Talk:Dementia

Gelder et al

The citations found in the "Comorbidities" section to (Gelder et al 2005) are incomplete.

Dave Earl (talk) 08:57, 2 June 2011 (UTC)

Contraindicated section

Should this be modified? Antipsychotic medications are included in this section, and the bit on these meds clearly states that they are 'not indicated'. That is different to contraindicated!. They do cause an increased risk of death (as do most treatments for most conditions, including for example chest-xrays), but their use needs to be carefully considered, weighing up the risks and benefits (e.g. without this treatment, there is a high risk that the patient will come to harm, or die, or be distressed etc). Perhaps antipsychotics should be moved to the 'off-label' section, where they belong? :) 166.83.21.221 (talk) 03:59, 21 April 2009 (UTC)

Chat

Do ya think it is possible to halt the decline of people with dxsxtia by giving them love and attention? I do.

My name is Monica Mariniello and I do believe love and attention can help those suffering from dementia like me. It has worked wonders in my life. I'm a new woman.

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I understand that it is possible for dementia to arise out of deprivation of activities that require cognitive thought. This would include human contact.

Perhaps this should be mentioned in the article?

I was redirected here from Senility, and this page does not so much as mention the word. I would like to know if the definitions are one and the same, or what the difference is.

--203.217.18.196 15:08, 2 Dec 2004 (UTC)

Yes: there is something about social networking and being connected to individuals that helps persons cope with this illness. there also be a biologic mechanism of social stimulation. new article just came out in Journal of American Geriatrics that documents this. We could put this in based upon this article by lopez, will work on it, but first need to finish a wiki article on informed consent, also check out my blog at http://stefanospantagis.net/journal/Culturejamstef

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Types

(...)
Vitamin B6 (thiamin) deficiency

F Vitamin B6 is NOT thiamin. What is meant ?

• Vitamin B6 (pyridoxal) deficiency
• Vitamin B1 (thiamin) deficiency

Thanks
Eras-mus 23:54, 2 Feb 2005 (UTC)

---

Why was the addition of Lyme Disease as a type of subcortical dementia removed? Given that 80,000 cases a year in Europe and 20,000 in the USA are being diagnosed every year with this disease, it seems to me to be as important a differential as Syphilis.

Damwiki1 (talk) 08:09, 21 May 2008 (UTC)

Disagree with kangaroo court pointing its fingers at cannabis. —Preceding unsigned comment added by 173.89.244.190 (talk) 13:49, 19 January 2009 (UTC)

False dementia

With regards to the recent addition of a "false dementia" section on this page, I understand this phenomenon to be more often called delirium, which is already mentioned elsewhere in the article. The distinction beteween dementia and delirium is an important one, and more development of this theme would be valuable. However, I think the use of terminology needs to be consistent, and the discussion of delirium and its relationship to dementia should be brought together into one place. sallison 09:25, 1 October 2005 (UTC)

In my vocabulary delirium is something really really bad. Do you really say that each and every weak old person who gets a urinary tract infection gets delirium? Still, I am not that familiar with the English terminology so I take your word for it. I have tried and merge the info on the two places in the article. I am sure it can be improved though. / Habj 18:04, 1 October 2005 (UTC)

Delirium is serious, but to call it "really really bad" is perhaps a bit over the top. Effectively it is the occurrence of psychotic symptoms (hallucinations and delusions, typically worse at night) as a result of an organic brain problem, which may be poisoning, infection, withdrawal of medication or various other things (e.g. electrolyte disturbances). The distinction is indeed vital, because delirium is readily treatable with removal of the precipitants and sometimes antipsychotics and benzodiazepines. Dementia, while it may be worsened by these causes, is not typically reversible in such a fashion. JFW | T@lk 22:37, 1 October 2005 (UTC)

agreed with JFW on all counts. sallison 03:32, 2 October 2005 (UTC)

Absolutely agreed on the reversibility criterion, which was why I added the subsection in the first place. There is a common observation that dementia patients get better by improvement in daily life, and relatives often don't realise that this can not affect the disease progression. Most dementia symptoms are not psychotic, like the typical malfunctioning memory regarding thing that happened recently (not childhood memories etc) and desorientation. I sincerely doubt that most dementia patients suffer from clinical delirium, but most dementia patients have a false dementia a.k.a. pseudo-dementia on top of the neurological disease that makes the day-to-day-status worse, but that can be improved. I haven't spent much time googling, but one of my first hits is this article talking about pseudo-dementia caused by depression which usually has nothing to do with psychosis. [1] I do suspect we are actually talking about different things, and that both aspects deserve a space in the article. I should check more sources to find good ways of putting it, though. / Habj 13:42, 3 October 2005 (UTC)

