parkinson's disease, as in the other two types of dementia, unveils a potential continuum between these affections, which could be reunited under the term of alpha-synucleinopathy. However, defining the modalities of various types of alpha-synucleinopathy has not been historically based on the notion of a continuum.

[Treatment of Alzheimer's disease].

Alzheimer's disease (AD) is a neurodegenerative disorder with a decline in memory and cognitive abilities. During the past 20 years, research on AD has increased the knowledge of the physiopathological mechanisms leading to the disease. The major hallmarks of AD are amyloid plaques and neurofibrillary tangles, associated with a prevalent and early cholinergic deficit and an excitotoxicity with inflammation.

[Pharmacological treatment in severe dementia].

Medical treatment of severe dementia is now available. Decrease of psychobehavioral disturbances, autonomy loss or care-giver burden appear as the main objective rather than reduction of cognitive deficits. Acetylcholinesterase inhibitors (AChE-I) should be maintained in patients with severe dementia when initiated in mild or moderate dementia.

[Nutrition and Alzheimer's disease].

Weight loss is frequent in Alzheimer's disease. Its severity increases with the progression of the disease and may be a predictor of patients' mortality. Weight loss often precedes the diagnosis and may be considered as a feature of the disease itself.