The nosology of dementia

The nosology of dementia has evolved from the simple distinctions between senility, degenerative dementia, and vascular insults that existed a few decades ago. The differentiation of normal cognitive aging from very mild dementia has sharpened considerably; however, appreciation of the heterogeneity of Alzheimer's disease (AD) and its clinical and pathologic overlap with other dementing disorders has blurred previous classification systems. Rather than viewing AD and vascular dementia, for example, as dichotomous entities, it may be more relevant to consider their additive or synergistic interactions producing dementia. Further elucidation of the nature and contribution of genetic factors in AD and related disorders will accelerate the use of genotype-phenotype correlations in dementia classification.