Dementia or Mental Confusion

I would like to place a link to this page from the Complications section of the article on Hip fracture (& others). However, I note there is another article on Mental confusion which seems less clinical and more descriptive of thought processes (possibly including my own!). Is it your opinion that the type of Confusion commonly encountered after hip fracture is properly dementia so the link should be to here? --Mylesclough 05:25, 25 October 2005 (UTC)

So which is it?=

"dementia, by definition, is irreversible. . . . Probably less than 10% of all dementias are reversible"

What?? -Branddobbe 08:18, 29 October 2005 (UTC)

I removed the absolute statement; it didn't make any sense given the context around it. -Cymsdale 10:14, 26 December 2005 (UTC)

parkinson's is listed as a less common cause of dementia. the more recent epidemiology on parkinson's dementia would tend to indicate that perhaps 80 percent of parkinson's patients ultimately go on to develop dementia. i've also seen it listed as the second most common cause of dementia in individuals over age 50. I am willing to find documentation for this; i'd like to move PD from the "less common" list to the "more common list."Bldavids 15:29, 10 February 2006 (UTC)

Suggestions for more content

What about Wernicke's encephalopathy, and Korsakoff's syndrome?

And I happen to be looking for a full list of the aetiology of dementia. Would be very grateful for any pointers/links to such a list.

Thanks

Disorientation

With regards to disorientation I'm taking the week part out of time - it's disorientation to not know the day of the week, maybe day of the month, but how many people can tell you which week of the year it is?

Cerebral Health Website

As director of the cerebralhealth.com website, I would like to offer an appeal to the editors of this page to include a link to either the homepage at http://www.cerebralhealth.com or to the Brain Research and Information Network (B.R.A.I.N.) at http://www.cerebralhealth.com/neuroscienceresearch.php

"Senile"

"Senile dementia" is a common term in the UK (at least) and I was surprised that this article did not include or explain the phrase, especially when the entry for "senile" redirects to this article.

When used on its own, the word "senile" (on its own) means 'physical or mental infirmity associated with old age' but in common use (again, in the UK at least) it refers specifically to generic dementia. Is it possible for someone (with more expertise than I have) to include the term in an appropriate place? Mrstonky 19:20, 27 August 2007 (UTC)

In the U.S., "senile" is now considered offensive and agist, and is largely replaced by "demented". Sylvia A (talk) 00:08, 13 December 2008 (UTC)

The word would have a place in this article if it had a "history" section. Why is there no history section? Takeshi357 (talk) 12:31, 22 May 2009 (UTC)

Colloquial use of 'demented'

The word 'demented' is used (in the UK at least) as a colloquial and non-PC insult for someone who is considered stupid or slghtly mad. I've also encountered terms like "herd of demented elephants" used. Could someone add a note to this effect to the article, please? I'd rather not do it myself as I'm not enough of an expert on this particular piece of vernacular. Sidefall 13:52, 31 August 2007 (UTC)

"When used on its own, the word "senile" (on its own) means 'physical or mental infirmity associated with old age'" Thats the exact reasoning as to why it has not been included in this article. DEMENTIA IS NOT A NORMAL AGING PROCESS. —Preceding unsigned comment added by Wistfuldesires (talk • contribs) 10:41, 18 May 2010 (UTC)

WikiProject class rating

This article was automatically assessed because at least one WikiProject had rated the article as start, and the rating on other projects was brought up to start class. BetacommandBot 16:25, 10 November 2007 (UTC)

Senility

Considering the words "senile" and "senility" both redirect here and that both are quite common terms, surely the article should at least mention these words in passing? Thedreamdied (talk) 15:59, 13 April 2008 (UTC)

Causes section needed

I think the article would be improved with a section on causes. The serpinopathy section of another article claims that "Well characterised serpinopathies include emphysema, cirrhosis, thrombosis and dementia." and provides a citation. I suspect their may be other causes as well, but was surprised to find this article mentioning nothing on it at all. N2e (talk) 18:54, 19 July 2008 (UTC)

I think you misunderstand the comment in serpin. It is not that all serpinopathies cause dementia, it is just that one particular serpin (neuroserpin) has been associated with (not even causally linked) with dementia. It is a technicality not perhaps necessarily worth mentioning in this article.

A section on "causes" is not needed in this article. Dementia comprises several syndromes (Alzheimer's, vascular dementia, amnestic syndrome etc), each of which has its own causes. JFW | T@lk 13:55, 20 July 2008 (UTC)

Dementia as a cause of death

Which forms of dementia are fatal, and what is the manner of death? I ask in regard to the recently created category Category:Deaths from dementia. Thanks. Delicious carbuncle (talk) 20:33, 23 August 2008 (UTC)

Detailed contribution from RoyallMD

Looks like a person made a well-intentioned edit a few days ago (January 23) that ended up confusing several readers. RoyallMD replaced a good general introduction with a very detailed one. I've reverted this, but here's a copy-and-paste of their contribution in case it can be re-integrated into the article in a useful way. Dreamyshade (talk) 05:15, 28 January 2009 (UTC)

Dementia (from Latin de- "apart, away" + mens (genitive mentis) "mind") is an acquired syndrome (set of symptoms) of cognitive decline in a clear sensorium that is sufficient to cause disability. By "acquired" it is suggested that dementia is not a developmental delay, as normal adult cognitive function was previously achieved. As a syndrome, the definition suggests a cluster of symptoms that occur frequently together, but this does not implicate any particular disease or pathological process. Cognitive decline from a previous baseline allows the consideration of aging-related dementias ("senility"), as "impairment" is usually referenced to age-specific norms. This practice precludes the possibility of aging-related dementias, despite evidence of disabling age-related cognitive declines relative to young adult levels of performance. Cognitive impairments in a clouded sensorium better characterize delirium, which is often confused with dementia. Cognitive dysfunction per se may not be disabling and may be a cause of handicap, but dementia implies a functional disability.

This definition avoids many of the presumptions about dementia that derive from confusing this syndrome with a particular disease process, such as Alzheimer's disease (AD), a common cause of the dementia syndrome. As a syndrome, dementia may be associated with many causes, some of which have unique pathological characteristics and natural histories. Thus, AD is associated with charateristic patholgical lesions, but these do not charaterize the dementia syndrome. AD is also associated with progressive decline, but other causes of dementia may not. AD tends to affect the elderly, but dementia can occur in any stage of adulthood. AD affects memory in the vast majority of cases, but the definition of dementia does not require memory impairment, and memory may be spared in certain non-AD dementias. AD is generally not reversible, but the dementia syndrome may be transient, and some dementias are reversible. The requirement for disabling cognitive decline may constrain the set of cognitive functions that can be invoked to define dementia because not all cognitive functions are equally related to functional outcomes. Executive function may be particularly relevant to disability, while memory impairment may be less so. Finally, cognitive decline is used rather than "impairment" becasue the latter is often defined relative to age-specific norms. This practice artificially defines disabling age-related cognitive declines as "normal" and effectively excludes aging as a potential cause of dementia syndrome.

Symptoms of dementia include cognitive, behavioral or affective disturbances, depending on the specific cause and brain regions affected by that disorder.Memory, attention, language, and problem solving are commonly affected. "Stages" of dementia have little meaning across diagnoses, but some disorders, notably AD, have very stereotyped presentations. AD begins with olfactory impairments, followed years or decades later by forgetfulness and memory loss. Disturbances of higher mental functions follow. Affected persons may be disoriented in time (not knowing what day of the week, day of the month, month, or even what year it is), to place (not knowing where they are), or to person (not knowing who they are or others around them)(agnosia). They may have difficulties in judgement or problem solving (executive impairment). They may have trouble reading, expressing themselves, or understanding others (aphasia). They may have trouble dressing themselves or using household implements (apraxia).

Treatment

The section on treatment is very sparely referenced.--Doc James (talk · contribs · email) 12:39, 28 January 2009 (UTC)

New 'causes' section

I've just rewritten the 'types' section and renamed it 'causes'. I notice that a previous major rewrite got reverted for being too technical - I hope mine doesn't suffer the same fate, but I'd be very happy to work it into less technical language if other users feel it would help.

This is my first major Wikipedia edit, so be gentle!

Neurotip (talk) 15:05, 12 October 2009 (UTC)

Treatment

Would the 'Treatment' section be better if the content were incorporated into the pages for each cause? In particular it seems redundant to have a section on the treatment of Alzheimer's disease here, when this is treated comprehensively on the Alzheimer's page itself. Similar comments apply to depression.

It would be reasonable to include comments relating to the management of patients with dementia here, where such management does not relate to the specific cause. Examples might include use of memory aids, management of behavioural problems, criteria for admission to institutional care, etc.

I don't know whether there's a tag for this - if so, perhaps someone could enter it if they agree.

Neurotip (talk) 15:14, 12 October 2009 (UTC)

I agree with the above, Neurotip. Anthony (talk) 09:46, 14 November 2009 (UTC)

Pain in dementia

Recently, a new editor posted a link on Pain to an article she/he wrote on her/his user page about the important emerging issue of assessing pain in dementia patients. Unfortunately she/he got blowtorched very rudely by a zealous editor and, I fear, chased away. Although I'm not studying this issue in particular, I encounter it frequently in my study of the cognitive effects of pain, and can fairly judge it a very competent and valuable contribution. I think this is it's home, because family and even healthcare professionals dealing with dementia are more likely to go to this page than Pain. And it is extremely important to the welfare of the patient. The essay is at: ♥♥♥ And the author's Talk page: ♣♣♣.

Anthony (talk) 22:05, 11 November 2009 (UTC)

I agree that the article is a useful contribution to an important subject, and that the Dementia page would be an appropriate place for it. Kudos to the author. Neurotip (talk) 19:42, 12 November 2009 (UTC)

Painaware has posted her/his essay as the Wikipedia article Pain in Persons with Dementia. I'd like to move it now into this article as a subsection and redirect from Pain in Persons with Dementia to here. Any objections? Anthony (talk) 09:22, 14 November 2009 (UTC)

I think this merge is improper by WP:SYNTH, this article is already big.--Nutriveg (talk) 13:18, 4 December 2009 (UTC)

The article is only 55 kb in size. Dementia is a widelyscoped topic that an article 80 - 100 kb could be justified. If synthesis of sources has occured then that will need to be fixed.--Literaturegeek | T@1k? 19:28, 4 December 2009 (UTC)

I've just included references to Hadjistavropoulos et al. (2007) - an authoritative review that, along with Shega et al. (2007) and Herr et al. (2006) supports every word of the subsection. As to the size of the article, are there Wikipedia guidelines relating to this? Anthony (talk) 19:29, 5 December 2009 (UTC)

Thank you for adding references. Yes there is, see WP:SIZE and a short cut to relevant section of the same article WP:SIZERULE. The individual types of dementia should probably be under 60 kb but this is the main article which is meant to summarise the whole topic of dementia and its different types etc.--Literaturegeek | T@1k? 19:40, 5 December 2009 (UTC)

Thank you Literaturegeek Anthony (talk) 19:47, 5 December 2009 (UTC)

This sentence needs fixing, IMO.

Research into the use of NSAID pain relievers has been going on for decades, but it is unlikely to ever be recommended, due to the fact that most NSAIDs are off patent and can be made very cheaply.

Both grammatical & other problems here. Grammar: "Research is unlikely to ever be recommended..." Huh? :-)

If it is NSAIDs which are unlikely to be recommended, being off-patent and cheaply made shouldn't play a role?

- Hordaland (talk) 17:24, 12 November 2009 (UTC)

Agree. It's speculative and unreferenced and should go. Anthony (talk) 09:31, 14 November 2009 (UTC)

missing defintions

Wow, this article has certainly improved since I last looked at it - good job all!

Somewhere in this improvement, the definition of cortical and subcortical dementia has been dropped, there is one reference to these types left in article. Looks like the limited definition which was [[2]] has merged into causes. I'm not sure if these are worth defining, but I would have thought so .. Lee∴V (talk • contribs) 12:12, 18 March 2010 (UTC)

I fear that was probably me. While I haven't looked into this issue specifically, I have a lurking suspicion that the cortical-subcortical distinction is much less clear-cut than used to be thought, and that the features thought to be characteristic of one may occur in the other. Both Alzheimer's disease (quoted as cortical) and Parkinson's disease with dementia (quoted as subcortical) typically involve both cortical and subcortical pathology, each of which may contribute to the cognitive impairment. In any case, does 'subcortical' mean (a) any white matter, (b) just 'subcortical' white matter, (c) deep grey matter nuclei, or (d) any of the above? Discussion welcome, but personally I think they're really legacy terms. Neurotip (talk) 19:57, 27 March 2010 (UTC)

Genetic factors

What is missing in the article is the discussion of genetic factors in dementia. I've added a sentence about protein handling to the lead. --Eleassar ^{my talk} 14:05, 12 June 2010 (UTC)

Prognosis

I've removed the Prognosis section

Severe dementia is frequently complicated by pneumonia, febrile illnesses, and eating problems. Life expectancy is 18 months.[57]

because the cited article does not proffer a life expectancy. Anyway, dementia is a feature of several distinct diseases and conditions, each of which has its own clinical course. Anthony (talk) 12:46, 20 September 2010 (UTC)

Sounds like a good move.--Literaturegeek | T@1k? 20:56, 22 September 2010 (UTC)

I read the reference, the 18 months mortality rate is 54 percent within 18 months for advanced dementia. The reference had been misinterpreted. I think that the text and reference should be added back in but with the corrections I have just mentioned. What do you think?--Literaturegeek | T@1k? 22:44, 22 September 2010 (UTC)

I'm not sure we can offer a blanket prognosis section for dementia, because it is a symptom cluster common to many diseases and conditions, each with its own prognosis and course. Anthony (talk) 19:32, 24 September 2010 (UTC)

Yes, that is exactly the problem. SBHarris 23:52, 24 September 2010 (UTC)

Good point, I agree with your reasoning. What might be good is if we or someone could find a review which discusses the mortality prognosis varying for different types of dementia.--Literaturegeek | T@1k? 16:01, 2 October 2010 (UTC)

How serious must impairment be to qualify as dementia?

I am not a medical doctor, and therefore do not feel qualified to amend this entry. However, I would like an opinion on whether dementia must, by definition, be a serious loss of cognitive ability. Is it not possible for dementia to be less than "serious" in its effects? I am concerned that the word "serious" here may alarm some people who have been diagnosed with dementia, and their relatives. — Preceding unsigned comment added by Redmagic (talk • contribs) 18:45, 21 January 2011 (UTC)

Classically the diagnosis is one of symptomatology-only, and so classically it must be fairly severe (enough to compromise at least some normal activities of daily living), by definition. Dementia is a symptom, as the article notes. However, sometimes "dementia" is used synonymously with "having one of the dementing diseases" (like Alzheimers). In this sense, it's possible to speak of "early dementia" (meaning in the early stages of a dementing disease) in which case the symptomatic impairment is not YET serious, but the implication is that (probably) it WILL be. With PET scans and other sophisticated technologies, "early dementia" is found more and move often, so that's a problem for the definition (which is changing, and is also not used correctly even by physicians). Probably something of this sort should be added to the lede. I'll see what I can do. SBHarris 19:42, 21 January 2011 (UTC)

Moved from article

An editor added this information to the Epidemiology section:

A study which followed subjects for 15 years found that higher levels of silica in water appeared to decrease the risk of dementia. The study found that with an increase of 10 milligram-per-day of the intake of silica in drinking water, the risk of dementia dropped by 11%.

What does everyone think? Does it belong in the article? I've seen a lot of information on aluminum (though not much on silica), and there seems to be a lot of variability in the results. Also, correlation often doesn't mean causation. Epidemiological studies always drive me crazy because I can give you dozens of reasons why increased silica why it might be correlated, but I can't think of any physiological reason why it might be causative. But before we add something like this (which really belongs in the Cause section), I thought we should discuss it. OrangeMarlin ^{Talk• Contributions} 17:54, 27 March 2011 (UTC)

Media coverage of dementia

I am not sure whether this is the best place to mention it, but there could be a mention somewhere in Wikipedia about how Radio Four are broadcasting, in May 2011, monologues about people with dementia in their series "Ancient Mysteries". ACEOREVIVED (talk) 19:55, 11 May 2011 (UTC)

The programmes are being broadcast at 7: 45 pm (after Front Row) each night in the week beginning May 9. ACEOREVIVED (talk) 19:56, 11 May 2011 (UTC)

Again, another media topic! I am so glad that this article mentions the problems of antipsychotic drugs - it was broadcast on news on Radio Four on June 9 2011 that there have been numerous problems with prescriptions of antipsychotic drugs to dementia sufferers. Perhaps the problems with antipsychotic drugs should go at the start of the article? The article could also mention recent (at time of typing) news coverage of antipsychotic drugs. ACEOREVIVED (talk) 19:57, 9 June 2011 (UTC)

Newest Changes

I made a few changes

• Edited ambiguous/incorrect statement regarding age as a “definining cut-off” and put in a reference for early onset dementia.
• Deleted information related to alcohol from the introduction that was repeated later in the article.
• Added a small list of the major forms of dementia with links to these pages. (This maybe better placed somewhere else, but I think a list needs to be somewhere on its own as it gets lost in amongst other information)
• Added some information on medications

I'm aware that I need to fix up some citation duplications. I'd be happy to discuss any of these changes

MitchMcM (talk) 22:56, 31 July 2011 (UTC)

Agree with all this. The main reason to delete alcohol is not that it's repeated (the lede is a summary and thus repeats things) but that it's a small part of the etiology stuff below-- much too long a list to mention in the lede, since we're talking about etiologies of dozens (who knows how many?) processes. There was a bit of history in the lede also, but not enough, since the article had no "history of the term" section. I wrote one and incorporated the history info in the lede into it. A line or two in the lede could be devoted to summarizing the history, I suppose, but it's long already. If anybody would like me to put a bit back in, I'll try. Otherwise, I think it's okay left out, given all the extra work that the lead/lede has to do now. SBHarris 15:12, 1 August 2011 (UTC)

Format in disrepair

I'm not sure what happened, but the article is in a three-column layout right now, and I have no idea how to fix it. fds^Talk 16:39, 24 August 2011 (UTC)

Vandalism

The article seems a bit short and it got pretty weird at the end. — Preceding unsigned comment added by 71.201.8.250 (talk) 01:22, 10 September 2011 (UTC)

Thanks, it's been fixed. You can fix vandalism yourself. See how to revert.-gadfium 06:49, 10 September 2011 (UTC)

A bias in this article

This article seems to be very much biassed towards a mainstream ultra-scienfitic neuro-biological approach to dementia. If one does a Google search, one can find articles on the spiritual care of people with dementia, and also on transpersonal, core process, humanistic and existential approaches to dementia. If no else does this, I may add some of this information to the article to remove its current bias. ACEOREVIVED (talk) 09:51, 20 September 2011 (UTC)

I have now added a little section on spiritual care of patients with dementia. It is still in embryonic stage at present, but at least it is a beginning. ACEOREVIVED (talk) 10:47, 20 September 2011 (UTC)

The new section:

Considerable literature has looked at the spiritual care of people with dementia. Literature on this subject was reviewed by Keast, Leskovar and Brohm (2010),who found the literature tackled three major common themes.

These were: (1) maintaining a sense of purpose in life, nurturing meaningful connections with the surrounding environment, and retaining a relationship with God; (2) identification of effective strategies for assessing individual spiritual needs and (3) use of formal religious interventions, such as prayer or spiritual reminiscence. (SOURCE: http://www.annalsoflongtermcare.com/content/systematic-review-spirituality-and-dementia-ltc)

The cited review does not describe the literature as "considerable," and the authors observe that "The majority of these studies had very small purposive samples, limiting the ability to generalize the results. A number of these articles originated from faith-based organizations; thus, the possibility of bias is present. There were no randomized, controlled studies, making it difficult to evaluate the effectiveness of the spiritual interventions." That is, nothing can be said with any confidence about the effectiveness of spiritual interventions in dementia care. There may be a place for a mention of this review somewhere in Wikipedia, but this overview article is not it. I'd be very much in favor of an article on spiritual aspects of palliative and dementia care being created. I have removed the section. --Anthonyhcole (talk) 12:26, 20 September 2011 (UTC)

Thank you - I appreciate and respect your views there. I wondered whether typing in "spirituality" and "dementia" into Google Scholar might yield better results. I did find this article:

http://dem.sagepub.com/content/2/3/379.short

But again, you might feel this is not sufficiently comprehensive enough to be added to the article. I shall leave it to readers of this article who might have knowledge / expertise in this area to add information on this theme to the article. ACEOREVIVED (talk) 15:12, 20 September 2011 (UTC)

(I took the liberty of indenting your comment, ACEOREVIVED, per this essay. If that was impertinent, please revert.) The article you cite there describes a single study; that is, it is a "primary source." Wikipedia medical articles are built on secondary sources – reviews like the one you linked to first, graduate-level textbooks, and national or international professional body guidelines. The relevant Wikipedia guideline governing sources for med articles is WP:MEDRS. I'll shortly be reading up on psychosocial and spiritual aspects of cancer pain management. If I find anything in that quest that is suitable for this article I'll certainly look at including it here. --Anthonyhcole (talk) 15:48, 20 September 2011 (UTC)

My review on Bbucks added sentence

It looks like Bbuck added a informational sentence on how consuming alcohol slows down the development of dementia. He sourced his sentence correctly.AlyceBort (talk) 23:10, 8 October 2011 (UTC)AlyceBortAlyceBort (talk) 23:10, 8 October 2011 (UTC) [User:AlyceBort|AlyceBort]] (talk— Preceding unsigned comment added by AlyceBort (talk • contribs) 22:44, 8 October 2011 (UTC)

It's a self-selected epidemiological study, and thus has all the problems of studies of self-selected groups. We hardly know WHAT else might be different about Italians who drink moderately than those who don't drink at all. I suspect a lot of things. The authors of the study say the same, and qualify it that way. As they should. I've added their qualification to this article. SBHarris 23:16, 8 October 2011 (UTC)

please let me know how to cure progressive dimentia...... — Preceding unsigned comment added by 14.99.144.17 (talk) 16:44, 1 November 2011 (UTC)

If I knew I'd be rich and famous. SBHarris 20:23, 1 November 2011 (UTC)

Need editor for link I think is of interest please

Hello, would an editor be so kind to place a link to www.dementia.co.uk under the links section of dementia. I have a conflict of interest, but feel that this site would be a valuable addition to the links on the article dementia. Thankyou John cordingly (talk) 18:46, 10 December 2011 (UTC)

I think it would be appropriate for us to reconsider the existing external links, in a similar process to what's happening at Talk:Huntington's disease#Inadequacy of dmoz for external links.

John, could you please explain who runs your site? Is it just you, or is it the site of an organisation involved in dementia care or research? How can we be assured that the material on it is accurate? In general, we would prefer to link to a site which gives its sources for stories, and which has a well-known body behind it.-gadfium 22:22, 10 December 2011 (UTC)

Hello, I run the site but the articles are written by workers at a daycare centre that runs sessions for dementia sufferers. So the articles are written from hands on people who have direct contact with families, friends and sufferers of dementia. I dont think you can get closer to the subject than that. I think the site i have suggested contains as much, if not more information than most of the links listed, and the subject matter is DEMENTIA not Alzheiemer's, yet Alzheimer's sites are listed. I think small sites should also be considered alongside big company sites because they give real views and advise from the front line, from people who deal with dementia everyday. You cannot just include "Well known body" organisations because that dosen't allow for the small man to have his voice heard. Thankyou John cordingly (talk) 12:57, 13 December 2011 (UTC)

Can puzzles help to reduce risk of dementia?

It was announced on the front page of the Daily Express some time ago that doing puzzles, such as crosswords, may help to reduce risk of dementia. It is true that a national newspaper may hardly be an academic source (see WP: Reliable sources),but if any one does know a good, academic source for this claim, it could go in the article. ACEOREVIVED (talk) 16:47, 15 December 2011 (UTC)

"Off label"

I have no idea what the heading "Off label" means. Can someone insert a definition? If not, I will suggest removing that sub-heading. 66.67.24.71 (talk) 17:28, 21 January 2012 (UTC)

It means use of drug for a purpose the FDA never formally approved it for (such approved uses are indicated on the drug "label" which practive means the package insert (it's too long to be a label stuck to a bottle), a list of which is tabulated in the Physicians' Desk Reference (PRD) which is either paper or electronic. Such uses, BTW, are not illegal. Once a drug is approved for some use, it can usually be legally prescribed for any other that the physician wants to, with no problems with the FDA (though the DEA and state licensing boards and civil courts still get their say if something goes wrong). A fair fraction of drugs are used by doctors in off label uses, since often the studies (difficult, risky, expensive) have never been done. Using adults drugs off-label in pediatrics is a common practice, for example. SBHarris 20:53, 21 January 2012 (UTC)